Costa Rica is one of the most popular retirement destinations in the Americas, famous for its "Pura Vida" lifestyle and a public health system that consistently ranks well for the region. For Britons settling here, though, there is a firm rule to know about: enrolling in the public system is a legal condition of residency.
This guide explains how Costa Rica's Caja works, why legal residents must join and pay into it, and why so many expats also carry private cover for faster, wider-choice treatment.
Healthcare in Costa Rica: how the system works
Public system: Caja Costarricense de Seguro Social (CCSS, the "Caja").
Costa Rica's public healthcare is run by the Caja Costarricense de Seguro Social, universally known as the "Caja". It provides comprehensive hospital, doctor and prescription care nationwide, funded through income-based monthly contributions. It is well regarded for the region, but it is busy, so waiting times for non-urgent appointments and elective procedures can be long.
Britons who become legal residents are required to enrol in the Caja and, once enrolled, can use its hospitals and clinics. Many expats also use the country's private hospitals for speed and choice. A UK GHIC has no validity in Costa Rica, and a domestic UK policy will not cover you as a resident, so private cover is arranged separately from your Caja membership.
Is health insurance mandatory in Costa Rica?
Enrolling in the public Caja (CCSS) is a legal condition of residency in Costa Rica: to obtain and keep legal residency you must sign up for and pay monthly contributions to the Caja, calculated on your declared income. This is mandatory regardless of whether you also hold private insurance — private cover does not exempt you from Caja membership. Confirm the current contribution rules for your residency category as part of your application.
Why British expats take out private cover
Caja membership is compulsory but comes with public-system waiting lists and limited choice of doctor, so many expats add private cover to skip the queues, choose their specialist and be seen faster. International private medical insurance also offers higher limits, repatriation and cover on trips back to the UK, which the Caja does not provide.
What expat health insurance costs in Costa Rica
Your mandatory Caja contribution is a percentage of your declared income, so it scales with what you report rather than a fixed premium. Private care in Costa Rica is good value compared with the UK or US, and private-insurance premiums depend mainly on your age, medical history and whether you want local or worldwide cover.
Good to know before you move
- Enrolling in and paying into the Caja (CCSS) is a legal condition of Costa Rican residency.
- Private insurance does not exempt you from mandatory Caja membership — the two run alongside each other.
- Caja contributions are income-based, so they vary with your declared income.
- Many expats add private cover to avoid public waiting lists and choose their own specialist.
Private hospitals and where Britons settle
Costa Rica is a popular retirement destination, though its British community is smaller than the large North American one.
Leading private hospitals include Hospital CIMA in Escazú, Hospital Clínica Bíblica and Hospital Metropolitano in San José.
Popular with British expats: San José, Escazú, Tamarindo, Atenas, Grecia.
How a UK broker helps expats in Costa Rica
International private medical insurance is a specialist market, and the right policy depends on your visa, your age, your medical history and how much time you spend outside Costa Rica. A UK-based specialist broker can compare the international insurers available through its service, check that a policy meets any local or visa requirement, and explain what is — and is not — covered before you commit.
A broker can compare only the insurers and policies available through its service, and may receive commission or charge a fee. Ask for the insurer panel, the remuneration disclosure and the total price. Requesting a quote is free and puts you under no obligation to buy.
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Expat health insurance in Costa Rica: FAQs
Is health insurance mandatory for residents in Costa Rica?
Yes, in the form of the public Caja. Obtaining and keeping legal residency requires you to enrol in the Caja Costarricense de Seguro Social (CCSS) and pay monthly, income-based contributions. This applies even if you also hold private insurance.
Does private insurance exempt me from the Caja in Costa Rica?
No. Private cover does not replace or exempt you from mandatory Caja membership, which is a legal condition of residency. Many expats pay into the Caja as required and take out private insurance on top for faster, wider-choice care.
How much does the Caja cost in Costa Rica?
Caja contributions are set as a percentage of your declared income rather than a flat premium, so the amount varies from person to person. Because the rules and rates can change, confirm the current figure for your residency category when you apply.
Does my UK health insurance work in Costa Rica?
No. A domestic UK policy is for UK residents and will not cover you once you live in Costa Rica, and a GHIC has no validity there. Private cover is arranged separately from your compulsory Caja membership.
Why do expats in Costa Rica pay for private cover as well as the Caja?
The Caja is compulsory but can involve long waits for non-urgent care and limited choice of doctor. Private and international cover buys faster treatment, choice of specialist, and — with worldwide plans — repatriation and cover on trips back to the UK.
Other expat destinations
Visa, residency and insurance rules change and vary by individual circumstances. This guide is general information, not personal or regulated advice — always confirm the current requirements for your situation before you rely on them. Health Insurance UK is an information and lead-generation service, not an insurer or broker.