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An American Hospital Administrator Reviews The Costa Rican Health Care System

Dr. Jeff Ackerman was a hospital administrator before retiring in Costa Rica and gives us his impression of the Costa Rican healthcare system below.

What is Healthcare like in Costa Rica?

All residents, Costa Ricans and expats, are covered by the CAJA system, a government program that has clinics and hospitals throughout the country. It costs around $45 a month for a couple.

Most expats also buy private health insurance obtained either through INS, which is affiliated with the government, or through another insurance company. Coverage and premiums for these policies vary depending on whether they cover care in Costa Rica only, in Costa Rica and Latin America, or include the United States.   Obviously, they also vary by age and gender.

There are 3 full-service private hospitals in Costa Rica which are accredited by the Joint Commission, the same institution that accredits hospitals in the United States. They have English-speaking staff and cater to medical tourism. Many physicians in the private hospitals have been trained in the US.

As a doctor, how do you assess the care that is provided in Costa Rica?

I think the care provided by the private hospitals and the physicians that operate there would be equal to the majority of the hospitals in the United States.

What is the difference between the healthcare system in the US and the healthcare system in Costa Rica?

It’s less expensive here.

While they have the same technology, the processes that they use here are somewhat different. For instance, if your private physician ordered an x-ray for you as an outpatient, here you pick up the x-ray and take it to your follow-up appointment.

Billing is also different. Private physicians will not bill your insurance directly. With INS, when you go to the doctor you take a form with you for him to fill out, you pay for your care at the time, and then submit that form to the insurance company. They’ll reimburse you for whatever percentage your policy covers.

Do you choose to receive all of your medical care in Costa Rica or do you reserve some care for when you are in the US?

We receive all our care here. We don’t need a lot of care but Margo’s had surgery here. Some expats tend to go back to the states to see trusted doctors or to do follow-up appointments.

On the other hand, we had friends who lived here 17 years, both of whom got cancer, and they were very happy with the treatments and care they received here. It’s a personal decision based on your preference, your experience, and whether or not you’ve had chronic disease in the US.

Also some expats living here choose to use the CAJA system. A lot of doctors can practice both at the private hospital and at the CAJA. One of our friends decided to stay at a CAJA hospital as his private doctor also practiced there. My friend speaks Spanish so it was no big deal. However, someone who doesn’t speak much Spanish would find communication there challenging. Also, because CAJA is socialized, the waiting time is extensive.

Summary: The healthcare provided by the private physicians and hospitals in Costa Rica is equal to the care provided by many American physicians and hospitals.

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