More than 40,000 Americans travel each year to Costa Rica to seek medical and dental treatment. These “medical tourists” have discovered that this little Central American country has high quality healthcare available at a very low cost.

And expats who live in Costa Rica are able to take advantage of this benefit every day of the year, paying a fraction of what they did back home for doctor’s visits, surgeries, prescriptions, and any other care they need.

There are two medical systems in Costa Rica, with expats allowed to access both.

Public Practice

First is the Caja Costarricense de Seguro Social (CCSS), known as “Caja” for short. This is universal healthcare, provided and managed by the government. It’s available to citizens and legal residents, including foreigners with the pensionado visa, for example.

As part of “Caja”, you pay a monthly fee based on the income you reported on your residence application, 6% to 12%. This covers the applicant and a dependent spouse, with the average fee running from $75 to $150 per couple.

After you pay your monthly fee, all your care is covered. Doctor’s visits (including specialists), diagnostic testing, prescriptions, surgeries…everything. And there are no exclusions for age or pre-existing conditions. Most expats say the “Caja” provides good care, although there can be issues with wait times for doctor’s visits and non-emergency procedures. The system has an emphasis on preventative care.

Private Practice

There is also an extensive private medical system in Costa Rica, with doctors, clinics, and hospitals throughout the country. You can pay cash to see private providers, but it’s still cheap. A doctor’s visit is $50; you’ll pay $80 to $100 to see a specialist. An ultrasound will run you about $75. And even major surgeries are cheap, about half to a quarter of the cost in the U.S.

You can also use insurance, either international policies or those provided by Costa Rican companies. Most private hospitals have international patient departments to help you arrange financial matters.

Often expats mix and match private and public medical care. They might see a private doctor and pay cash and then have their prescription filled in the Caja pharmacy for free. Or if a procedure is taking too long to schedule at a public clinic, they might go private.

Something to keep in mind: although there are well-regarded facilities throughout the country, the best hospitals and most specialists in both the public and private system are in San José, Costa Rica’s capital. So if you have a serious medical issue, you will likely have to travel there to seek treatment.