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Source: CIMA Hospital
CIMA hospital, San Jose, Costa Rica.
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I was sitting on our cantilevered terrace, listening to birdsong and the river flowing below me. I pondered the 11,000-foot-tall Volcano Irazú in the distance. From the top of the tallest volcano in the country, it's possible to see both the Atlantic and Pacific Oceans on a clear day.
Suddenly there came a rapid-fire knock at the door. I knew something was different this morning—Costa Ricans rarely get worked up.
A neighbor, who knew I'd worked as a doctor in the U.S. before retiring to Costa Rica, wanted me to check his uncle, who was "having a problem." I found an elderly fellow, surrounded by supportive family members, who was in pain and having a nosebleed. We loaded him in my car and drove the three miles to the nearest Caja—the nickname for the local public healthcare office.
Although the waiting room was occupied by folks waiting their turn, everyone generously ushered us to the front of the line. The old man was immediately assessed by the physician, received an ECG (to check for electrical problems with the heart), was stabilized, and later transported to a large hospital about 30 minutes away. There he was treated for his heart attack. I never saw it handled any faster when I was working in the U.S.
When my partner and I left Texas for Costa Rica, many friends said, "Well sure, you're not worried about medical care; you're a doctor." To tell the truth, that actually makes me much more critical of the medical care available in other countries. Unlike some foreign nations, Costa Rica has nothing to worry about; state-of-the-art services are available here in all branches of medicine and dentistry.
Costa Rica has both public and private healthcare sectors. Every town has its EBAIS (Caja) office where people from the neighborhood—expat residents as well as locals—can receive preventative and primary care. And there's no pre-existing condition exclusion.
There are also private doctors and hospitals, just as you're used to in North America.
"When my fishing buddy, Kenneth Thomas, needed dental implants last winter, he drove past myriad dental offices in icy Fort Worth, Texas, and flew to sunny Costa Rica. He found he could save $15,000, even after paying for the airfare and his lodgings."
For example, CIMA Hospital in San José has it all…intensive care, all the surgical specialties, and even dental treatments.
All at 30 percent to 70 percent cheaper than U.S. or Canadian prices. And it is Joint Commission International-certified. That's the gold standard in healthcare—many U.S. hospitals fail to receive that accreditation. And it is the only hospital in Central America that is accredited by the Department of Veterans Affairs.
That's not to say that public hospitals aren't up to snuff.
Margaret Aliff, an expat who lives in the San José suburb of Escazú, tells this story: "I've had three ER [emergency room] experiences in Costa Rica: one at a private hospital and two at a public hospital. I would rate all ER experiences as very good, but I thought the public hospital was more thorough both times."
Many expats use a combination of the two systems. Donald Martin, 73, had knee surgery in Georgia some time ago that is now failing him. He needs a series of injections in his knee. He saw his Caja doctor here in Costa Rica, who reviewed the records his orthopedist sent from Atlanta. He could have waited a few weeks for an appointment within the Caja system—about the same wait time for new patients to see a specialist in the U.S. But he preferred to be seen immediately and was referred to three nearby surgeons in the private sector.
The next day, he learned he could receive the same treatment he'd had in Georgia, but at a considerable saving. "Not only am I saving on time and airfare back to Georgia, but the cost of the injections is $400 here, as opposed to the $1,200 I was quoted there."
While some U.S. insurance carriers won't cover costs in Costa Rica unless it's an emergency, many expats find that private insurance here is very reasonable. John and Lori Jowett have recently gotten their insurance through Blue Cross of Costa Rica. "For a premium of $462 per month, we have better coverage than we had in Florida, and at half the cost." They also point out that, because healthcare is less expensive here, the $1 million policy here buys you closer to $3 to $5 million of care.
In addition, the country is finding new ways to help lower healthcare costs. I recently discovered a program called MediSmart. It works with Hospital Metropolitano, one of San José's private hospitals. Essentially, a couple can get deeply discounted medical services at Metropolitano by paying a $17-a-month "retainer." While normal office visits may run $40 to $50 (still a bargain, at one-third the U.S. cost), they're reduced to $14 to $18 by paying the retainer. Other costs can show similar price breaks, like a CT scan for only $320, compared to $800 in Texas.
And expats aren't the only ones who benefit from Costa Rica's healthcare. Medical tourism is also growing rapidly. An estimated 40,000 people visit Costa Rica each year for some specific healthcare need.
When my fishing buddy, Kenneth Thomas, needed dental implants last winter, he drove past myriad dental offices in icy Fort Worth, Texas, and flew to sunny Costa Rica. He found he could save $15,000, even after paying for the airfare and his lodgings. Smiling a new perfect smile, Thomas reveals an added benefit: "I got to enjoy a few extra days in the paradise of beaches, as well as in some of the country's numerous national parks. That will make you want to visit the dentist!"
Commentary by John Michael Arthur, an American doctor who relocated to Costa Rica.
