Adrian’s Coffee Tour

At major private hospitals in San José — particularly Hospital CIMA, Clínica Bíblica, and Hospital La Católica, English-speaking physicians are common, and international patient departments are set up specifically for this. At CAJA facilities and in rural areas, Spanish is the primary language of care. If you do not speak Spanish, using a private hospital or bringing a translator to CAJA appointments is strongly advisable for any complex medical discussion.

CAJA specialist care works through referral. You first see your primary care physician, your médico de cabecera, at your registered EBAIS clinic. If the doctor determines you need a specialist, they issue a referral and you are placed on a waiting list at the regional hospital or specialty clinic. Wait times for non-urgent referrals range from a few weeks to several months depending on the specialty and region. For urgent cases, CAJA does prioritize — the long waits apply primarily to non-emergency, elective referrals.

You can bring a reasonable personal supply of existing medications into Costa Rica for your own use. For ongoing needs, you will need a Costa Rican prescription from a licensed local physician. Most common medications are available at Costa Rican pharmacies (farmacias), often at lower prices than in the US. Some specialty medications may not be available locally and would need to be imported. It is advisable to establish care with a local doctor early to maintain prescription continuity without gaps.

CAJA provides basic dental care — extractions, basic fillings, and some preventive care — through its dental clinics, but wait times are significant and the scope is limited. For restorative work, implants, cosmetic dentistry, or orthodontics, the private dental sector in Costa Rica is excellent and dramatically less expensive than in the US or Canada. Most expats use private dentists for all their dental care and consider it one of the best value aspects of living in Costa Rica.

CAJA handles chronic conditions well. Once you are registered in the system with a diagnosis — diabetes, hypertension, thyroid conditions, and similar — the system manages your follow-up appointments and provides medications from the CAJA formulary at no cost. The main limitation is that newer branded drugs may not be in the CAJA formulary and would need to be purchased privately. For most common chronic conditions, CAJA’s coverage is genuinely good once you are established as a patient in the system.

For non-urgent elective surgery, the private system is usually preferable for expats who can afford it — faster scheduling, English-speaking surgeons, and modern facilities at the top private hospitals. For emergencies, CAJA surgeons are highly competent — Hospital México and Hospital San Juan de Dios in San José handle complex surgeries daily. For major planned procedures, getting quotes from private hospitals and weighing the cost against your insurance coverage is worthwhile. Many expats find that paying out-of-pocket at a private hospital in Costa Rica still costs far less than the equivalent procedure in the United States.