Health Care Staying Healthy

Unlike other countries in Latin America, especially Mexico, Costa Rica’s water supply is good and perfectly safe to drink in San José and in the majority of small towns. In most places you can drink the water without the fear of Montezuma’s Revenge (diarrhea) or other intestinal problems. However, be careful when you drink water in the countryside. We have lived in Costa Rica for years and have not heard many people complain about the quality of the country’s water. But if you prefer, bottled water is available. Just as in the U.S. there are about twenty brands of bottled water in all size containers sold at the supermarkets. You will be pleased that Costa Rica’s water is soft for bathing and washing your hair.

Although the Costa Rican government takes precautions to monitor the quality of the water and the country has high standards of sanitation, there are some precautions you should take. Wash and peel all fresh fruits and vegetables. Avoid drinking fruit drinks made with water that are sold in stands on the street. You should also watch out for raw seafood dishes, like ceviche, served in some bars and restaurants. This type of seafood is soaked in lemon juice and not cooked with heat.

Costa Ricans are proud of their nation’s achievements in the field of health care. Their up-to-date, affordable state-run “cradle to grave” health care system reaches all levels of society by offering the same medical treatment to the poor as those with greater resources. Hospitals, clinics and complete medical services are available in all major cities and some small towns. Over 90% of the population is covered the Costa Rica Social Security system.

Many international medical authorities rate Costa Rica as having one of the best, low-cost medical care systems in the world when preventive and curative medicines are considered. The United Nations consistently ranks Costa Rica’s public health system as the best in Latin America and one of the top 20 in the world.

Costa Ricans are a healthy people. The infant mortality rate of less than 11 in 100,000 live births in Costa Rica is lower than that in the United States. This figure is on apar with any industrialized country in the world. Life expectancy of 76.3 years for men and 79.8 years for women. Hospitals have the latest equipment and laboratories are excellent. You can feel safe having most operations without returning to the U.S. or Canada. Most surgical procedures cost only a fraction of what they do in the U.S. Heart bypass operations cost about a third of what they do in the U.S.

Even if you are in good health the probability of needing medical care increases with age so that the security of knowing that good health services are available represents an enormous relief. Thus health care shouldn’t be a major stumbling block in the decision to live in Costa Rica.

Most Costa Rican doctors are excellent and have been trained in Europe, Canada or the United States. If you don’t speak Spanish, you don’t have to worry since many local doctors speak English, but most receptionists and nurses do not. Doctor’s fees for office visits vary. A good private specialist usually charges between $30 and $40 for each visit, although some doctors charge a little more and others a little less.

If you join Costa Rica’s national health care system, you don’t have to pay for each office visit, only a small monthly membership fee. If you have any questions about medical fees or doctors you should direct them to the Colegio de Médicos, which is the Costa Rican equivalent of the AMA.

To find a good English-speaking physician or specialist talk to other retirees, look in the Yellow Pages under Médicos or look for doctr’s ads in the Tico Times.

Public medical facilities are so good that you don’t usually need private care. Most private specialists are required by law to work part-time in public hospitals. However, private clinics and hospitals do provide quicker services with more privacy enabling you to avoid long lines and the bureaucracy of the public system.

You will be happy to know you can receive first-rate care at any of San José’s three largest private hospitals. The Clinica Bíblica (Tel: 257-5252, 800 911-0800, Fax:255-4947, E-mail:asoserme@racsa.co.cr, www.clinicabiblica.com), in downtown San José, is now affiliated with the Blue Cross-Blue Shield network. It is a first-class private hospital with an excellent coronary unit. This fine hospital is staffed with doctors who are highly trained. Complete hospital services as well as lab work are available.

In addition to the main branch in downtown San José the Clínica Bíbilica has smaller satellite branches with a doctor on duty, pharmacies and express delivery of medicines in Heredia (Tel: 260-4959), Cartago (Tel: 551-0511), San Francisco de Dos Ríos (Tel: 218-0035 ), and in the San Pedro Mall Tel: 283-6058.

The Clínica Católica (Tel: 225-5055, E-mail: infoing@clinicacatolica.com, www.clinicacatolica.com), in Guadalupe, a suburb of San José, is another fine private hospital with complete hospital and emergency services.

Hospital CIMA (Tel: 231- 2781, E-mail cimahsj@racsa.co.cr, wwww.hospitalsanjose.net), in Escazú right off the highway, is the newest private hospital in the San José area and is affiliated with the Baylor University Medical Center. It is a full service hospital that boasts the latest health care technology state-of the-art medical equipment and the most sophisticated physical plant in Central America. It offers complete services including X-ray, ultrasound, emergency and intensive care, as well as an advanced coronary unit. The average cost of a room per day is between $130 and $140, very reasonable when compared to the cost of a hospital in the United States. Hospital Cima (Tel: 208-1800) recently opened a smaller branch in the eastern suburb of Los Yoses about 100 meters west of the San Pedro Mall. They also plan to open a full-service branch near Flamingo beach in Guanacaste. The Clínica Santa Rita (Tel: 221-6433), near the court buildings, has an excellent maternity center. The Hospital Cristiano Jerusalem (Tel: 285-0202), in the Alto de Guadalupe, offers limited services. Although not a hospital, the Clínica Americana (Tel: 222-1010), next to the Clínica Bíblica, offers private out-patient service and U.S.-trained doctors, who are on call 24-hours a day. San Juan de Diós (Tel: 222-0166) is the public social security medical facility in San José.

If you have to enter a private hospital, costs will generally be well under a hundred dollars a day. This includes a spacious private room and bathroom, usually a T.V. and an extra bed or sofa bed so a relative may spend the night, if necessary.

Our son was just operated on for an appendectomy at the Clínica Bíblica. The total cost including the surgeon’s fee was under $1,000. Our INS insurance covered all but $140.

We know an American who spent a couple of days in the private Clínica Católica hospital and said, “The attention was first class, the food was as good as home cooking and the same care would have cost thousands of dollars in the States.” It is important to know that payment can be made at most hospitals and clinics with any major credit card. Foreign medical insurance is not accepted, but you may get a reimbursement from your health insurance company, if they cover you abroad.

Emergencias Médicas Tel: 290-4444 is a private company offering quick ambulance service. For a small yearly fee you can take advantage of their first-rate service.

Low Cost Medical Insurance
Costa Rica’s health care system is available to retirees (pensionados) and other foreign residents. They may join the Caja Costarricense de Seguro Social (Costa Rican Social Security System) and enjoy the same inexpensive medical coverage as most Costa Ricans do. Most foreigners don’t enroll in this system because of the long waits for medical attention and delays.

Most foreigners and retirees opt for the medical insurance offered by the government’s insurance company—the National Insurance Institute or INS. Everyone is eligible to apply including permanent residents, pensionados and even tourists. Elderly people have to submit to a physical before they can be insured. The medical policy covers expenses due to illness, accidents,hospitalization, office visits, lab work, medicines and medical costs in foreign countries. However, if you do incur medical expenses abroad, the INS will only pay the amout of the same treatment in Costa Rica and you have to pay the difference.

When you purchase a policy, the INS will supply you with an identification card and a booklet that lists the names of affiliated groups such as hospitals, doctors, labs and pharmacies. Most surgical procedures are covered 100%. You only pay a small deductible for office visits, labs, medicines and treatments. If you seek medical services not affiliated with the INS, you have to pay up front. You then submit a claim to the INS and will be reimbursed in a few weeks.

Depending on age and sex, the annual cost of this insurance is around $800 for a man between 50 and 69. For example, rates for a 18-39 year old man run around $250 per year; for a 70-year old man around $1,200; woman of all ages pay an average annual rate of about $400. Women of childbearing age pay slightly more than men. There is a discount if more than one person is insured on the same policy. It is easy to enroll an entire family for a low monthly rate. If you belong to a group of fifteen or more people—like the Residents Association (ARCR) or American Legion— you can obtain around a 20% discount.

There is a ceiling of around $17,000 per individual. Since medical costs are so low in Costa Rica, this policy is more than enough to take care of your medical needs. So, retirees and other residents need not worry about lacking adequate medical coverage in Costa Rica. For information, go to the Residents Association (ARCR) or contact them at: (Tel: 011-(506) 233-8068), Fax: 011-(506) 222-7862). You can reach the National Insurance Institute at (506) 223-5800.

The INS now offers a new international insurance policy which cover your needs in Costa Rica and the rest of the world. This new medical policy covers medical expenses due to accident or sickness. Here are some of the items covered: Hospitalization and ambulatory expense, maternity, prosthesis, organ transplants, air evacuation, repatriation of remains, funeral costs and a yearly check-up and eye test. The rates are high but the coverage is very complete.

Comparing Costa Rica’s
Health Care Plans
Here is a brief comparison of the C.C.S.S. (Caja Costarricense de Seguro Social) and the INS (Instituto Nacional de Seguros) medical plans available in Costa Rica.

C.C.S.S. - National socialized system.
1. Covers doctor’s visits, medications, examinations and hospitalization.
2. Doctors are assigned to the patient.
3. Covers pre-existing conditions.
4. Covers all medications including dental and eyes.
Some reasons to consider this plan.
1. Have pre-existing health condition and do not qualify for INS insurance.
2. Take medication on a regular basis.
3. Have it as major medical in case of serious illness.
Monthly premiums cover all illnesses for the member and his immediate family for that month. The cost, younger than 55 years old, $55 per month; 55 years or older $37 per month.


INS - The semi-autonomous governmental insurance company.
1. Covers 80% of the cost of doctor’s visits, medications, examinations and hospitalization.
2. Individual chooses the doctor.
3. Does not cover any pre-existing medical condition.
4. Does not cover most dental or eye exams, treatments or glasses, preventive medical check-up, illness or disorders related to female reproductive organs during the first 12 months of coverage, or birth of a baby during the first 6 months of coverage.


Some reasons ARCR members have the INS plan.
1. Can choose a doctor.
2. Can make doctor’s appointments with less red tape.
Rates of coverage depend on age and sex, 20% deductible for each doctor’s visit
. This program generally saves between 20 to 25% of the cost of medical, laboratory and doctor costs. Currently about 400 medical professionals are affiliated with the plan and include most specialties. Members receive a directory that gives the name of a doctor or medical service by specialty, the location, phone number and percentage of discount. Residents Association (ARCR) members quality for a discount of 35% in this plan, which sells for around $125.00 for a family or $100.00 for a single person. For more information contact Servicios de Salud de Costa Rica at Tel: 256-4747, Fax: 256-2141.

Medibroker Tel: 0-191-297-2411/44-191-297-2411, Fax: 0-191-251-6424, www.medibroaker.com, e-mail: medibroker@aol.com. is a company which offers medical coverage for retirees, expats and others living abroad. The y have various plans from which to choose.

While checking out Costa Rica as a tourist, to see if it is the place for you to settle, you can get temporary medical insurance through the Costa Rican Social Security office and the International Organization of Cultural Interchanges (O.I.C.I.). Contact them at 011-(506) 222-7867. Medicines and Pharmacies

Pharmacies are numerous in Costa Rica and they stock most standard medicines available in Europe, Canada and the U.S. In general, the cost of most medicines is lower than those in the U.S. Most drugs requiring a prescription in North America are freely available “over the counter” in any Costa Rican farmacia . Exceptions are strong pain relievers and narcotics that require a special prescription. In Costa Rica pharmacists are permitted to prescribe medicines as well as administer on-the-spot injections. They are also available to answer your questions and give free medical advice about less complex conditions.

Some pharmacies open 24-hours a day are in downtown San José at Clínica Bíblica Hospital, 223-6422; at the Clínica Católica Hospital, 225-9095; and at the Farmacia del Este in San Pedro, 253-5121. The main branch of Fischel pharmacy 223-0909, across from the main post office in San José. It has a doctor on duty to give medical advice. Fichel will deliver medicine and prescriptions in the San José area. Many of their employees speak English. They also have smaller pharmacies in other locations around San José and in Heredia, Alajuela, Cartago and Puntarenas.. For home delivery call them toll-free at 800 Fischel (800-347-2435). Recently Fischel opened the country’s first online pharmacy. They offer the sale of prescriptions and over-the-counter products. In addition, their staff of pharmacists and doctors will answer your questions. Their site also provides general information on topics such as proper use and storage of medicines. You may view their site at www.fishel.co.cr. The Los Yoses Pharmacy 234-9698 or 225-1730, is open 365 days a year and offers free home delivery in the San José area.

Dental Care
Many tourists come to Costa Rica to have their cosmetic dental work done inexpensively. The quality of dental work in Costa Rica is equal to that found in Europe, Canada or the U.S. On the average, dental work costs about 25 to 30% less than in the U.S. Most dentists charge around $35 for an initial exam. The approximate costs of the most common cosmetic procedures are: wisdom tooth surgery $175; single root canal $150; new crown $250; implants $750; fillings about $30 per tooth and regular tooth extraction $40. If you have children, orthodontics are very affordable. Check prices with the dentist of your choice, since rates vary.

Costa Rican dentists offer the following services: implants, gum treatment, root canals, bleaching, oral surgery, crowns, bridges and nitrous oxide sedation.

One word of caution for foreigners, some Costa Rican dentists advertise in English publications and cater almost exclusively to foreigners. Patients will soemtimes pay more for dental services these doctors provide. So, it’s a good idea to shop around and ask for recommendations. The Costa Rican Surgeons and Dentists Association (Tel/Fax: 256-3100, E-mail: dentista@racsa.co.cr) will give you a list of dentists practicing in Costa Rica.

Cosmetic Surgery
Costa Rica has long been the destination for those in search of the “Fountain of Youth.” People from all over the world flock to Costa Rica for cosmetic surgery because prices are lower than in the U.S. for comparable procedures. Costa Rica’s surgeons are among the worlds best, and now, some clinics offer HGH (human growth hormone) and testosterone hormone replacement treatments. Furthermore, and most of Costa Rica’s plastic surgeons are trained in the U.S. or Europe. They keep up-to-date on new trends and methods in their field and attend professional seminars regularly. Rates for different operations vary from doctor to doctor. You can combine several procedures to reduce the price substantially. There are even package prices that combine surgery, hotel and hospitalization. In general, prices average 25 to 60 percent less than in the U.S., although the final cost is open to negotiation with the surgeon. The low cost of cosmetic surgery should not, however, be interpreted as a sacrifice of quality for affordability. The cost of a full-face lift is between $2000-$3,500 (add a few hundred dollars per day in the hospital to recuperate from the surgery); nose surgery around $2000; liposuction $800-$1,500; with a tummy tuck, $2,000 -$3,000, breast implant $2,500-$3,500 and eyelid surgery between $800-$1,500. Many doctors send their patients to special recovery houses for about $70 a day. Rates will vary from surgeon to surgeon. We suggest you contact Dr. Arnoldo Fournier (please see his ad at the end of this guidebook). They are the best plastic surgeons in Costa Rica and will be more than happy to send a brochure and answer any of your questions. For information about travel arrangements or cosmetic surgery vacations see: Unique Costa Rica Tours at www.costaricabooks.com/travel

One quick word about cosmetic surgery in Costa Rica. There are a couple of doctors who advertise their services as cosmetic surgeons but have no specialized training in the field. Therefore to get the best results from your surgery we suggest you do the following: (1) Ask the U.S. Embassy for a list of certified plastic surgeons. (2) Also check with the Colegio de Médicos (the local equivalent of the A.M.A.) to see if a particular doctor is a real plastic surgeon. All doctors in Costa Rica must be registered with the Costa Rica Doctor’s Association or Colegio de Médicos (Tel: 232-3433, Fax: 232-2406, E-mail: medicos@racsa.co.cr). Only registered plastic surgeons may advertise their services. (3) Ask a local family doctor for a recommendation of a good plastic surgeon. (4) To find out if they are pleased with the results of their surgery, talk with former patients of the doctor of your choice before you make a decision. Find out if they are pleased with the results of their surgery. (5) Just because some cosmetic surgeons advertise in an English publications doesn’t mean they offer the best quality or prices.

Care for the Eldery
In Costa Rica there is also full service custodial health care available for the elderly at a very low cost. Care for less independent senior citizens is around $1000 per month. Retirement Centers International offers comprehensive medical care and assistance which includes all medicines, lab work, dental care, physical therapy, rehabilitation and special diets.

These programs are some of Central America’s best and are considerably less expensive than in the United States. However, if these facilities are beyond an elderly person’s means, a full-time live-in domestic worker can be hired as a nurse for a couple of hundred dollars monthly. In addition to caring for an infirm person this worker can manage other household chores.

If interested in a full-care facility, contact The Golden Valley Hacienda. Located in a beautiful countryside setting, they offer experienced nursing and medical care with a fully bilingual staff. Prices range from $1,400 for a shared room to $1,700 for a single room.
For additional information contact:
THE GOLDEN VALLEY HACIENDA
P.O. Box 8406-1000
San José, Costa Rica
Tel: (506) 433-8191
Fax: (506) 236-9676
E-Mail: golden@arweb.com
WEBSITE: http://www.arweb.com/golden
P.O. Box 8406-1000
San José, Costa Rica
CASA ISREAL
Tel: (506) 223-1169

* Once again, to find a good physician or specialist talk to other retirees, look in the yellow pages under MEDICOS or look for doctors’ ads in the Tico Times and Central America Weekly. Below are the names of some English speaking physicians.
Dr. Patrick Gabriel—Chiropractor.
Tel: 011-(506) 296-0020


Dr. Claudio Orlich—Urology
Apartado 8040-100, San José, Costa Rica
Tel: 011-(506) 233-1514 Fax: 011-(506) 290-3106


Dr. Joaquín Martínez—Ophthalmology
Tel: 011-(506) 289-7418; Fax: 011-(506) 238-0005


Dr. Rudolf Nuñez—Clinical Dermatology
Tel: 011-(506) 222-6265; Fax: 011-(506) 257-0244


Dr. Stephen Kogel—Physician/Psychiatrist
A U.S. born doctor who has helped many American clients with
alcohol and drug problems. Tel: 011-(506) 224-6176


Dr. Manuel Trimiño Vásquez—Physician/Psychiatrist
He has many clients from the U.S. and is bilingual.
He has helped many foreigners adjust to living in Costa Rica.
Tel: 011-(506) 221-6140 or 011-(506) 233-3333
For the names of more doctors and dentists, see the section in the back of this book titled “ More Phone Numbers.”
Hoodia, Health, Obesity & Weight Loss