Updated January 2026
Best Expat Health Insurance for Costa Rica
The honest breakdown: what each option actually covers, what it costs, and which one makes sense for your situation. No fluff, no sponsored rankings.
The Quick Answer
Digital nomads on a budget
SafetyWing + Medismart
~$76/mo total
Families or health conditions
Cigna Global
$200-400/mo
Long-term residents
CAJA + Medismart
7-11% income + $20-50/mo
Digital Nomad Visa
SafetyWing or Cigna
CAJA not accepted
The Deep Dive
Tap any card to see full details
SafetyWing
Budget-friendly nomad insurance
$56-135/mo
per month
Best for: Digital nomads, short-term stays, healthy young people
Our Take
Great for healthy nomads on a budget who need basic emergency coverage. Not ideal if you have ongoing health needs or want comprehensive care.
What's Covered
- •Emergency hospitalization up to $250K
- •Outpatient care and doctor visits
- •Emergency medical evacuation
- •COVID-19 treatment
- •Emergency dental (up to $1,000)
- •90 days US coverage included
What's NOT Covered
- •Routine checkups and preventive care
- •Pre-existing conditions (mostly excluded)
- •Mental health and therapy
- •Maternity and childbirth
- •Elective procedures
- •Chronic disease management
Pros
- Affordable starting price ($56/month)
- No commitment, cancel anytime
- Covers 180+ countries
- Includes some US coverage (90 days)
- Easy online signup in 2 minutes
Cons
- $250 deductible on all claims
- Limited pre-existing condition coverage
- Some users report slow claims (weeks to months)
- Max $250K coverage on Essential plan
- Not accepted for some visa types
Cigna Global
Top PickPremium international coverage
$200-450/mo
per month
Best for: Families, retirees, those with health conditions, long-term expats
Our Take
The gold standard for serious expats. Worth it if you need real healthcare, not just emergency coverage. Especially good for families and retirees.
What's Covered
- •Hospitalization (unlimited or high limits)
- •Outpatient care and specialist visits
- •Routine checkups and preventive care
- •Mental health and therapy sessions
- •Pre-existing conditions (after 12-24mo)
- •Emergency evacuation worldwide
- •Optional: dental, vision, maternity
What's NOT Covered
- •Cosmetic procedures
- •Experimental treatments
- •Pre-existing conditions in first year
- •Some adventure sports (check policy)
Pros
- 1.65 million doctors/hospitals in 200 countries
- Comprehensive coverage including routine care
- Mental health coverage included
- Pre-existing conditions covered (after waiting period)
- Excellent claims reputation
- Add dental, vision, maternity
Cons
- Expensive, starts around $200/month
- Annual premium increases reported
- Complex policy documents
- Overkill for healthy short-term nomads
CAJA (Public System)
Costa Rica universal healthcare
7-11% of income
per month
Best for: Legal residents, retirees, anyone staying long-term
Our Take
Once you have residency, this is a no-brainer to enroll. Pair it with Medismart or private insurance for faster access to specialists.
What's Covered
- •ALL hospitalizations and surgeries
- •Doctor visits and specialist care
- •All medications (heavily subsidized)
- •Maternity and childbirth
- •Pre-existing conditions (no exclusions)
- •Chronic disease management
- •Cancer treatment
- •Mental health services
What's NOT Covered
- •Private room upgrades
- •Cosmetic procedures
- •Experimental treatments
- •Care outside Costa Rica
Pros
- Covers EVERYTHING, no exclusions
- Pre-existing conditions included
- No age limits
- Medications heavily subsidized
- Income-based, can be very affordable
Cons
- Only available to legal residents (18-month wait)
- Long wait times for non-emergencies
- Limited English-speaking staff
- Bureaucratic enrollment process
- Quality varies by location
INS (Local Private)
Costa Rica government insurer
$100-300/mo
per month
Best for: Residents who want private Costa Rica coverage
Our Take
Good option once you have residency and want to transition away from international insurance. Works well paired with CAJA.
What's Covered
- •Hospitalization at private hospitals
- •Outpatient and specialist care
- •Ambulance services
- •Some medications covered
- •Lab work and diagnostics
What's NOT Covered
- •Pre-existing conditions (often excluded)
- •Care outside Costa Rica
- •Some chronic conditions
- •Maternity (check specific policy)
Pros
- Accepted everywhere in Costa Rica
- Network of private hospitals and clinics
- Government-backed, stable
- Spanish-language support
Cons
- Requires residency or work permit
- Spanish-only website and support
- Less flexible than international options
- Claims process can be slow
Medismart
Discount program (not insurance)
$20-50/mo
per month
Best for: Everyone. Use alongside any insurance
Our Take
Not a replacement for insurance, but a fantastic add-on. Most expats use this for routine care while keeping insurance for emergencies.
What's Covered
- •Discounted doctor visits ($25-40 vs $75)
- •Discounted specialist consultations
- •Reduced lab and imaging costs
- •Pharmacy discounts at network
- •Dental discounts
What's NOT Covered
- •THIS IS NOT INSURANCE
- •You pay full (discounted) cost out of pocket
- •No hospitalization coverage
- •No emergency coverage
- •No claims process. You pay at time of service
Pros
- Cheap monthly fee
- Major discounts at private clinics
- Doctor visits drop from $75 to $25-40
- No exclusions or waiting periods
- Easy signup, works immediately
Cons
- NOT insurance. You pay out of pocket
- No coverage for major events
- Discount amounts vary by provider
- Must be used at network facilities
What I Actually Use
After 2+ years in Costa Rica, here's my setup: SafetyWing for emergency/travel coverage, plus Medismart for cheap access to private doctors when I need them. Total: about $80/month.
Once I get residency, I'll enroll in CAJA (mandatory anyway) and keep Medismart. That's the sweet spot most long-term expats land on.
If I had kids or a chronic condition, I'd go straight to Cigna Global. The peace of mind is worth the premium.
What Expats Say
Mike R.
Tamarindo • 3 years
"Started with SafetyWing, had a minor claim that took 6 weeks to process. Coverage was fine but the wait was frustrating. Switched to CAJA + Medismart after getting residency. Way better for routine stuff."
Sarah K.
Nosara • 5 years
"Cigna Global saved us when my husband needed emergency surgery. They handled everything with the hospital directly. Expensive, but worth every penny when you actually need it."
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Disclaimer
This is not professional insurance advice. Prices and coverage details change. Always verify directly with providers. Your situation is unique. We use affiliate links where noted, but they don't influence our rankings. Do your own research.