New Insurance Program Starts March 1, 2010 – Expats Have to Pay for Caja Policy

Residency cards are required for

Residency cards are required for application to show proof of insurance

Starting Monday, a new requirement for foreign residents (expats or permanent residents), must show proof of insurance from the government Caja Costarricense de Seguro Social. Often cited as a reason for the country’s stability over recent decades, the Caja Costarricense de Seguro Social is the safety net for health care and pensions. Permanent residents are foreigners who can legally work.

There are two categories of insurance coverage available to individuals not on a formal payroll, Independent Worker and Voluntary Insurance.

Independent workers or self-employment coverage is for individuals with economic activity of any sort. Legally any foreigner with such activity should be enrolled with the Caja, regardless of immigration status. There is an additional workman’s comp insurance that is also required, but is not administered by the Caja.

Voluntary insurance is meant for those not engaged in active work, living from income property, pensions, retirement plans like 401Ks, investments, etc. The voluntary will effect many retirees that are living in Costa Rica and who have been granted residency based on their income.

What this does is, once registered, the only way to stop paying is to be put on a payroll at a formal business. A foreign who works as an employee does not have to pay, his or her company does.

Once resisted and in reality or theory, the Caja then can file a claim against the debtor’s property and income if they have not paid.  Both types  cover immediate family members, including spouse, minor children living under the same roof, and adult children up to age 25 who are full-time students. However, if you have a pre-existing condition, it is  not covered for the first six months.


  • Independent workers with monthly income of 200,000 colones about 21,000 colones. Independent workers with monthly income of 500,000, about 60,000 colones.
  • Voluntary Insurance program with monthly income of 600,000 colones ($1000US) or about $36.00US. Voluntary Insurance program with monthly income of 1,500,000 ($2500US), colones, about 71000 ($130.00US) colones.

The new law also says insurance must be maintained “from the moment residency is granted, in an uninterrupted manner until the moment the card is renewed.” As the Costa Rican Constitution prohibits the retroactive application of law, the requirement presumably takes effect on March 1, 2010.

Well what is this going to do?

Well first, it is no secret that many have abused the medical system. With that said, it will save the government lot and lots of colones. As for the resident, still a lot cheaper than that of the U.S.

Editors Note: To apply for voluntary insurance, the first step is to identify and/or go the clinic that is closest to your location. There, you will get a piece of paper called a Carné de Seguro Sociala. This is where you fill out the application, which is very simple, like name, address, proof of residency, and of course source of income and how much. Afterwords,  the clinic personal will submit it – then, sometime soon, you get to start paying your monthly insurance bill.

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  1. Peter says:

    As a retired person, living on a small pension, I have question:
    I do have an international health insurance for which I pay yearly and that covers me totally worldwide with execpetion of the USA and Canada.
    I was wondering, when I can proof that I am insured, if I still need to join the VOLONTARY Caja in Costa Rica, which would cost me another $400 per year for nothing.
    I heard that the retired  Tico's are free or almost free from paying to the caja.
    If this is all true, than I believe that it is not right to force us joining the caja when you can proof you have a good insurance.
    Please help me clear my mind on this. 

  2. My wife who is Tica is telling me that I must start this whole process in the CAJA in San Jose.  I much prefer to go to the little clinic in my neighborhood.  Are you certain I can avoid the long lines downtown?  I'm also curious – you mention converage for the individual.  Does this cover my wife of union libre and my children?  -Evan

  3. I am married to a tica. will i be covered under her caja coverage?

  4. Lydia Vogt says:

    Another hit on expats. I don’t think many of us were under the misconception it was going to be cheap to live here. Paying 70% on the used car we imported disabused us of that idea. However, when a retiree can pay under $100 a month for excellent Medicare coverage in the states, paying over $300 a month for Caja coverage that is the equivalent of inner-city, free-clinic-style medical care does not seem cheap. I don’t know where the folks who think this is a good deal came from, but it wasn’t my experience.

  5. Spy Cameras Spy Equipment says:

    Wow, I must say that Health Care is much cheaper than in the USA and I am told from friends who live there in Costa Rica that the quality of care is excellent also. So another great point on why to chose Costa Rica as place to retire. Knowing how long it takes to set things up in Costa Rica so you are not with out coverage is important of course.

  6. Phil Kolb says:

    Well this is all and good. However, what does one do for Medical when it takes Migration a YEAR or longer to say OK?????????? I cannot understand why it takes so long.

    When I moved to Germany, I was granted Residency in 45 MINUTES!!!! Tell me why it takes so long here? All thisn paperwork, another story, was not required in Germany.

    Anyway, as I am NOT living in the US anymore, NO MEDICARE. Living here, and having to wait for God knows how long, NO COVERAGE!!! What does one do????

    If it is MANDATORY, then make it such when you apply for Residency, you have to join, right then and there. Is it that hard to do? It appears this country wants to have Americans, Europeans and Canadians come here. They need to learn to speed up the process. All you get thrown in your face is YOU ARE NOT RESIDENT, YOU CANNOT DO THIS OR THAT. How are we to live??????

    So, who do we contact to build a fire under someone to get Residency granted within 90 days or less, and to make it MANDITORY when you submitt your paperwork for Residency, you automatically go onto CAJA?

    Simple, but maybe not. Suggestions?

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