Health insurance in Costa Rica.
Residents must pay into the Caja, whatever private plan they have. Nomads need their own cover for the visa. Here is how it fits together.
The rules
What Costa Rica asks of you.
Checked against official sources on 23 October 2026. Rules change, so the broker confirms them again before you apply.
- The Caja is required by law
The migration law makes CCSS (Caja) membership a basic requirement for residency.
Source: iin.oea.org - No gaps at renewal
To renew permanent residency, you must show unbroken Caja membership since the day residency was granted.
Source: iin.oea.org - Pensionados and rentistas pay too
They must join the Caja and pay a share of the income declared for residency. A bill to exempt them was rejected.
Source: costaricalaw.com - Digital nomad visa: US$50,000
You need medical insurance for your whole stay with at least US$50,000 of cover, for you and each dependant.
Source: visitcostarica.com - International or local insurer
For the nomad visa, an international insurer is fine. A local one must be regulated by SUGESE.
Source: visitcostarica.com
Residents get public care through the Caja and must stay enrolled to keep their residency. Tourists generally cannot use Caja services except in limited cases.
Source: binasss.sa.crLocal or international
We compare both. You keep the one that fits.
Residents must pay into the Caja anyway. A local plan regulated by SUGESE or an international plan adds faster access and care abroad.
- Local plans
Plans sold in Costa Rica. Often cheaper, sometimes required for your visa. Filed by a broker licensed in Costa Rica.
- International plans
Plans that cover you in Costa Rica and beyond, and stay with you if you move again. Filed by our international broker partner.
What to look for
Choosing a plan in Costa Rica.
Ankyro checks each of these on every plan, so you don’t have to read the fine print.
- US$50,000 for nomads
Check the limit is at least US$50,000 and runs for your full stay, including a renewal year.
- Every dependant covered
Each family member on a nomad application needs their own cover on the policy.
- An accepted insurer
International insurers are fine. A local plan must come from an insurer regulated by SUGESE.
- Private cover on top of the Caja
Residents pay the Caja anyway. A private plan is for faster access or care abroad, not a replacement.
Step by step
Getting covered in Costa Rica.
- 01Nomads: buy cover for the full year. The policy needs at least US$50,000 of cover for your whole stay, with its own cover for each dependant. If you plan to renew for a second year, check it can run that long too.
- 02Nomads: translate your documents. Every document in a nomad visa application, the insurance certificate included, must be in Spanish, translated by a registered translator or a notary.
- 03Residents: join the Caja once residency is approved. Caja membership is a basic condition of residency under the migration law. Pensionados and rentistas pay a share of the income they declared for residency.
- 04Pay the Caja every month. Permanent residency renewal needs unbroken Caja membership since the day residency was granted. A gap can stall your renewal.
- 05Add a SUGESE regulated or international plan. Private cover sits on top of the Caja for faster appointments or care outside Costa Rica. A local insurer must be regulated by SUGESE.
Common mistakes
3 we see all the time.
- 01Thinking a private plan replaces the Caja. Residents must stay enrolled.
- 02Letting Caja payments lapse. Gaps can block your residency renewal.
- 03Forgetting that each dependant on a nomad application needs their own cover.
Real published prices, and the 6 things that move yours.
Just visiting?For a holiday or a short trip, travel insurance is enough. See what Costa Rica asks of visitors, and what care costs.
Questions
People also ask.
Do expats have to pay into the Caja in Costa Rica?+
Yes, if you are a resident. Pensionados and rentistas pay a share of the income declared for residency.
What insurance do I need for the Costa Rica digital nomad visa?+
Medical insurance for your whole stay with at least US$50,000 of cover, for you and each dependant.
Can I use a Costa Rican insurer for the nomad visa?+
Yes, if it is regulated by SUGESE. International insurers are accepted too.
Can I renew residency if I stopped paying the Caja?+
Gaps can block it. Permanent residency renewal needs unbroken Caja membership.
Other countries
Going somewhere else?
Most UK visas don’t ask for private insurance. You pay a yearly surcharge instead, and it opens the NHS. Here is what the surcharge buys, and what you still pay for.
02AustraliaMost visitors can’t use Medicare, and many visas carry condition 8501. Here is what each visa asks for, who gets Medicare, and what to check.
03Dubai and the UAEIn Dubai, no insurance means no visa. Your employer covers you, but not always your family. Here are the rules, and what the basic plan leaves out.
04PhilippinesThe retiree visa asks for a medical certificate, not a policy. The new nomad visa does ask for cover. Here is what each visa needs, and how PhilHealth works for foreigners.
05NetherlandsIf you live or work in the Netherlands, Dutch basic insurance is the law. A few people are exempt. Here is who must sign up, by when, and what it costs in 2026.
06CanadaEach province runs its own health plan, and some make you wait. The super visa has strict insurance rules. Here is how Ontario and BC differ, and what the super visa needs.
07Saudi ArabiaIn Saudi Arabia, no insurance means no iqama. Your employer pays for you and your family, and visitors need a policy too. Here is who pays, and what each policy covers.
08JapanIf you live in Japan, joining public insurance is the law. A private plan can only sit on top. Digital nomads are the exception.
09GermanyEveryone in Germany must be insured, and a residence permit needs cover equal to the public system. Here is how to choose, and what gets rejected.
10SingaporeThe national plan is for citizens and PRs. Hospital bills for foreigners are high, and families are often left out. Here is what to check.
11ThailandRetirement visas have hard minimums, the DTV has none, and public care is not free for foreigners. Here are the rules, and what to check.
12SpainSpain has the strictest visa insurance rules in Europe: a Spanish-authorised insurer, no co-pays, no waiting periods. Here is what passes.
13MalaysiaPublic hospitals charge foreigners full price, and work schemes only cover injuries at work. Here is what each pass asks for, and what to check.
14QatarMost visitors need a QAR 50 a month policy before Qatar issues a visa. The law covers expats too, but that part is still rolling out. Here are the rules.
15FranceThe public system is open to residents, but not on day 1 if you don’t work, and it only pays part of each bill. Here is how to cover the gaps.
16PortugalThe visa asks for travel medical cover. The public system opens once you are a resident. In between, and after, here is what to check.
17MexicoNo visa asks for it, so many expats skip it. Then a private hospital asks for payment first. Here is how cover really works in Mexico.
18ItalyWorkers join the public system for free. Retirees and nomads need private cover for the visa, then pay at least €2,000 a year to join. Here are the rules.
19South KoreaStay more than 6 months and you must join the national plan. Before that, and for your share of each bill, you need your own cover.
20VietnamOnly long local contracts come with public cover, and most expats use private hospitals anyway. Here is what the rules say, and what to check.
21Bali and IndonesiaMost Indonesian visas don’t ask for insurance. But hospitals ask for payment first, and serious cases fly to Singapore. Here is what to check.
22GreeceThe consulate takes travel cover for the visa. The residence permit then asks for full health cover. If you don’t work for a Greek employer, that means a private plan.
23ColombiaNomads and retirees need a private policy with exact wording. Residents who work must join the public EPS system. Here are the rules.
25USAThe US has no public plan you can simply join. Some visas set minimum cover. Others leave it to you. Here is what a J-1 needs, who can use the Marketplace, and what plans cost.
26SwitzerlandBasic health insurance is compulsory for everyone who lives in Switzerland. You have 3 months to sign up. Here is how it works, and what to check.
27IrelandNon-EEA students must hold private medical insurance. Everyone else gets public care once they count as living in Ireland for 1 year. Here is what to check.
28Dominican RepublicThe residence visas for retirees and rentistas ask for a medical certificate, not an insurance policy. Public care is limited. Private care is good but costly.
29New ZealandStudent visas require insurance. A work visa of 2 years or more may open public health care. ACC covers accident injuries. Here is what to check.
30IsraelIn Israel, the public system is for residents. If your life is centred there, you join a health fund (kupat holim). If not, you need private cover.
31Hong KongPublic hospitals in Hong Kong are cheap for eligible persons. Many foreigners are not on that list. Here is who is, what the rest pay, and what to check in a plan.
32ChinaIf you work in China on an employment permit, your employer must enrol you in social insurance. That includes basic medical cover. Here is how it works, and what to check on top.
33ArgentinaEmergency care is open to everyone. For other care at national hospitals, foreigners without permanent residence must show insurance or pay first. The rules are new, so check them.
34IndiaWe found no official rule that ties health insurance to an Indian work visa. We also could not confirm a public scheme for foreign residents. So the plan is yours to choose. Here is what to check.
35TurkeyA residence permit application needs valid health insurance for the whole permit. Most new expats buy a private policy. The public SGK system opens later, after 1 year of residence.
36BrazilThe digital nomad visa needs health insurance valid in Brazil. The public system is open to migrants by law. Many expats add a private plan for speed.
37PanamaThe Pensionado visa asks for a health certificate, not an insurance policy. The public system is tied to the Caja. Private care is the main option for most expats.
38South AfricaStudy and exchange visas ask for proof of cover from a registered medical scheme. Public clinics offer free primary care. Here is what to check.
39KenyaKenya’s public fund is run by the Social Health Authority (SHA). A foreigner who lives in Kenya for more than 12 months pays into it. Shorter stays need travel health insurance instead.
40TaiwanTaiwan has one national health insurance. Foreigners with a residence certificate can join. If you have a job, you join through your employer. If not, there is a wait.