Private Hospitals in San José, Costa Rica: An Expat Guide

How private and public care fit together around the capital, and how to choose where to live with health care in mind.

The best-known private hospitals in San José for expats are Hospital CIMA in Escazú and Hospital Clínica Bíblica in central San José, both accredited by Joint Commission International. They sit alongside the public CCSS system, known as the Caja, whose large national hospitals are also in the capital. Most expats use a mix of public and private care.

Health care is the number one reason retirees choose to live near San José, or within driving distance of it. Our team lives in Guanacaste and has written about health care near Playas del Coco; this guide covers the capital, where the country's most specialized care is concentrated. It is general information, not medical or insurance advice.

How does health care work in Costa Rica?

There are two parallel systems. The public system, run by the Caja Costarricense de Seguro Social (CCSS), covers residents through monthly contributions and runs clinics and hospitals across the country. The private system includes hospitals, clinics, labs and independent specialists, paid by insurance or out of pocket.

Legal residents are required to join the Caja. Many also carry private insurance, or pay privately, to see specialists faster and choose their doctor. Our article on the Caja, private insurance and using both explains the details.

Hospital CIMA

Hospital CIMA is a private acute care hospital in Escazú, west of San José. It opened in 2000 and is accredited by Joint Commission International, the US-based body that accredits hospitals worldwide. It offers emergency care, inpatient and outpatient services and surgery. Its location is one reason Escazú is so popular with retirees, and it is easy to reach from Santa Ana and from Route 27 for people coming up from the Central Pacific.

Hospital Clínica Bíblica

Hospital Clínica Bíblica is one of the country's oldest private hospitals, in central San José. According to La República, it has held Joint Commission International accreditation since 2007, renewed every three years, and in 2019 its Santa Ana branch was included in the accreditation for the first time. That gives residents of the western suburbs another accredited option closer to home.

Other private options

Several other private hospitals and many specialist clinics operate around San José, including Hospital Metropolitano and Hospital La Católica. Capabilities differ by facility and specialty, so if you have a specific condition, ask which hospital your specialist works at and confirm your insurance covers that location.

The public hospitals

The Caja's large national hospitals in San José, including Hospital México, Hospital San Juan de Dios and Hospital Rafael Ángel Calderón Guardia, handle the most complex cases in the public system, and their specialists are highly regarded. Access normally runs through your assigned local clinic and a referral, and waiting lists for non-urgent procedures can be long, which is why many expats combine public coverage with private care.

Insurance: check before you need it

Three questions save a lot of trouble:

• Is the hospital in my network? Some international plans bill major private hospitals directly; others require you to pay first and claim reimbursement.
• Do I need prior authorization? For planned procedures, most insurers want approval in advance.
• Is my doctor covered at that location? A familiar hospital name does not guarantee every service or branch is covered.

An immigration consultancy's hospital overview makes the same point well: do not assume a discount membership is the same as health insurance. US citizens should also know that Medicare does not generally cover care outside the United States.

What to do in an emergency

In Costa Rica, dial 911 for emergencies. The Red Cross (Cruz Roja) runs ambulance service across the country, and private hospitals also run their own ambulances for members and insured patients. Save the emergency numbers of the hospital you plan to use in your phone, and keep a copy of your passport or residency card, insurance details and a short list of your conditions and medications where family can find them.

If you live outside the capital, know where your nearest public clinic and nearest emergency room are, and how long it takes to reach a major hospital. In serious cases, patients are stabilized locally and transferred, which is one reason so many retirees choose to live within a couple of hours of San José.

Practical tips for new arrivals

• Bring your records. Carry copies of recent test results, imaging and prescriptions, translated into Spanish if you can. Doctors appreciate it and it saves repeat tests.
• Check your medications. Some medicines sold in the United States or Canada are sold under different names in Costa Rica, and a few are not available. Ask a pharmacist before you move.
• Find a general practitioner early. A good private GP who knows your history is the best entry point to the system, public or private.
• Ask about language. Many doctors at the major private hospitals speak English, but not all staff do. Some hospitals have international patient offices that help with appointments and insurance.
• Keep receipts. If you pay first and claim reimbursement, insurers will want itemized invoices and reports.

Residency and the Caja

If you become a legal resident, joining the Caja is part of the process, and your monthly contribution depends on your residency category and declared income. Our guides to the pensionado visa and residency by investment explain how that works. Confirm current rules with a licensed immigration attorney, since requirements change.

Where to live if health care is your priority

If you see specialists often, live within an easy drive of the hospital you plan to use. That is why Escazú and Santa Ana are so popular with retirees, and why the Central Pacific beaches at Jacó and Playa Hermosa, about an hour and a half away, appeal to people who want the beach without giving up access to the capital. In Guanacaste, Liberia and the coast have their own private and public options, with San José a short domestic flight away.

Our San José neighborhood guide reviews each area expats choose. When you are ready to look at homes, tell us what matters to you, including how close you want to be to care, and we will help you narrow it down.

Frequently asked questions

What is the best private hospital in San José for expats?

Hospital CIMA in Escazú and Hospital Clínica Bíblica in central San José are the two most often recommended to expats, and both hold Joint Commission International accreditation. The best choice for you depends on your insurance network, your doctor and where you live, so confirm coverage and the specific facility before you need care.

Can expats use Costa Rica's public health system?

Legal residents join the public system, the CCSS or Caja, and pay monthly contributions, which gives access to public clinics and national hospitals such as Hospital México, San Juan de Dios and Calderón Guardia. Tourists are not enrolled. Many expats combine the Caja with private insurance or pay privately for faster appointments.

Do private hospitals in Costa Rica accept US insurance?

Some international insurance plans have direct billing arrangements with major private hospitals, while others require you to pay first and claim reimbursement. Medicare does not generally cover care abroad. Check with your insurer and the hospital before treatment, and ask whether prior authorization is needed.

Cover photo: Rodtico21, CC BY-SA 4.0, via Wikimedia Commons · Photo: Mario Alberto Matamoros, CC BY-SA 3.0, via Wikimedia Commons