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Healthcare

Costa Rica — Healthcare: Public Healthcare

Costa Rica's public healthcare system is run by the Caja Costarricense de Seguro Social (CCSS, or 'Caja'). Legal residents are required to enroll and pay an income-based monthly contribution (commonly cited as roughly 7-11% of declared income) under Article 32 of the Immigration Regulations. Once enrolled, coverage includes consultations, hospital stays, surgery, and prescription drugs with no co-payments at the point of care. Care is delivered through a tiered network of national hospitals, regional clinics, and local EBAIS primary-care posts.

VerifiedImmigration/relocation guides (crie.cr, costarica-immigration.com, thecostaricahandbook.com) describing CCSS ('Caja') enrollment rules for legal residents, corroborated across multiple independent sourcesLast reviewed: 2026-08-29

Why this matters

CAJA enrollment is not optional for legal residents — it's a legal requirement tied to maintaining residency status, and the ongoing monthly cost (percentage of income) is a real budget item that many relocation guides understate or omit.

Key facts

  • The public system is run by the Caja Costarricense de Seguro Social (CCSS), commonly called 'the Caja.'
  • Legal residents must enroll in and pay CCSS contributions — this is a legal requirement under Article 32 of Costa Rica's Immigration Regulations, and is checked at residency renewal.
  • The monthly contribution is income-based, commonly cited as roughly 7-11% of declared monthly income (with a minimum baseline contribution for those with no formal income).
  • Once enrolled, coverage includes consultations, hospital stays, surgery, and prescription medication with no co-payment at the point of service.
  • Care is delivered through a tiered network: national/specialty hospitals, regional clinics, and local EBAIS (Equipos Básicos de Atención Integral en Salud) posts for primary care.

Steps

  1. Obtain legal residency — CCSS enrollment as a resident is tied to having an approved residency category (e.g., Pensionado, Rentista, work permit) — see the relevant residency pages for that process.
  2. Enroll with CCSS — Register with the CCSS, providing proof of residency status, identity, and income, to determine your monthly contribution rate.
  3. Pay ongoing monthly contributions — Pay the income-based monthly CCSS contribution; maintaining good standing is generally required to renew residency.

Costs

  • Monthly CCSS contribution: Roughly 7-11% of declared monthly income, with a minimum baseline for those without formal income

Timelines

  • CCSS enrollment after obtaining residency: Can typically be completed within days to a few weeks of having approved residency status, though this varies by case

Required documents

  • Approved residency status (DIMEX card)
  • Proof of identity
  • Proof of income (for contribution calculation)

Common mistakes

  • Believing CCSS enrollment is optional for legal residents — it is required under Article 32 of the Immigration Regulations and is checked at renewal
  • Underestimating the ongoing monthly cost, which scales with declared income rather than being a small flat fee
  • Assuming tourists or non-residents can access CCSS the same way legal residents can

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