in Costa Rica
The Costa Rican government views medical care as a public obligation. And because of that, the cost for medical care and prescription drugs in Costa Rica is significantly less than in North America so that it's available to all citizens regardless of income class. There are 3 main ways residents can obtain coverage:
CAJA (Public Healthcare)
More than 50 years ago, the Costa Rican government created a workers' health insurance program that, today, covers about 90% of the population. This is because one worker may cover several members of his or her family under one policy. This system is known as the "Caja Costarricense de Seguro Social" more commonly referred to as the CAJA (ca-ha). Even if you are not working, you can pay out of your pocket to obtain medical health coverage which, on average, runs about $100 a month, or about $37 a month, per person. This insurance covers just about anything, but there are drawbacks. Since the CAJA is practically free, the system is predictably overcrowded, so long waiting lists for specialized surgeries are the norm. And you're care can only be administered at any one of the public hospitals or certified smaller clinics throughout the country. Life threatening injuries or illnesses do go to the front of the line how ever. For all it's draw backs, the public health care is generally regarded as excellent - especially considering the price.
INS (Private Healthcare)
The other way to obtain coverage is through the government’s monopoly insurance provider "Instituto Nacional de Seguros" or INS. This coverage is more of what you would expect in a North American insurance plan, and though the care is generally better and more responsive, there's a co-pay that goes with every transaction, and there are many restrictions on coverage, such as:
Your monthly premium varies depending on age, sex, and physical condition, but the cost is usually around $50 a month per person. This covers 70% of exams, doctor's visits, prescription drugs and hospitalization. And it covers 100% of surgeries and anesthesia up to $17,000. Another benefit of INS is that you can select your own doctors and use private hospitals & clinics which will see you promptly as compared to the CAJA, but you cannot apply for this coverage after the age of 75.
Using both th CAJA and INS
Because medical insurance is so affordable in Costa Rica, and because the 2 major insurance plans above, each have their pros and cons, it's not uncommon for people carry both public and private insurance.
This approach offers a variety of benefits which can help avoid delays on processing time of your tests and major surgeries. The CAJA is always good to have to fall back on as well. For instance, if there was a major emergency, and you chose to go to a private hospital, but that hospital is not able meet your needs or perhaps they feel the public hospital is better equipped to handle your particular emergency, you are covered free of charge.
Having both insurances also gives you the ability to obtain a second opinion where necessary. This is a great option for anyone who needs full medical coverage, but also wants the freedom to pick when and where they receive their medical treatment.