1. Costa Rica
Costa Rica’s national health care system, the Caja Costarricense de Seguro Social, offers nationalized health care for all of its citizens and legal residents. The World Health Organization places Costa Rica in the top rankings for life expectancy, and the United Nations ranks the country’s public health care system in the top 20 worldwide. The Caja operates 30 public hospitals, as well as 250 clinics across the country, plus 1,000 smaller units to cover rural areas.
Once their residency application is approved, expats qualify to join the Caja. They typically pay between 7% and 11% of their reported monthly income. There are no additional copays, no age restrictions and no rejection because of preexisting conditions.
The public system has a couple of downsides. Most of the staff speak only Spanish, and apps and their website do not have an English option. Wait times are long for nonemergency procedures, which prompts many expats to blend both the public and the private health care systems. Many Costa Rican doctors work in both sectors and have studied in North America or Europe, and most in the private field speak English. The country has three Joint Commission International-certified medical centers in San José.
It’s possible to purchase health insurance policies from familiar companies such as Blue Cross Blue Shield, CIGNA, BMI/Aetna or the local Costa Rican private insurance, INS, from agents there. As an alternative, the country offers a private health care discount program called Medismart for as little as $14 per person per month.