The Healthcare System in Costa Rica: CCSS, Public and Private Sector, Access for Foreigners, Emergencies and Health Risks

Article 73 of the Constitution establishes social insurance for manual and intellectual workers, under a system of compulsory contribution from the State, employers and workers, to protect against the risks of sickness, disability, maternity, old age and death. Its administration is entrusted to an autonomous institution, the Costa Rican Social Security Fund (Caja Costarricense de Seguro Social, CCSS), whose funds may not be used for other purposes. The founding law of the CCSS (No. 17) specifies that the compulsory seguro social includes sickness, maternity, disability, old age and involuntary unemployment (articles 1 and 2). Insurance against occupational risks is the exclusive responsibility of employers; the National Insurance Institute (INS), the public insurer, handles work risks, and France Diplomatie cites its number (800 800 8000) among the country’s useful numbers.

Alongside the CCSS public network, a private sector of clinics and practices exists. France Diplomatie describes it from the angle of payment: private facilities require a payment guarantee on admission, and even in the public system care beyond emergencies is chargeable for uninsured people. The CCSS website could not be consulted when this page was written: details of services, waiting times and contributions should be read directly from the fund. The guides to healthcare systems abroad and budgeting for health abroad help you compare.

The seguro social is compulsory for all manual or intellectual workers who receive a wage (article 3 of Law No. 17): a French employee on a local contract is therefore registered with the CCSS by their employer. Self-employed workers may insure themselves, with exemption from the employer share, and the State’s share is increased for those whose net income is below the legal minimum wage.

For foreign residents, Immigration Law No. 8764 ties residence to social cover: a temporary resident must prove their aseguramiento (affiliation) to the CCSS insurance schemes, since the grant of their residence and without interruption, in order to renew their foreigner’s card (articles 80 and 86); the same requirement applies to permanent residents (article 78). It therefore concerns pensionados, rentistas, investors, company managers and families holding a residence. The spouse and children under 25 of a rentista are covered by the same residence application. The remote worker (Law No. 10008) follows another rule: they take out a private medical policy for the whole length of their non-resident stay. The reimbursements depending on each situation are detailed on the dedicated page.

The official texts consulted do not describe the detail of first-contact care (local health teams, appointment booking, attachment to a facility) or the list of public hospitals; these rules should be confirmed with the CCSS at the time of affiliation. France Diplomatie does, however, provide the useful benchmarks for a French resident: find out about local cover before settling, keep cover for private care, and expect private facilities to ask for a payment guarantee.

To choose a home, the distance to a full-service healthcare facility counts as much as the rent: the winding roads, often poorly signposted and marked by a very high accident rate according to France Diplomatie, lengthen journey times, and the active volcanoes of the Central Valley or the rainy season can disrupt travel. The page on living in Costa Rica sums up these conditions.

• 911: the country’s single emergency number, which covers the fire brigade, the Red Cross and the police.
• +506 2220 2020: National Emergency Commission (CNE), for natural hazards; +506 2261 0781: OVSICORI volcanological and seismological observatory, for volcanic activity.
• French embassy: on-call line reserved for serious emergencies (accident, death, arrest) outside opening hours; the embassy’s “Emergency - Difficulty” pages explain what to do.

For medicines, the official sources consulted detail neither the lists of medicines covered by the CCSS nor their prices. A resident on long-term treatment brings a detailed prescription (international nonproprietary name), checks the local availability of their molecule and plans a transition stock. France Diplomatie warns against consuming ayahuasca, a hallucinogenic plant that carries serious cardiac and psychological risks.

According to France Diplomatie, mosquito-borne diseases are the main risk: dengue is endemic and peaks from May to November in the tourist provinces, chikungunya and Zika also circulate, and malaria is considered almost eradicated, with a minimal risk. Typhoid fever is transmitted through contaminated water and food, and rabies through contact with animals. A health alert on measles, issued on 13 March 2026, concerns several regions of the Americas.

• Routine vaccines of the French schedule up to date (diphtheria, tetanus, poliomyelitis, whooping cough, measles, etc.).
• Yellow fever: proof of vaccination, on the paper certificate and not as a photo, required since 11 May 2025 for travellers coming from certain at-risk African or American countries.
• Hepatitis A and typhoid: recommended depending on the conditions of the stay; tuberculosis (BCG) for children under 15 in the event of frequent or prolonged stays.

Prevention measures (repellents, covering clothing, safe water) apply all year round. The family doctor or an international vaccination centre adapts the schedule to age and to the plan for the stay.

A few simple steps, taken in the first weeks, avoid unpleasant surprises. The first is to align CCSS affiliation with the residence permit calendar: the law requires affiliation to be continuous from the grant of residence until the foreigner’s card is renewed, and an interruption may jeopardise renewal. The second is to keep, in a single file, the proof of affiliation, the residence permit, translated prescriptions and the vaccination certificate, since yellow fever is proved on paper.

• Before departure: review your medical history and treatments, ask your doctor for a detailed prescription, bring your vaccines up to date, and choose supplementary cover for private care and repatriation.
• On settling in: register on the register of French nationals living abroad with the embassy (a service offered on its website), identify the nearest full-service healthcare facility to your home and note the emergency numbers.
• Each year: check that CCSS affiliation, supplementary insurance and the conditions of the residence status (pension or income, medical policy for the remote worker) remain in order.

For a family, children and spouse are covered according to the policyholder’s status, a point detailed in the guide to children’s health cover abroad. The first 90 days checklist helps you put these steps in order.

No social security agreement binds France and Costa Rica: the country is not in the list of the 94 countries or territories for which CLEISS (the French liaison centre for international social security) publishes a country page. A French national can therefore combine local cover, necessary to maintain their residence, with an arrangement that provides reimbursements based on their actual costs or on a French scale:

• CFE: the Caisse des Français de l’étranger, the French expatriates’ health fund, reimburses abroad according to a rate or flat amount specific to the country of care applied to actual expenses; cover is immediate if enrolment takes place before departure or within three months of settling in. The CFE asks for no health questionnaire.
• First-euro international insurance: actual costs reimbursed within ceilings, direct payment possible in network facilities, evacuation and repatriation.

The page on expat health insurance presents the offers, the page on healthcare reimbursement in Costa Rica covers each situation, and Expavy helps you compare these solutions.