Costa Rica’s Caja, a basic understanding


Once you receive your official residency in Costa Rica, you become a “voluntary” member of Caja Costarricense de Seguro Social (CCSS or Caja). This enables you to access the socialized medical system here in Costa Rica. By voluntary, this means you are choosing to become a resident of Costa Rica and therefore are a voluntary member of the CCSS system. You are charged a certain amount each month based on your residency category. Married couples pay as one unit. In return, you are allowed to use the medical system in Costa Rica called Caja. This is also a requirement of our residency.

CCSS clinic in Costa Rica, also known as the Caja

To Americans or other foreigners who are not familiar with socialized medicine, this can be a huge adjustment. The main reason is that CCSS does not have fancy offices or waiting rooms that many of you are accustomed to seeing.

Inside a Caja clinic

With this said, I have found that once you learn how the system works it is quite easy to use. The hardest visit is your first visit. You will need to be fluent in Spanish or take someone with you that is fluent. This is when they will set up your folder and develop a medical plan for you. All your background information is taken and recorded. If you are on high blood pressure medicine, are diabetic, have high cholesterol, etc., they will set you up with an appointment every six months to monitor your condition. They will go over what medications you are taking and what medications they have that are either the same or similar. At this time the doctor will give you a script for blood and urine tests, x-rays, mammograms, EKG or any other test they deem necessary. The Doctor will prescribe any medications necessary and you can pick them up at the pharmacy there in the clinic. Medications usually take a few hours to fill so you must be patient. This is not Walgreens! Go grab a bite to eat or run some errands.

Signage in a Caja hospital in Costa Rica

If you still have private health insurance in the country you are moving from you may want to take all CCSS results and let your family doctor review them. I have been very pleased to find out that my test results have been spot on.

One thing you may hear about Caja is that it is a slow process if you need an MRI or other diagnostic procedures. This is can be true depending on the situation, so you will have to decide if you feel you can wait or if you need to seek private screening.

All in all, the system does work. You just have to be patient, literally, and I think you’ll be pleasantly surprised with the results!


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