Costa Rica (CR)

CCSS primary care is delivered through EBAIS clinics — each assigned by home address. To find your EBAIS: visit ccss.sa.cr and enter your address, or ask at any CCSS office. Your EBAIS doctor is your gateway to specialist referrals, lab orders, and prescription medications. Private GPs (médicos generales) are available at private clinics without appointment — walk-in usually possible. Private GP consultation: ₡25,000–₡70,000 per visit.

At CCSS: your EBAIS doctor refers you to a specialist at a CCSS hospital. Referral waitlists: 2–6 weeks for common specialties (dermatology, orthopaedics, gynaecology), up to 6 months for some. For urgent cases, your EBAIS doctor can flag the referral as priority. Private sector: no referral required — book directly with a private specialist. Many private specialists are also CCSS doctors who see private patients in the afternoons at their private clinics.

CCSS emergency rooms: all CCSS hospitals have 24/7 emergencias open to all enrolled members. Triage by severity — critically ill patients seen immediately; non-critical may wait 2–6+ hours. Private emergency rooms (CIMA, Clínica Bíblica): faster, more comfortable, but expensive (₡150,000–₡400,000+ for a visit). For life-threatening emergencies: call 911 (Cruz Roja ambulance) or go directly to the nearest CCSS or private emergency room. Cruz Roja: 128.

CCSS emergency rooms operate 24/7. For non-emergency evening/weekend medical advice, call the CCSS nurse line (800-0434-444) or visit the nearest CCSS CAIS (Centro de Atención Integral de Servicios). Private 24/7 clinics exist in San José and tourist areas — check with your hotel or local expat groups for the nearest option. There is no equivalent to Germany's 116 117 non-emergency line.

At CCSS: prescriptions from CCSS doctors are dispensed free at CCSS pharmacies using your DIMEX/tarjeta de asegurado. Some medications not on the CCSS formulary require purchase at private pharmacies. Private pharmacies: Fischel, Chavarría, Cruz Verde, and Sucre are major chains open 8am–8pm; some 24-hour locations. Private prescription costs: ₡5,000–₡40,000 depending on medication. Generic medicines (genéricos) are widely available and much cheaper than brand-name equivalents.

CCSS provides limited basic dental care (extractions, fillings, basic preventive care) at designated CCSS dental clinics — long waiting lists (months). Private dental care in Costa Rica is world-class and significantly cheaper than the US or Europe: cleaning ₡20,000–₡50,000; filling ₡25,000–₡80,000; implant USD $1,000–$1,800; crown USD $400–$800. Costa Rica is a top medical tourism destination for US dental patients. Escazú, Santa Ana, and San Pedro have excellent dental clinics with English-speaking dentists.

CCSS provides psychiatric and psychological services at public hospitals — waitlists are 3–9 months for non-emergency psychological therapy. Emergency psychiatric care is available at 24/7 mental health units at Hospital Calderón Guardia and Hospital México. Private therapy: ₡40,000–₡90,000/hour with a licensed psychologist (psicólogo); ₡60,000–₡120,000 with a psychiatrist (psiquiatra). English-speaking therapists are available in San José and tourist areas — ask ARCR or expat Facebook groups for recommendations. Online therapy (Teladoc, MDLive) accessible with US insurance.

CCSS provides complete free maternity care from prenatal consultations through delivery and postnatal visits. Hospital Nacional de la Mujer is CCSS's dedicated maternity hospital in San José with 3,000+ deliveries/year. Private maternity: Clínica Santa Rita and CIMA are the most popular private options for expat families (private room, English-speaking, birth plan respected); cost USD $3,000–$8,000 for uncomplicated vaginal delivery, USD $5,000–$12,000 for C-section. Children born in Costa Rica receive automatic Costa Rican citizenship regardless of parents' nationality.