Health Insurance Options for Expats Over 60

If you’re over 60 and planning a move to Costa Rica, compare your CCSS eligibility, the terms of any private policy, and the care you might pay for yourself. Start with your health needs, exact destination and coverage dates rather than another retiree’s arrangement.

Ken GardnerPublished April 21, 2026

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Visiting for treatment rather than moving? Start with our Costa Rica medical travel guide and questions to ask your insurer about planned treatment abroad.

Over-60 insurance: public care, private policies and gaps

Confirm which CCSS insurance category applies to you, what it will cost and when benefits begin. For private insurance, request a written quote and the terms that apply to your age, medical history and residence plans. Before cancelling existing coverage, confirm that suitable replacement arrangements are active and that you understand any gaps or exclusions.

Plan the Coverage Transition

Do not assume that filing a residency application activates CCSS coverage. Ask the CCSS and your immigration adviser which steps apply to your category, what documents are needed and when coverage takes effect.

Ask your existing insurer whether your policy remains valid for the purpose and full length of your stay, including a move abroad. A policy sold for a holiday may not fit a relocation. The Government of Canada’s travel insurance guidance distinguishes travel cover from insurance needs when living abroad. Confirm effective dates, renewal arrangements and exclusions in writing, and budget for any uncovered period.

CCSS Coverage and Costs

What you get is broad public coverage: doctor visits, hospitalization, prescriptions from the CCSS’s official medication list, and treatment for chronic and pre-existing conditions, with no age limit. Check the CCSS official medication list by active ingredient, strength and formulation, then ask your treating team about prescribing criteria and availability. A medicine outside the LOM is not automatically impossible to obtain: a separate authorization process may apply under CCSS pharmacy rules. Approval and local stock are not guaranteed. Ask about referral and waiting times for your particular treatment before choosing where to live.

For a usable budget, ask the CCSS which insurance category applies to you, how it will assess your contribution base, which current rates apply, and when payments and benefits begin. Do not treat an immigration income requirement or a percentage quoted in an expat forum as your personal CCSS assessment. Obtain the calculation before cancelling existing coverage or committing to a long-term budget.

Compare Private Policy Terms

Assess the specific policy offered to you. Ask the insurer or a licensed broker about maximum new-entry age, renewal conditions, medical underwriting, pre-existing-condition exclusions, waiting periods, deductibles, co-payments and benefit limits. Request a written premium quote and ask how future premiums may change. Qualifying to renew an existing policy is not the same as qualifying for a new one.

Check territorial and residence requirements, the provider network, prior authorisation and whether you must pay the hospital before claiming reimbursement. For an INS proposal, use its general policy conditions together with the specific conditions and exclusions issued for your application. Do not treat another person’s policy as proof of your coverage. Ask the insurer which service needs prior approval, then ask the facility what it will accept and what you must pay at the appointment. Record the claims contact, required receipts and who will follow up on an unanswered reimbursement question.

Combining Public and Private Care

You may consider using public services alongside private insurance or self-paid appointments. Confirm the public services available to you, then request local written quotes for private consultations, tests and prescriptions you may need. Include the possibility of major hospital costs when assessing whether self-pay is affordable.

For each town, identify the clinic and referral hospital serving your address, the private services available, after-hours arrangements and the journey from your proposed home. Keep a dated record of confirmed cover, care you would pay for yourself and questions still awaiting an insurer or CCSS answer. Use the healthcare access guide to organise separate coverage and local-service enquiries, and the region comparison to shortlist locations.

Six questions before choosing health insurance in Costa Rica

What coverage will carry me through the residency application period until my CCSS coverage is confirmed active?
What will the CCSS assess as my reference income, and what contribution follows from it?
Are my medications listed, what prescribing or special-authorization rules apply, and what is my private backup plan?
Can I still buy private coverage at my age, and what exactly is excluded?
Which EBAIS clinic and which hospital serve the exact town I’m considering?
Does my coverage plan survive my 70s, not just my 60s?

Frequently Asked Questions

Is Caja enrollment really mandatory for residents?

CCSS enrollment is generally part of the residency process. Confirm the requirements for your category and when your coverage starts; a pending immigration application is not proof of active health coverage. Ask the CCSS for your contribution assessment and keep suitable interim coverage until the transition is confirmed.

Does the Caja cover pre-existing conditions?

The CCSS does not exclude members for age or pre-existing conditions the way private insurers can — a major reason it anchors over-60 plans. Specific services and medications remain subject to CCSS rules, clinical criteria, the official formulary, and availability, and some voluntary-insured situations carry qualifying periods.

Can I get private health insurance in Costa Rica at age 65 or older?

It depends on the insurer and the specific policy. Ask for the maximum new-entry age, renewal conditions, exclusions, waiting periods and a written premium quote. Do not assume another retiree’s policy or an old age-limit estimate will apply to your application.

Is Medicare usable in Costa Rica?

Original Medicare generally does not cover care outside the United States, apart from limited exceptions. Do not rely on it as a routine Costa Rica coverage plan. Ask your plan about any separate travel benefits and their limits before arranging long-term coverage.

Check Medicare’s official overseas coverage guidance and your own policy documents. Travel emergency benefits are not a substitute for confirming long-term resident coverage.

Keep Planning

The full system explained: healthcare in Costa Rica
Where healthcare access shapes town choice: region comparison and microclimate matcher
The bigger picture: aging well in the tropics, savings finder, and buying property as a foreigner
Questions about your situation? Contact us

Editorial update, October 1, 2026: clarified private-policy and transition questions and added treatment-trip resources. This update is not a new review of all CCSS benefits or residency requirements.

General planning information, not medical, insurance, or legal advice. Rules, contribution scales, formularies, and insurer policies change and vary by individual circumstances — verify current details with the CCSS, insurers, and a qualified local advisor. Last reviewed: August 31, 2026.

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