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Best Health Insurance in Costa Rica

6 insurers ranked and reviewed · Updated May 2026

Sources:OsaTropicalProperties.comHealthHubCR.comCostaRicaBoard.com

Healthcare System Overview

Costa Rica has a universal public healthcare system through the CCSS (Caja Costarricense de Seguro Social), known as 'La Caja,' mandatory for all residents and legal workers. Contributions are income-based (7-11% of declared income, $50-200/month). The Caja covers all pre-existing conditions from day one. A parallel private insurance market exists, led by INS (Instituto Nacional de Seguros), which was a state monopoly until 2008 when CAFTA opened the market.

#1

Cigna Global / Allianz Care

private50K members
82Score
Top International Health Insurers(2026)
★★★★☆4.2satisfactionFinancial strength: Cigna (S&P: A), Allianz (S&P: AA)

Languages

Full English

Global Network

Yes

Medical Evacuation

Yes

  • Full English-language service and support
  • Global provider network with no geographic restrictions
  • International medical evacuation coverage
  • Premium comprehensive plans
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#2

CCSS (Caja Costarricense de Seguro Social)

Caja Costarricense de Seguro Social (La Caja)

public5.0M members
80Score
Universal Public Healthcare System(2026)
★★★☆☆3.5satisfactionFinancial strength: Government-backed

Coverage

Near-universal (~5M people)

Pre Existing Conditions

Covered from day one

Premium Range

$50-200/month (income-based)

  • Universal coverage — mandatory for all residents
  • Pre-existing conditions covered from day one
  • Income-based premiums ($50-200/month)
  • Comprehensive coverage including surgery, maternity, medications
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#3

INS (Instituto Nacional de Seguros)

Instituto Nacional de Seguros (INS)

hybrid500K members
78Score
HealthHubCR: Dominant Local Insurer(2026)
★★★☆☆3.7satisfactionFinancial strength: State-backed

Monopoly Until

2008 (CAFTA)

Plan Range

$50-$250/month

State Owned

Yes (commercial operations)

  • Most established insurer in Costa Rica (since 1924)
  • State-owned but operates commercially
  • Accepted at most private clinics
  • Flexible plans from $50-$250/month
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#4

ASSA Compania de Seguros (Costa Rica)

ASSA Compania de Seguros S.A.

private200K members
72Score
HealthHubCR: #2 Private Insurer(2026)
★★★☆☆3.7satisfactionFinancial strength: Grupo ASSA (regional, publicly traded)

Parent Group

Grupo ASSA (Panama)

Costa Rica Entry

2010

Blues Cross Acquisition

Triple-S Blue business

  • Second largest private-capital insurer in Costa Rica
  • Part of regional Grupo ASSA from Panama
  • Acquired Triple-S Blue (Blue Cross) business
  • Growing rapidly since 2010 market entry
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#5

Mapfre Costa Rica

Mapfre Seguros Costa Rica

private100K members
70Score
Mapfre: International Standards(2026)
★★★☆☆3.6satisfactionFinancial strength: Mapfre S.A. (S&P: A)

Parent Group

Mapfre S.A. (Spain)

Financial Rating

S&P: A (parent)

Market Entry

Post-2008 CAFTA

  • Part of global Mapfre group from Spain
  • International standards and processes
  • Multi-line coverage (health, auto, property, etc.)
  • Spanish parent company with S&P: A rating
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#6

Blue Cross Blue Shield Costa Rica

Blue Cross Blue Shield de Costa Rica

private80K members
68Score
US Brand Recognition(2026)
★★★☆☆3.8satisfaction

Us Brand

Yes (BCBS)

Dual Coverage

Costa Rica and US

Target Market

US expats, dual residents

  • Recognized US brand (Blue Cross Blue Shield)
  • Coverage in both Costa Rica and United States
  • Ideal for US expats and dual residents
  • Multiple plan options available
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About Health Insurance in Costa Rica

Costa Rica has a universal public healthcare system through the CCSS (Caja Costarricense de Seguro Social), known as 'La Caja,' mandatory for all residents and legal workers. Contributions are income-based (7-11% of declared income, $50-200/month). The Caja covers all pre-existing conditions from day one. A parallel private insurance market exists, led by INS (Instituto Nacional de Seguros), which was a state monopoly until 2008 when CAFTA opened the market.

Our editorial team has evaluated and ranked the top 6 health insurers in Costa Rica based on editorial ratings from trusted sources, customer satisfaction, financial strength, and coverage quality. Rankings are updated regularly to reflect the latest market changes.

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