For example, CIMA Hospital in San José has it all…intensive care, all the surgical specialties, and even dental treatments. All at 30 percent to 70 percent cheaper than U.S. or Canadian prices. And it is Joint Commission International-certified. That's the gold standard in healthcare—many U.S. hospitals fail to receive that accreditation. And it is the only hospital in Central America that is accredited by the Department of Veterans Affairs. That's not to say that public hospitals aren't up to snuff.
Margaret Aliff, an expat who lives in the San José suburb of Escazú, tells this story: "I've had three ER [emergency room] experiences in Costa Rica: one at a private hospital and two at a public hospital. I would rate all ER experiences as very good, but I thought the public hospital was more thorough both times."
Many expats use a combination of the two systems. Donald Martin, 73, had knee surgery in Georgia some time ago that is now failing him. He needs a series of injections in his knee. He saw his Caja doctor here in Costa Rica, who reviewed the records his orthopedist sent from Atlanta. He could have waited a few weeks for an appointment within the Caja system—about the same wait time for new patients to see a specialist in the U.S. But he preferred to be seen immediately and was referred to three nearby surgeons in the private sector.
The next day, he learned he could receive the same treatment he'd had in Georgia, but at a considerable saving. "Not only am I saving on time and airfare back to Georgia, but the cost of the injections is $400 here, as opposed to the $1,200 I was quoted there."
While some U.S. insurance carriers won't cover costs in Costa Rica unless it's an emergency, many expats find that private insurance here is very reasonable. John and Lori Jowett have recently gotten their insurance through Blue Cross of Costa Rica. "For a premium of $462 per month, we have better coverage than we had in Florida, and at half the cost." They also point out that, because healthcare is less expensive in Costa Rica, the $1 million policy here buys you closer to $3 to $5 million of care.
In addition, the country is finding new ways to help lower healthcare costs. I recently discovered a program called MediSmart. It works with Hospital Metropolitano, one of San José's private hospitals. Essentially, a couple can get deeply discounted medical services at Metropolitano by paying a $17-a-month "retainer." While normal office visits may run $40 to $50 (still a bargain, at one-third the U.S. cost), they're reduced to $14 to $18 by paying the retainer. Other costs can show similar price breaks, like a CT scan for only $320, compared to $800 in Texas.
And expats aren't the only ones who benefit from the Costa Rica healthcare system. Medical tourism is also growing rapidly. An estimated 40,000 people visit Costa Rica each year for some specific healthcare need.
When my fishing buddy, Kenneth Thomas, needed dental implants last winter, he drove past myriad dental offices in icy Fort Worth, Texas, and flew to sunny Costa Rica. He found he could save $15,000, even after paying for the airfare and his lodgings. Smiling a new perfect smile, Thomas reveals an added benefit: "I got to enjoy a few extra days in the paradise of beaches, as well as in some of the country's numerous national parks. That will make you want to visit the dentist!"
Commentary by John Michael Arthur, an American doctor who relocated to Costa Rica. CNBC contributors.