Hands down, one of the most common concerns we hear about moving to and living in Costa Rica? Healthcare. How does Costa Rican healthcare work? What are the practical differences between public and private care? Are your pre-existing conditions covered? On and on.
Because health is important.
We’re not going to get into all the nitty gritty details here – healthcare is a pretty big topic, better covered in multiple articles – but we are going to discuss one very important healthcare hack: medicina mixta, otherwise known as mixed medicine.
What is Mixed Medicine?
Medicina mixta is a well-named blend of public and private medicine. And, if that sounds a little ambiguous, we’ll be clearer: Mixed medicine is the practice of using inexpensive private healthcare to fast-track your more expensive exams, tests, and prescriptions through the public system.
Still unclear? Let’s talk specifics:
Example #1: You wake up at 6:00 a.m. with a fever. You know it’s already too late to get in line at your local clinic – most appointments are taken by 5:30 a.m. – so you hop online to try to snag a last-minute appointment. They’re all taken but your fever isn’t going away. Enter mixed medicine: You make an appointment with your mixed medicine doctor ($45), who thinks you’re coming down with strep throat. She orders your throat culture and antibiotics through the Caja; those tests are free, since you already pay into the Caja every month.
Example #2: Or, even more useful: You’re having terrible allergies. Your Caja GP finally refers you to an allergist with the intention of getting a full allergy test ($1,000+ in private care). The rub: You have to wait a few months before you can get in to see a Caja allergist. Instead of waiting it out, you seek the help of a private-pay allergist who participates in mixed medicine. She sees you, then immediately refers you for that allergy test – at the public hospital. You paid just $60 for the private-pay allergist and are getting your $1,000+ test for free (as part of your Caja affiliation).
How to Use Mixed Medicine in Costa Rica
Thankfully, mixed medicine is super simple: Just contact a doctor who advertises an affiliation with medicina mixta and you’re well on your way.
From now on, you’ll pay for appointments with your mixed medicine doc – usually, $30-$60 a pop – who can write prescriptions, request labs, schedule surgery in public hospitals, and otherwise work with the Caja. And, beyond your standard monthly contribution, you won’t pay an extra colón for any of your Caja services.
Even better, as of 2018, the CCSS announced that medicina mixta is expanding: the mixed healthcare network now includes more doctors, more services, and an even wider array of dentists.
A final word: Don’t worry that you’re “cheating the system” with mixed medicine. It’s a widely-used service and very popular with Costa Ricans. What’s more, the experts agree: Mixed medicine takes some of the pressure off the Caja’s already stressed resources. (= Part of the reason why all those appointments are taken.)
So, do yourself a favor and search out a mixed medicine GP who you trust. You’ll thank yourself, the next time you wake up at 6:00 a.m. with a sore throat.