There are several international insurance carriers that offer far more robust health insurance policies than INS. Some have lifetime limits of $5 million and they will pay no matter what country you are in when the expenses are incurred. Some even have reduced premiums if you specify that expenses will ONLY be incurred in one country or in Central America.
Note: While you cannot buy health insurance in Costa Rica from any other company than INS or CCSS, these other policies are perfectly legal to purchase and many have payment arrangements already in place with several private hospitals in Costa Rica. This is one way to get around one of the great monopolies of Costa Rica-INS.
You can do some research on this by Internet or contact Guardian Angels at firstname.lastname@example.org for some of your options with International coverage.
An alternative to the INS plan is the CCSS plan. (Caja Costarricense de Seguro Social) This is the government medical plan that most Costa Ricans have. The plan covers pre-existing conditions, doctor visits, prescription drugs, examinations, hospitalization, dental and eyes. There is no limit on annual amounts paid out by the plan. A doctor and clinic is assigned to the patient. Lines and the processes can be long, but you will get decent care!
The cost is very reasonable – about $37.00 per month for a family where the principal insured person is over 55 years of age, and $58.00 per month where the principal insured is under the age of 55. For those under 55 there is a compulsory pension fund payment in the premium. Family includes spouse and dependants under the age of 18 years. The prices quoted are from 2004 and have likely gone up slightly.
Insurance through CCSS Requires Costa Rican Residency.
You CAN have both INS and CCSS! Many people have both.
Also, many doctors in the private hospitals are CCSS physicians and can often arrange billing through CCSS.