In theory, foreigners who have residency must actually live in Costa Rica or risk loosing their residency. Temporary residents are subject to strict requirements, which vary according to category. Permanent residents are only required to be in the country once every two years. In practice, it is necessary to keep a cedula current. Doing so, requires paying cedula renewal fees and making monthly payments into the national heathcare system.
Although citizens can face sanctions for failing to pay their voluntary health care policy, they are not required to enroll. Many do not enroll in the voluntary system because they are automatically covered by their payroll tax contributions. However, once enrolled voluntary coverage is irrecoverable. So, a resident who originally enrolls in the system and then becomes a citizen does not get an option to opt-out.
However, with the new rules citizenship starts to become more attractive when you consider moving back to the United States or going to a third country. This may be the case if want to follow a job opportunity or raise your children, provided the spouse agrees in the United States. It’s also nice for retired people who decide to spend an extended period, living with family or deal with a sudden medical need in the U.S. system.
A little known rule is that while voluntary health coverage is irrevocable, it can be suspended for periods you are outside the borders of the national territory. A “trámite” in advance is required, but is relatively easy. Citizens enjoy more flexibility under the rule because they can remain outside of Costa Rica for many years, and not risk losing their citizenship. It’s also unclear if under the new immigration law, a permanent resident would be allowed to use this option. Cedulas for citizens are also valid for ten years and there is no charge for replacement or renewal.
Note: This article is a part of a series on naturalization and deals with just one benefit. We will cover others, along with the current requirements in another article.