Private elder care in Costa Rica can cost far more than many pensions cover, leaving families to bridge a growing gap as the country’s population ages. Recent research on Costa Rica’s care system found that private long-stay residences for older adults cost between ₡500,000 and ₡1.6 million a month, roughly $1,100 to $3,500 at current exchange rates.
The average private residential cost was about ₡804,000 a month, or roughly $1,760. The price depends on the type of room, the level of care required and the services included. Shared rooms generally cost less than private rooms, while facilities offering more medical attention, therapy, nutrition services and daily activities can quickly push the monthly bill above ₡1 million.
For many families, the shortfall is immediate. A retiree receiving ₡400,000 a month who moves into a facility charging ₡600,000 would leave relatives covering another ₡200,000 every month. At the average private residential rate, the gap would be closer to ₡400,000 a month.
The pressure comes as Costa Rica ages quickly. People 65 and older made up 8.9 percent of the population in 2020, and official projections show that share rising sharply in the decades ahead. Updated demographic estimates place the country on track for roughly one in four residents to be 65 or older by mid-century.
The pension system is already stretched. A University of Costa Rica report found that 215,528 people age 65 and older had no formal pension coverage. The same report said 44 percent of people in that age group were covered by a basic contributory pension, while 17 percent depended on the noncontributory pension system.
Women face added vulnerability in old age. Researchers pointed to lower lifetime earnings, informal work, fewer years of pension contributions and unpaid caregiving responsibilities as factors that leave many older women with less economic security.
In-home care can be cheaper than a private residence, but it is still a major expense. Independent caregivers surveyed in the care-system study charged between ₡120,000 and ₡280,000 a month for five hours of care a day, five days a week. Specialized companies charged more, from about ₡240,000 to ₡560,000 a month, depending on the complexity of the care.
That option can help an older adult remain at home, but it does not solve the affordability problem for lower-income households. A family relying on a modest pension can still spend most of that income on basic daytime support before accounting for food, medicine, transportation, diapers or medical appointments.
Costa Rica does have public support programs. The National Council for Older Adults, known as CONAPAM, directs public resources to older adults in poverty, abandonment, vulnerability or social risk. Its Red de Cuido program works through nonprofit organizations, local governments and community networks, and includes long-stay homes, day centers and home-based support.
Those services, however, are targeted by need and do not erase the wider gap between income and care costs. Subsidized long-stay homes also face their own financial limits. The State of the Nation study found that subsidized homes reported monthly care costs of ₡575,000 to ₡825,000 per resident.
Costa Rican law allows a permanent resident of an elder care home to contribute up to 90 percent of monthly pension income toward the cost of care. For families, that can reduce part of the bill, but it also leaves little pension income available for personal needs.
Care facilities are also under pressure from rising costs. Homes surveyed for the study cited higher spending on food and personal-care supplies, especially diapers, while public support can be limited or fluctuate. Some facilities rely on family contributions, fundraising, municipalities or other institutions to close operating gaps.
Regulation remains another concern. Long-stay homes for older adults must be authorized by the Health Ministry, under national rules that apply to public, private and mixed facilities. Recent Health Ministry actions against elder care homes have cited problems including poor sanitary conditions, structural deficiencies, lack of clinical staff, improper medication handling and failures in waste management.
The result is a care market split between what families want, what pensions can cover and what the state can subsidize. For Costa Rica’s retirees, the real cost of growing old is no longer just a private family issue. It is becoming one of the country’s clearest demographic and social policy challenges.
