San José, Costa Rica, since 1956

Do Private Hospitals Always Require a Deposit?

A friend of mine recently had to be admitted to the hospital after an emergency room visit, but was not allowed in until a deposit was made. Here’s what happened:

My friend June, a U.S. citizen who has residency in Costa Rica and TRICARE foreign medical insurance for U.S. military personnel and their families, recently hit the back of her head near a fleshy spot where there is no bone. It was about 6:30 p.m. when I arranged for her to be taken to the private Hospital Clínica Bíblica emergency room in downtown San José. Before she left, I placed her TRICARE card, a credit card and some money in her pocket. I called Clínica Bíblica to tell them this and explain about the accident and the danger associated with her fall because of a preexisting medical condition.

An emergency room doctor at Bíblica treated her and said she should spend the night in the hospital for overnight observation.

However, at about 10:30 p.m. the hospital informed me June would not be admitted until I came to the hospital and paid a $1,000 deposit. I had been using crutches for months and only recently started using a cane, which limited my walking.

In the area where I live, there are no taxis after 10 p.m. and the closest bus stop is about two kilometers away. It was physically impossible for me to get to the hospital and I told this to several hospital employees. I said I could be there early the next morning to pay the deposit. That proposition was rejected. Instead, I was told June would be shipped off to Hospital Mexico (a public hospital in western San José).

During several phone calls with employees, I was not able to convince anyone to admit her. Around midnight, she finally allowed admissions personnel to use her credit card. She had to sign a bunch of papers that she was totally incapable of reading or understanding. Once signed, then and only then did she receive pain medication. She did not reach a hospital room until after 1 a.m.

Is this standard procedure?

Doug Hicks


All patients, whether foreign and local, are required to pay a deposit in advance for admission to most – if not all – of the country’s private hospitals, according to Brad Cook, insurance manager at Clínica Bíblica.

The Tico Times confirmed this with officials at the private CIMAHospital in Escazú, west of San José.

CIMA is committed to admitting all emergency cases for treatment, regardless of a patient’s ability to pay, CIMA’s Assistant Director Roberto Herrera explained. However, if a patient requires hospitalization once he or she is stabilized, CIMA gives them the option of staying and paying hospital fees and the required deposit, or being transferred to a public hospital, such as Hospital Mexico.

In the above-described case at Clínica Bíblica, Cook says June was immediately examined and stabilized by the emergency room staff at no cost. It was not until her condition required hospitalization that Bíblica staff requested an admission deposit, he told The Tico Times in an e-mail.

For this reason, the staff spoke with “a friend of the patient who then verbally insulted our staff over the phone in regards to the deposit,” Cook said in the e-mail.

“After going back and forth on the issue (June) finally presented the credit card she had in her possession all along and paid the admission deposit,” he said.

Cook also explained that TRICARE patients at Clínica Bíblica are required to pay up front for any services the program doesn’t cover, including many types of medication. All the hospital’s registered TRICARE patients were informed of this requirement in a letter the hospital sent out in June 2005, explaining the policy resulted from the difficulty involved in collecting money from TRICARE patients after their release.

In the e-mail, Cook offered apologies for any inconvenience this situation may have caused.

Patients who consider they have been wronged by any private or public health institution in the country can file a complaint at the Public Health Ministry’s Quality Control Office, in downtown San José. The office investigates complaints and helps protect consumers’ health rights.

For more information, call 222-3940

from 7 a.m.-3 p.m.Monday through


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