Medical clinic or hospital

After gaining Temporary residency your wife would be covered for healthcare. This is presently taking 18+ months. There are many very good private facilities here with 'reasonable' costs which I would recommend instead of the CAJA provided services. for a serious condition.
Some areas of Puriscal, San Ramon, San Isidro de El General may suit your requirements.

Be sure you check your wife's ability to obtain insurance coverage and meds.  CAJA covers pre-existing conditions; the private national health insurance does NOT.  I have to maintain my private US health insurance for get adequate treatment for my diabetes.  What CAJA offers, I'm not willing to accept.  You shouldn't assume you can get the same drugs either;  I'm going to refer you to some friends of ours, Paul and Gloria Yeatman, who know a LOT about the healthcare systems in CR.  contact them through their website:  retireforlessincostarica.com  They live in San Ramon which is definitely a place that would meet your criteria.  San Isidro de General itself is low in a valley but surrounded by high mountains and we like that area too.  Don't know anything about Pursical.

I have just such a property (distant ocean view) that is near San Ramon. As for medical care of the type you speak of though, I can't say for sure. They do have a hospital in San Ramon and quite a few doctors.
Of the places mentioned - San Ramon, Puriscal and San Isidro - I think San Ramon is best for anyone with a medical condition.

Why? Because it is a faster/ easier trip to San Jose' should you need hospital or care there, like for a special problem or condition. That's one reason we chose San Ramon over San Isidro and Puriscal. Puriscal is relatively close but that long winding road can be slow and not fun. San Isidro - love that area but the long trip to San Jose' is a bear! From San Ramon it's a quick mostly-freeway trip to San Jose and the airport is even closer.

Also the fact it is 45 min or so from the airport should you need to get back to the USA in a hurry like for a major operation or ? I mean from what I hear  Costa Rica private hospitals are just as good if not better than the USA but I have heard of people saying they wanted to go back to the USA to be treated.

As riggadeaux said, check everything re medical care out very carefully before moving there. Don't assume anything, get the facts first hand. That said, I imagine that  Costa Rica will have more to offer than Ecuador or D.R. in this regard.

You can contact Premiere Medicine for an estimate:
premiere-medicine.com

I think this may have been answered before but I can't remember so I'd appreciate if someone would reply with an answer:

When applying for permanent residency we are not allowed to get CAJA, right?
But we are not required during the application process to have any particular insurance, correct?

Once we are approved for permanent residency, as pensionados, we are then required to pay for CAJA EVEN THOUGH we also have private insurance? Is that correct?

"When applying for permanent residency we are not allowed to get CAJA, right"?    WRONG!!  I think you may mean 'Temporary residence'. It will take approx 5 years from your initial application to get Permanent resident status.

Once you have received the 'final resolution' saying that you have been approved, you then go to your local CAJA/CCSS office and apply for coverage. You will be provided with a temporary carné de seguro, identification. The paperwork and paid initial receipt must be taken to your final interview, when you will then be photographed and fingerprinted for your cedula. After this you return to the CAJA office and you will be given a carné de seguro 'booklet' which you must take when going for any treatment plus the most recent copy of a paid receipt.

CAJA is  mandatory for all expats unless they are approved for citizen ship, if they so desire after living here for 7 years. Obtaining citizenship could take a further 2 years.
However, if you have obtained residency due to marriage or birth of a Costa Rican citizenship, you can apply after two years .
You are not required to provide proof or to have additional medical coverage while waiting for approval.

kohlerias wrote:

"When applying for permanent residency we are not allowed to get CAJA, right"?    WRONG!!  I think you may mean 'Temporary residence'. It will take approx 5 years from your initial application to get Permanent resident status.

Once you have received the 'final resolution' saying that you have been approved, you then go to your local CAJA/CCSS office and apply for coverage. You will be provided with a temporary carné de seguro, identification. The paperwork and paid initial receipt must be taken to your final interview, when you will then be photographed and fingerprinted for your cedula. After this you return to the CAJA office and you will be given a carné de seguro 'booklet' which you must take when going for any treatment plus the most recent copy of a paid receipt.

CAJA is  mandatory for all expats unless they are approved for citizen ship, if they so desire after living here for 7 years. Obtaining citizenship could take a further 2 years.
However, if you have obtained residency due to marriage or birth of a Costa Rican citizenship, you can apply after two years .
You are not required to provide proof or to have additional medical coverage while waiting for approval.

I meant "while applying for Temporary Residency". I said it wrong because here in the U.S. you apply for permanent residency, and part of the process is that you GET temporary residency...

So we are not allowed to get CAJA until our Temporary Residency is approved, correct?

So no matter what better insurance you may have, you still have to pay the CAJA for that insurance. That's worse than the USA. Here you only have to show proof of one or the other; i.e. you don't have to buy Obamacare if you have a private insurance policy. But then again, Obamacare is a lot more expensive than CAJA.

So we are not allowed to get CAJA until our Temporary Residency is approved, correct?

Right, you cannot purchase coverage thru CAJA until final approval is given.

So no matter what better insurance you may have, you still have to pay the CAJA for that insurance. That's worse than the USA. Here you only have to show proof of one or the other; i.e. you don't have to buy Obamacare if you have a private insurance policy. But then again, Obamacare is a lot more expensive than CAJA.

Yes...and you are still likely to either purchase additional for private insurance or 'pay as you go' due to 'wait times for treatment' or due to the possible shortcomings of your local facilities.