Just wanted to give a bit more info about costs... I have a colonoscopy schedueld for this weekend and it will cost $360 and a mamogram is about $70. A general office visit costs around $45 and I just bought an additional insurance for about $16 a month from INS (Instituto de Seguro Nacional) which should help reduce some out of pocket costs on some procedures. It is much more affordable to pay out of pocket in Costa Rica.