From the outside the careful clinic and the careless one look identical. The difference is in the answers to eight ordinary questions.
Longevity medicine is new enough here that the good and the careless look alike from the outside. Both have a website, a doctor's name and a panel of tests. The difference shows up in the answers to a small number of ordinary questions, and a clinic working inside the rules can answer all eight of these without hesitating.
None of them is hostile. Most of them are questions the Ministry of Health has effectively already asked on your behalf.
A name is not an answer. Only a physician registered with the Colegio de Médicos y Cirujanos may prescribe, the register is public, and the number lets you check. If the clinic's clinical face is a nutritionist, a trainer or a coordinator, ask who signs the prescription and whether you will ever speak to them.
The regulator's requirement is a prescription that follows an individual assessment. In practice that means bloodwork before medicine, not alongside it. A clinic that can tell you a price for a treatment before it has seen a single result has reversed the order of the work.
This is the question that separates a clinic from a sales channel, and it is worth asking plainly. Sometimes the right outcome of an assessment is that nothing should be prescribed. Ask what that visit costs, what you leave with, and whether the fee is the same either way. If the economics only work when you accept a prescription, you already know which way the judgement will lean.
Three facts, demanded by name in the Ministry's October 2025 warning. A provider who cannot give all three is not offering you a registered medicine. Ask also where it is dispensed — a licensed pharmacy, or the clinic's own fridge — and how the cold chain was maintained.
Magistral preparation is legal in Costa Rica: a licensed pharmacy may compound a medicine for one named patient against one individual prescription. What is not legal is compounding to hold stock, selling at scale, or advertising the compound to the public. So the question is not "is it compounded" but "was it compounded for me, by whom, and against which prescription". A catalogue with photographs and a price list is the wrong answer.
Commercial arrangements between clinics and suppliers are common and not in themselves improper. What matters is that you are told, and that the arrangement cannot change what is prescribed or how much of it. Ask directly. A clinic that discloses an arrangement is easier to trust than one that has no answer ready, and the follow‑up question is better still: does anyone here earn more if I take more?
Starting a medicine is the easy half. Ask what is retested, at what intervals, who reads it, and what finding would lead to stopping or reducing. A clinic with no stopping rule has not thought about the second year.
Under the teleconsultation regulation, the clinician is custodian of your clinical record and your consent has to be informed and revocable. You should be able to leave with your results, your consultation notes and your prescriptions, in a form you can hand to another doctor. A clinic that makes leaving difficult has told you something about how it thinks about patients.
These questions help you judge a clinic. They do not help you judge a treatment — whether you need one, and which, depends on your own measurements and history, and is a conversation with a physician who has seen them.
Every patient starts the same way: thirty minutes with a physician, then a full biomarker panel drawn at a laboratory near you. Whether any medicine follows is your doctor’s decision, made after reading your results with you.
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