Cost of living comes up a lot. The short answer is "you have more options". I will try to explain those options and then you can pretty much pick your cost of living.
Food
In this area I hear the most "it is more expensive" cries from people who moved here from Gringolandia. For example, I know a person who orders virtually all his food on-line, in cans, and has it shipped here. He spends a lot of money on food. Living in the tropics where food literally grows on trees, this seems strange but it certainly is an option..
You will have no trouble finding a way to spend more money on food yourself so let me address the low-end options. Obvious ones are beans at Q5/lb. and tortillas at 4 for Q1 but there are lots more. Here are a few:
I am "almost vegetarian" but do eat seafood so you will have to check out your own dead animal prices.
If you eat in restaurants there are prices all over the map -- as you would expect. I have other posts about various things such as cheap breakfasts so read them. In general, you can find breakfasts starting at Q10 and lunches at Q25. There are lots of more expensive options and many are well worth it.
Energy
The big difference here is not the cost but the requirements. First, is heating and cooling. When I left Seattle in January 2002 I have spend zero on heating or cooling beyond the occasional use of a fan. In a house with reasonable thermal mass and windows you can open and close, no issues.
The least expensive energy for cooking is gas. Expect to pay about Q100 for 25 lbs. of gas. How long that lasts depends on how much you cook, of course, but for us it is usually 2 to 3 months.
The same goes for hot water. We used 100 lb. cylinders of gas in our bed and breakfast and a flash water heater. The 100 lbs. lasted from 1 to 4 months, depending on how many guests we had.
Electricity is a bit over Q2/kwh. In the bed and breakfast we had bills from Q200 to Q800 per month -- much of that attributable for five refrigerators and a freezer running. Lighting was minimal as most of our lights were LED and 12-13 hour of daylight minimize lighting needs.
Health Care
Here you have choices the cheapest being accept the free care that is available in Centros de Salud and public hospitals. My daughter had an appendix operation and a C-section in the public hospital. The scars are not pretty but it worked.
Beyond that (and I recommend beyond that) there are lots of clinics, doctors, hospitals and options. I don't know the prices but I would guess 1/4 a U.S. price or less for hospitals and "amazingly cheap" for quick consultations.
There are insurance plans available. The one data point I have is called Salud Siempre. Their basic plan for senior citizens is Q830/month. My opinion is that when you are shopping find something local. Something associated with a big U.S.-based insurance company will generally have big U.S-based prices.