Health insurance and healthcare in Panama for expats

Medicare and most US health plans don’t pay for care in Panama. You need to arrange cover before you move, and your age and health history decide which options are open to you.

How healthcare in Panama works

• Private hospitals and clinics. This is what most foreign residents use. The main private hospitals are in Panama City, and David, near Boquete, has private hospitals as well. You pay directly or through insurance, at prices well below US levels.
• Social security (CSS). A public network for people who pay social security contributions, mainly employees and their families.
• Ministry of Health facilities. Public clinics and hospitals open to everyone for low fees. They are the only option in some rural areas.

Outside Panama City and David, expect clinics for routine care and a transfer for anything serious. From the beach towns that is an hour or two by road. From Bocas del Toro it can mean a flight.

The kinds of cover

• Private Panamanian insurance. Policies from local insurers cover treatment at private hospitals in Panama. They are usually the cheapest private option and cover little or nothing in the US.
• International insurance. These policies cover you in Panama and other countries, sometimes including the US at a much higher premium. They suit people who travel or want the option of treatment at home.
• Hospital membership plans. Some private hospitals sell their own plans that discount or cover care at that hospital. They cost less than insurance, cover less, and tie you to one place.
• Paying directly. Many residents pay for routine visits and medicines themselves and insure only against large hospital bills.

Residents of retirement age and Pensionado visa holders are also entitled by law to discounts on consultations, medicines and uninsured hospital bills.

What changes the price

• Your age. Premiums rise steeply after 65, and some insurers stop accepting new customers at a set age.
• Existing conditions, which may be excluded, surcharged or subject to a waiting period.
• The deductible you choose.
• Whether cover includes the US.

When to arrange it

Get quotes before you commit to moving, especially if you are over 65 or have a health condition. Buy the policy a month or two before the move so it is active the day you arrive. The short-stay visa for remote workers requires proof of health insurance that covers you in Panama.

What to ask a broker

• Which hospitals near where I’ll live accept this policy directly, without me paying first?
• How are my existing conditions treated, in writing?
• Up to what age can I renew, and how have premiums risen for people my age?
• Is emergency evacuation included, including transport from the interior to Panama City?
• Does the policy cover me on visits to the US?

Common questions

Is healthcare in Panama good?

Private healthcare in Panama City is modern, and many doctors trained abroad and speak English. Quality and choice fall as you move away from the capital and David. Public hospitals are cheaper and more crowded, with longer waits.

Can I use Medicare in Panama?

No. Medicare generally doesn't pay for care outside the United States, so you need other cover while you live in Panama.

Can expats use Panama's public health system?

The social security system covers people who pay contributions, mainly employees of Panamanian companies and their families. Most foreign retirees are not covered. Ministry of Health clinics and hospitals treat anyone for low fees, with limited resources.

How much does health insurance cost in Panama?

It depends mainly on your age, health and deductible, and whether the policy covers you outside Panama. Premiums rise steeply after 65. Get quotes at your actual age before you fix a budget.