What Quality Of Healthcare Can You Expect In Panama?
If you are living and working in Panama, you may be wondering what kind of healthcare you can expect to receive. This will depend to some extent on whether you choose to use the public or the private healthcare sector. We will look at all aspects of the Panamanian healthcare system below and consider some of your options.
Public healthcare in Panama
Panama is a relatively small country, and the quality of medical care there varies between urban centres, such as Panama City and David, and the more rural areas. You should have no difficulty in accessing a high standard of healthcare in the cities, but you may experience a lower standard of provision in rural parts of the country. Waiting times can be lengthy, for instance, and there may be a shortage of medical personnel.
Panama has a two-tier health insurance system, divided between a form of national insurance and the private sector. The public sector is funded by the Ministerio de Salud (MINSA) and the Social Security Fund (Caja de Seguro Social/CSS), using contributions from employers and employees. These operate separate facilities, and the Caja de Seguro Social also runs a pension fund.
Despite this national scheme, there is a big healthcare gap between the wealthy parts of Panama and the remote, poor, rural regions, as mentioned above. The maternal mortality rate for Panama is 70 deaths per 100,000 live births, for example. This means that the country ranks in the top ten in Latin America and the Caribbean for good maternity outcomes. Meanwhile, in some indigenous areas, the death rate is much higher, at 658 deaths per 100,000. This is comparable with Haiti, which has the highest maternal mortality rate in the Western Hemisphere. The discrepancy is due to poverty, poor diet, limited medical provision, and overall marginalisation of these communities.
According to the UN, the current infant mortality rate for Panama, in 2020, is 13.517 deaths per 1000 live births. This is a 2.21% decline from 2019. Infant mortality has been steadily declining in recent years.
In 2017, the main cause of death in Panama was cancer, with over 3,000 occurrences. Vascular diseases came second, accounting for 1,667 deaths, closely followed by coronary artery disease, with 1,623 deaths. As in many developing nations, the mortality rate from non-communicable diseases (NCDs) now outstrips that from infectious diseases.
Health authorities in Panama are thus looking at issues such as tobacco use, in an attempt to improve overall health in the country. However, this does not mean that infectious disease is nonexistent. Dengue fever, malaria, bacterial diarrhoea, cholera, Chagas’ disease, rabies, and hepatitis A are all present in the country.
Healthcare costs in Panama are significantly lower than in the US. Out-of-pocket care is still cheap in the public hospitals, especially when compared to in the USA. However, it is becoming more expensive. For example, expats have quoted $20 for a GP visit and $60 to $65 to see a specialist. A hip replacement will cost you $5000. Cataract surgery has been quoted at around $2000.
In addition to public insurance schemes, you will find Health Maintenance Organisations (HMOs). These are medical insurance groups providing health services for a fixed annual fee and discount care plans run by individual hospitals. There are no age restrictions, no deductibles, and pre-existing condition coverage will commence after your first year. Some discount plans will cover 85% of your medical costs.
If you are a member of the US military, you may also be eligible for Tricare, which is a benefit rather than insurance per se.
The state health insurance schemes cover:
- General and specialist care
- Surgery
- Hospitalisation
- Laboratory and X-ray services
- Medicine
- Maternity care
- Basic dental care, dental prostheses and appliances
In short, Panama has a good standard of public healthcare in urban areas. There are also a reasonable number of English-speaking personnel, since quite a few medics from Panama have either trained or worked in the US.
You may have difficulties in finding an English-speaking doctor, however, if you’re living in a remote area. You may also need to travel quite a distance to reach your nearest hospital. Depending on your age, health and fluency in Spanish, these factors may prove challenging.
Most expats opt for private healthcare, due to issues in the public healthcare system, such as lengthy waiting times.
Private healthcare in Panama
Panama is currently a destination for medical tourism. Hospital Punta Pacifica, for example, is a partner institution to the Johns Hopkins Medical Center in the US. The private sector comprises four large hospitals – Hospital Nacional (HN), Centro Medico Paitilla, Hospital Punta Pacífica (HPP), and Clínica Hospital San Fernando (CHSF) – and a limited number of smaller health establishments.
You may opt for private cover, for speed of access and added comfort. Some plans, such as Cigna Global, will give limited coverage for the USA, as well as Panama.
Expat patients report that private medical care is generally good, but not all private clinics offer the same standard of provision as you might find in the USA. Do not be afraid to ask for testimonials and references, and contact the expat community for recommendations. Your health is very important, and endorsements and warnings from other expats could prove helpful.
You may be better off taking complicated medical issues to the US, but you will need financing for this. A Panamanian health insurance plan costs about $145 a month for a couple in their 60s, and this will pay between 50% and 70% of most healthcare expenses. You will not need to pay for prescriptions, and you will also be eligible for discounts on things like healthcare services. Many expats, however, prefer to opt for fully comprehensive coverage with one of the big international providers.
Check with your clinic of choice that they accept your health insurance, and ask your insurer whether you need pre-approval. Check, too, to see what form of payment your chosen clinic would prefer. Some may offer a reduction for cash payments. You can also pay out of pocket – healthcare costs in the private sector are cheap compared to in the USA, although be aware that they can add up.
Prescriptions In Panama: What Is Available And How To Ensure You Get The Right Level Of Care
Healthcare in Panama is of a good standard, and there are numerous pharmacies across the country. You should therefore have little difficulty in accessing your prescription medication. There are restrictions on some drugs, however, as mentioned below.
What is available?
Panamanian drug laws are strict. If you have any queries about your prescription, contact immigration before you land. Take your medication with you in its original packaging, and take your prescription, too. Expats have reported difficulties in taking medication into the country in recent years.
You may find it difficult to buy antibiotics, sleeping tablets and strong pain medication over the counter, and you will need a prescription from your doctor. However, in general, pharmacies (farmacia) are well stocked, and you should be able to access your medication once you have registered with a GP. Panama spends in the region of US$620 million per annum on pharmaceuticals and has recently revised its legislation in order to cope with any critical shortages.
The country has a number of chains, such as Arrocha, Metro X and El Rey. El Rey is part of a supermarket chain that has 24-hour provision. Pharmacists in these chains are said to be particularly knowledgeable.
How much do prescriptions cost?
Medication is significantly cheaper than in the USA, and over the counter and prescription remedies will not cost you a great deal. Ask your pharmacist whether there is a generic equivalent to your brand name medication, as these are usually cheaper.
Check with your individual insurance provider to see whether your medication is covered under your policy. If your health insurance covers medication, you will need to pay upfront. Ensure that you have a receipt (facture), and send this to your insurance provider for reimbursement.
If you are an expat retiree, you can opt into one of the Panamanian national health insurance schemes voluntarily, but you may also be eligible for a pensionado discount. This will entitle you to doctor visits, hospital stays, and prescription drugs. The pensionado discount applies to Panamanians, expats with a pensionado visa, and expat women who are over 55, or men who are over 60, who have a residency visa.
How to get the care you need
Make sure you register with your local GP when you arrive in Panama; you can find clinics online or in the phone book. As mentioned above, pharmacies are widely accessible. You will also find a number of independent pharmacies. In rural areas, these may dispense through clinics or doctor’s surgeries. Another option is to order your medication online. However, you should check with your doctor to see whether anything you require is on the restricted list.
Maternity Care In Panama: What The Options Are And How To Decide On A Birth Plan
If you are intending to give birth in Panama, you will need to make a decision early on regarding whether to use the public or the private sector. In general, the public system is of a good standard in the cities, but it may be less so in more rural areas. The private sector is of an extremely high quality. You should have few problems finding a suitable hospital or clinic in which to have your baby.
How to decide on a birth plan
A birth plan is a list of what you would like to have happen during labour and afterwards. It is written so that your doctor knows what your wishes and expectations are.
- Where do you want to give birth?
- Who do you want to have with you (e.g. your partner)?
- What kind of birth do you want (e.g. vaginal birth or a Caesarian)?
- Do you need any birthing aids?
- Do you want pain relief, and if so, what kind?
- What kind of birthing environment would you prefer?
Consult your obstetrician and your midwife regarding epidurals, which are available in Panamanian hospitals, along with other forms of pain relief.
Giving birth at home is allowed in Panama but is not common. If you want this kind of birth, consult your midwife.
Maternity care in Panama
You should have no difficulty in accessing a high standard of healthcare in Panama’s cities, but note that, as mentioned above, you may experience a lower standard of provision in rural and more remote areas. Waiting times can be lengthy, for instance, and there may be a shortage of appropriately trained medical personnel.
Experts report a large healthcare gap between the wealthy parts of Panama and the poorer regions. The maternal mortality rate for Panama is 70 deaths per 100,000 live births, for example, and this places the country in the top ten in Latin America and the Caribbean for good maternity outcomes. However, in some indigenous areas, the death rate is considerably higher, at 658 deaths. This is comparable with Haiti, which has the highest maternal mortality rate in the Western Hemisphere. The discrepancy is due to poverty, poor diet, very limited medical provision, and overall marginalisation of these communities. This is very unlikely to have an impact on you as an expat, but it is worth considering if you are resident in one of the more remote parts of the country.
As an expat mother-to-be, you will want to consider carefully whether to use the public sector or to go private. In either case, it is important to visit the hospital that you have in mind. Do not be afraid to ask questions regarding maternity provision and outcomes.
If you believe that you may be pregnant, your first port of call will be your GP. S/he will arrange the schedule of your prenatal care, which will include:
- Checkups
- Full blood tests
- Cervical smear
- Ultrasound scan
- Rh factor test
You are likely to have checkups every month, but you might have them every two weeks (or even weekly, later on in your pregnancy). In your 28th week, you should be scheduled for a glucose tolerance test (GTT), with more blood tests and a RhoGAM shot if necessary.
Ultrasounds will be conducted at week 12, week 20, and week 32.
You will need to choose a pediatrician, who will attend to you during the delivery. You can also consult a midwife (partera). Note that medical staff are often, but not invariably, bilingual.
Panama City has prenatal classes, but you may not find these in remote areas, which often keep to traditional methods of pregnancy and birth, although a midwife is usually involved.
If you are giving birth in the public sector, you will need to choose your hospital. If you have private insurance, it is possible that your provider will select the hospital for you, and they will need a deposit. Usually, you will be offered a variety of delivery packages.
Some expat mums have reported being pressured into C-sections, even when these were unnecessary. This is because there is a cost factor, as C-sections cost around four or five times the price of a normal birth – a normal birth is usually around US$1K to US$2K, whereas a C-section can be from US$5K to US$6K.
Some expats also say that they have been pressured to use hospital formula milk rather than breastfeeding, as some hospitals are tied into contracts with formula companies. As an expectant mother, you have quite enough going on without having to deal with this sort of thing as well, so if you feel that you need a patient advocate, make sure you set this up in advance of the birth. If you are uncertain about anything, get a second opinion from a doctor that you trust.
You are likely to find English-speaking personnel in the private sector, many of whom will have trained or worked in the States.
You are likely to be in hospital for a couple of days, but obviously this can be longer (three to five days) if you have had a Caesarean.
You will be scheduled for monthly checkups after the birth, which may become three-monthly checks after the first year. Some Panamanians hire a nurse after the birth. Panama City also has provision for postnatal classes.
In the case of maternity care, 100% of the insured person’s average earnings in the last nine months is paid for up to six weeks before and eight weeks after the expected date of childbirth.
Births must be registered at the Civil Registry in Panama. The hospital will do this automatically, but they will need the parents’ IDs (passports, residency cards), as well as two witnesses who are not related to the parents. You will be given the birth certificate at the hospital. In the case of a home birth, you will need to register the birth independently. This can be done either by yourselves, a grandparent, or a lawyer.
Will my baby be a Panamanian citizen?
The short answer is ‘yes.’ Anyone born on Panamanian soil is a citizen of Panama, and parents can apply for naturalisation for their child after three years of residency.
How To Register With The Health System In Panama
Panama has a two-tier health system, divided between the state sector, with a form of national insurance, and the private healthcare market. The public sector is funded by the Ministerio de Salud (MINSA) and the Social Security Fund (Caja de Seguro Social or CSS), using contributions from employers and employees. These operate separate facilities, and the Caja de Seguro Social also runs a pension fund. The private sector has a growing market share in the country, with the rise of medical tourism.
How does the Panamanian state health insurance system work?
Panamanian health insurance operates on a reimbursement model, and if you are covered by one of the organisations above, you and your dependants will be entitled to use the public, or ‘regional’, hospitals, clinics (polyclinicas) and social security hospitals, depending on the type of national insurance you have. You will be expected to pay upfront if you visit a healthcare provider, including for emergency treatment.
As an expat retiree, you can opt into a national scheme voluntarily, but you may also be eligible for a pensionado discount – this entitles you to doctor’s visits, hospital stays, and prescription drugs.
If you are employed, your employer should register you with the CSS, but check that they have signed you up for this.
Note that your social security payroll contributions will not actually fund your health insurance per se. They are designated for old age, social and disability insurance. The contribution made by the government is designated for health insurance and maternity cover.
It is also possible to make voluntary contributions into the national health insurance schemes, such as if you are self-employed. To do this, you will first need to contact the CSS itself. It may need to see the following documents:
• Personal identity card or passport or original permanent resident card
• Copy of your income tax return and your payment receipt for comparison
• Any other document that the CSS requires in coordination with the Ministry of Economy and Finance
• Probate card for the designation of beneficiaries and/or heirs
If you are not working and wish to make contributions, contact the CSS and check whether it is possible to pay contributions into the system on a voluntary basis.
In order to register with your local doctor, look online or ask your local expat community for recommended practices. Many Panamanian doctors have worked or trained in the US and are bilingual. The US Embassy has a list of English-speaking providers in the hospital sector here. Costs are quoted at around US$20 to US$30 for a session with a GP, but they can be less.
Similarly, you should be able to locate your local dental practice (which is likely to be a private one) online or through word of mouth recommendations.
Panama has a large number of pharmacies, and you will be able to access your prescription medication once you have registered with a local GP. You will need to pay upfront. Ensure that you have your receipt (facture), and send this to your insurance provider for reimbursement. If you are a retiree, check with the pharmacist whether you are entitled to a pensioner’s discount, as outlined above.
If you opt to sign up with a hospital discount plan, costs will vary between institutions but can be as low $18 per month. They can include benefits such as: 100% reimbursement for emergency room services, 70% reimbursement for diagnostic tests, and 50% reimbursement for routine screenings.
Private health insurance in Panama
The private healthcare sector in Panama comprises four large hospitals – Hospital Nacional (HN), Centro Medico Paitilla, Hospital Punta Pacífica (HPP), and Clínica Hospital San Fernando (CHSF) – and a limited number of smaller health establishments.
You may choose to opt for private cover, in order to receive quicker access and added comfort. Some plans, such Cigna Global, will give limited coverage for the USA, in addition to Panama. Alternatively, you could register with a local health insurance provider.
You will need some or all of the following documentation to sign up with a local provider:
• Application form
• Copy of passport, residency card, or cedula
• Medical history
• Medical exam in Panama by an approved network doctor; men need a recent PSA exam, and women may need a recent mammogram
• Proof of residency or that you live in the country for 10 months a year
Remember to check with your insurance provider whether you will need to get any pre-approval for surgery or major treatments. Check, too, with your chosen clinic to see whether they will accept your insurance and, if so, how you will be expected to pay.
How To Keep Your Health Insurance Costs Low In Panama
Panama has a two-tier health insurance system, divided between national insurance and the private sector. The public sector is funded by the Ministerio de Salud (MINSA) and the Social Security Fund (Caja de Seguro Social/CSS), using contributions from employers and employees. These operate separate facilities, and the Caja de Seguro Social also runs a pension fund.You may be registered with one of these organisations and be entitled to access public healthcare, but standards can vary considerably. For example, you will find more provision in urban areas. Most expats in Panama take out private cover. We will look at some of your options below.
Personalising your health insurance cover
If you are employed, your employer should register you with the CSS. It is worth checking that they have done this.
Your other option is to pay out-of-pocket expenses in the private sector. Remember, however, that costs can escalate rapidly if you have a chronic condition or need to see a specialist.
It is advisable to take out medical evacuation insurance as part of your policy. Panama has limited hospital provision, and you may find yourself having to fly north to seek treatment.
Selectable options
Check the small print of any private health insurance policy to see whether it covers treatments that you may want to access, such as specialist surgical treatment or more advanced dental care, like crowns or dental implants.
Remember to check whether your potential policy covers pre-existing conditions; the definition of a pre-existing condition will vary between insurers. Usually, the term applies to any conditions that present symptoms or for which you’ve been treated in the last five years. This normally includes any conditions you were diagnosed with over five years ago, but some insurers have different time limits on when the diagnosis must have been given.
You may also want to check whether your policy has a ‘hospitalisation’ clause covering you for occasional hospital visits. You may need to discuss this directly with your insurer. You may also wish to check whether there is a medical evacuation clause.
Take a good look at your potential policy for any cover relating to healthcare that does not apply to you. Some policies have provision for maternity care, for instance, and if you are not intending to become pregnant (or prefer to rely on the cover provided by the Panamanian maternity system), then you may wish to reduce your policy costs by having such options removed.
Cost sharing
You may also be able to reduce the cost of your premium through cost sharing. This is where you and your insurer share the costs of any treatment. You will pay up to an agreed limit, and your provider will cover the rest. Different insurers will have different ways of arranging cost sharing.
Co-pay: where you pay a fixed sum for your treatment and your insurer covers the rest. For instance, if the total cost of your treatment is €85, and your co-pay amount is set at €40, then you will pay €40 and your insurer will pay €45.
Co-insurance: where you pay a fixed percentage of the total cost and your insurer covers the rest. For instance, if your co-insurance is set at 20%, you will pay 20% of €85 and your insurer will cover the remaining 80%.
Deductibles: where you pay the entire amount allowed for all services provided until the deductible is met. For instance, if your policy has a €1,000 annual deductible, you would pay €85 for each visit to your GP for 11 visits (€1000/€85 = 11.8), after which your insurance would pay out to the doctor directly.
You may also need to take a look at whether there is an out-of-pocket maximum that you would be expected to pay after your deductible has been met.
Let’s say that your plan above, with a €1000 deductible, also has a co-insurance option of 20% and an out-of-pocket maximum of €1500. You will thus pay €85 for 11 visits to the doctor under your deductible until it is met. You will then pay €17 for each visit as your 20% coinsurance, until you reach the co-insurance ceiling of €500 (€1,500 minus the deductible of €1,000), or about 29 more visits (€500/€17 = 29.4). At that point (40 total visits in a year), you would pay nothing more for the remainder of the plan year.
It’s worth doing the maths, especially if you don’t think that you’ll need to make more than a couple of visits to your GP in any one policy period. For example, if you just want dental check-ups with an occasional filling, it might be worth working out whether one or two out-of-pocket costs might be cheaper than full dental cover.
As so many variables have an effect on the cost of international private medical insurance it becomes very difficult to give accurate estimates without knowing the full details of the coverage required. However, as a very rough guide, using a standard profile of a 40 year old British male with no deductibles, no co-insurance, a middle tier plan/product, all modules included and worldwide coverage excluding the US, a ballpark price of around £4,000/$5,000 might be expected. Were coverage to be expanded to include the US then the premium could increase to almost double that amount.
Panama Health Insurance
How To Move To Panama
How To Keep Fit And Healthy In Panama
If you are intending to live and work in Panama, you will be pleased to know that there are plenty of opportunities to keep fit and healthy there. Sports are popular. The country’s national sport is baseball, and the national team is highly ranked globally.Football is also popular, and the Panamanian national team, the “Marea Roja” or “Red Tide”, qualified for the FIFA World Cup for the first time in 2018. Panama were runners-up in the 2005 and 2013 Football Gold Cup, losing to the United States. Basketball is also highly regarded in the country, and so is boxing.
Panama also participates in the Bolivarian Games, which is a multi-sport competition involving athletes from Bolivia, Chile, Colombia, Ecuador, Panama, Peru, and Venezuela.
You will find a number of international sporting events in Panama, including the Gulf Coast Triathlon and the ocean to ocean Panama canal cayuco (canoe) races in March-April.
Cricket is popular, and there is a Panamanian Cricket Association. Batsman Geoge Headley, who played for the West Indies, came from Panama.
You will find many hiking opportunities in Panama, including mountain trails, such as those found on La India Dormida. These vary in difficulty, from the Chorro de las Mozas and Chorro el Macho trails to the more challenging La Piedra Pintada, and you will see some magnificent views and waterfalls along the way.
Panama City has the Metropolitan Natural Park at its centre, giving you the chance to do some jungle trails and to see some wildlife at the very heart of this urban environment. The jungle trails of the Soberania National Park allow you to experience the bird life of the country.
If you are planning on walking and hiking, make sure you take plenty of water with you, as well as sunscreen, and it is advisable to take insect repellent and a hat as well. The country is very hot, and it is easy to become quickly dehydrated and to overheat.
You will also find opportunities for cycling in Panama, although the country does not have a national cycling route, so you will have to choose back roads or the Pan American Highway. Cyclists report that Panama City does not provide ideal conditions, with limited road space and very congested traffic. Road quality varies significantly, too.
Experienced cyclists recommend the Route to Santa Catalina, the Azuero Peninsula, and Bocas Del Toros. Touring cyclists can stay at camping sites or truck stops. Alternatively, you may want to look at Warm Showers Community, which is a free worldwide hospitality exchange for touring cyclists.
There are a number of golf courses across Panama, including the Lucero, the Mantarraya, the Club de Golf de Panama, which dates from the 1920s, and the 18-hole Buenaventura.
If you enjoy horse riding, you will also be able to find some riding holidays in Panama, including on the island of San Cristobal.
Since Panama has an extensive coastline, you will be able to go diving and snorkelling. You can also go jet skiing, paddle boarding and parasailing. Swimming is an option too, and there are some safe places to do this, such as Bocas del Toro. Panama is one of the few countries in the world in which you can swim in both the Atlantic and the Pacific on the same day. Exercise reasonable caution, however, if you are visiting a beach that does not have lifeguards. There have been a few sharks sighted off Panama City Beach.
Panama has been described as ‘a surfer’s paradise’, and you will find beach breaks from Punta Chame, El Palmar and Buenaventura. The Panama Bay is considered by experts to be great for bodyboarding and surfing, catering for all ages and levels of experience. Playa Venao, Azuero Peninsula, is a famous beach break and hosts international surfing competitions. The sea turtles’ home of Cambutal is also famous for its waves, and the island resort of Morro Negrito is well known, too. Santa Catalina, close to the National Park of Isla Coiba, has one of the longest beach breaks in Central America.
The above examples are just a few of the possibilities for surfing along Panama’s extensive coastline. You will find many more, but make sure that you are aware of local conditions, such as rip tides.
If you are planning to take part in any water sports, make sure that anyone you sign up with is licensed, if necessary, and qualified, and make sure that you have the appropriate insurance cover.
There are also a large number of spas and wellness centres in Panama. The Alta Vita Spa in San Francisco is a luxury Medi-spa and holistic wellness centre. The Spa at The Bristol offers a range of massages and other beauty and relaxation treatments, as does the Sortis Hotel Spa, which has a rejuvenation Vitality Pool and a champagne room. The Central Hotel Panama has secluded treatment rooms and a dry sauna. You will find plenty of gyms and fitness clubs in Panama, as well.
In addition to being able to partake in fitness and relaxation activities, you will be able to eat healthily in Panama. Panamanian food is mildly flavoured, and much of it is corn-based. Plantain and yuca are eaten widely, as is rice. You will find a lot of empanadas, tortillas and tamales. Seafood is readily available, which is unsurprising given that the country has such a long coastline.
If you are vegan, you will find a reasonably wide range of options in Panama. You may enjoy lentil soup, rice with pigeon peas and coconut, Hojaldre (a type of fried dough), and salads. You will find a number of vegan restaurants that serve international dishes, such as vegan tempura or pad thai.
Overall, keeping fit and healthy in Panama should present you with few difficulties, with plenty on offer in terms of exercise, relaxation and diet.
How Much Do Health Procedures Cost In Panama?
How much you will have to pay for health procedures in Panama will depend on whether you access the public or the private sector. If you are registered with the Social Security Fund (Caja de Seguro Social or CSS), your costs will be very low, but since the country is a growing market for medical tourism, with some excellent private clinics, you may wish to take advantage of your time there to access some treatment.Costs in Panama are significantly lower than in the USA, but some hospitals are affiliated with healthcare providers in the States. Hospital Punta Pacifica, for example, is a partner institution to the Johns Hopkins Medical Center. Hospital San Fernando is affiliated with the Miami Children’s Hospital, and Tulane University and Centro Medico Paitilla is a 166-bed private hospital that was founded in 1975 and is affiliated with the Cleveland Clinic of Ohio.
Panamanian health insurance operates on a reimbursement model. If you are covered by this, you will be entitled to use the public or ‘regional’ hospitals, clinics (polyclinicas), and social security hospitals, depending on the type of national insurance that you have. You will be expected to pay upfront if you visit a healthcare provider, including for emergency treatment.
Out-of-pocket care is still cheap in public hospitals in Panama, especially when compared to the USA, but it is becoming more expensive. Expats have quoted costs of US$20 to US$30 for a GP visit and of $US60 to US$65 to see a specialist.
In addition to public insurance policies, Panama also has health maintenance organisations (HMOs), which are medical insurance groups that provide health services for a fixed annual fee, and discount care plans, which are run by individual hospitals. There are no age restrictions on these policies, no deductibles, and pre-existing condition coverage will commence after your first year. Some discount plans will cover 85% of your medical costs.
As an expat retiree, you can opt into a national scheme voluntarily, but you may also be eligible for a pensionado discount. This entitles you to doctor’s visits, hospital stays, and prescription drugs. The pensionado discount applies to Panamanians, expats with a pensionado visa, and expat women who are over 55, or men who are over 60, who have a residency visa.
If you are a member of the US military, you may also be eligible for Tricare, which is a benefit rather than insurance per se.
Costs in the private sector are higher than in public clinics, but they are still competitive compared to in the USA. Medical tourism agencies say that costs for typical dental and medical surgeries are 1/4 to 1/3 lower than in the US and Europe. They also report that waiting times for surgeries are shorter than in Canada.
A knee replacement, for example, will cost you around US$12K (compared to around US$35K in the States). A hip replacement will cost you in the region of $5K, compared to up to US$57K in the US. A facelift costs $2.5K, compared to a minimum of $10,500 in the US. A breast lift costs $1,500 to $3K, in comparison to $4K to $9K in the US. Glaucoma treatment (per eye) costs $2,500, compared to $4,800 to $7,500 in the US.
Although Panama does not have many hospitals, due to the fact that it is a small nation, you will find a wide range of treatments. Specialties of Hospital San Fernando, for example, include:
• General surgery
• Orthopedics
• LASIK eye surgery
• Hip and knee replacements
• Gallbladder removal
• Gastric bypass
• LAP-BAND surgery
Panama is also a destination for dental tourism, with high quality treatment in the private dental sector and lower prices than in the US or Europe. Some sample quoted prices are:
• Veneers: US$550 to US$650
• Crowns: US$500
• Implant: US$1500 to US$2K
• Whitening: US$100
• Cleaning: US$25
• Fillings: US$30 to US$60
Some clinics in the private sector provide cutting-edge treatment, such as stem cell treatment for autoimmune disorders, but if you are intending to go down this route, note that recovery from your illness under these new treatments is not guaranteed. Do not be afraid to ask some hard questions regarding outcomes, and ask also for testimonials, references and proof of qualifications. No reputable provider will object to providing you with this information.
Check with your insurance provider to see whether a particular procedure is covered under your insurance, and check with the clinic to make sure that they accept your insurance.
Make sure you are aware of any hidden costs and that you discuss the full details of your treatment with your chosen clinic. If you are visiting the country specifically for treatment, check how long you will need accommodation for, as there may be follow-up appointments etc.
Dental And Ophthalmic Care In Panama: How To Find The Right Options For You
Public healthcare provision in Panama is generally of a good standard in urban areas, but less so in rural and remote parts of the country. You will find good provision for both dental and eye care in Panama, particularly in Panama City, and especially in the private sector.Treatment is significantly cheaper in Panama than in the USA, and Panama is currently an increasingly popular destination for medical tourism, with links to healthcare in the USA. Hospital Punta Pacifica, for example, is a partner institution to the Johns Hopkins Medical Center in the US.
How to register with a dentist
If you are looking to register with a local dentist in Panama, it may be worth asking other expats for their recommendations, especially if you are intending to have corrective or cosmetic treatment. Alternatively, you could find a local dentist online.
To what extent does national insurance cover dentistry?
Basic dental care, dental prostheses and appliances are covered under the national scheme, the Social Security Fund (Caja de Seguro Social or CSS). You may also opt for private dental cover or to pay out-of-pocket. Panamanian dental care is of a high standard and is relatively cheap. For example, it costs around $50 to get your teeth cleaned and under $1000 for a dental implant.
Accessing private dental treatment
As mentioned above, Panama is a destination for dental tourism, with high quality treatment in the private dental sector and lower prices than in the US or Europe. Some sample quoted prices are:
• Veneers: US$550 to US$650
• Crowns: US$500
• Implant: US$1500 to US$2000
• Whitening: US$100
• Cleaning: US$25
• Fillings: US$30 to US$60
Check for references, qualifications and testimonials. If your private policy covers dental treatment, check with your provider to see what is covered. Also, check with the clinic to make sure that they will accept your insurance.
Make sure you are aware of any hidden costs, and discuss the full details of your chosen treatment with the clinic. For example, if you are visiting the country specifically for the treatment, find out how long you will need accommodation for, whether there will be any follow-up appointments, etc.
Many medical personnel in Panama are bilingual, as they have worked or trained in the US, and you may find American medics working in the country as well. However, bear in mind that not everyone in Panama speaks English.
How to register with an optometrist in Panama
If you are looking to register with an optometrist, you may want to ask your local expat community for recommendations, or you could find a clinic online. There are independent opticians, and there are also small chains, such as Óptica López, which have a number of branches throughout Panama City and provide a full range of services.
To what extent does national insurance cover optical care?
National insurance only covers optical treatment to a very limited extent. For example, it will cover you in an emergency, if your eye is injured. Often, you will need to seek treatment in the private sector instead.
Accessing private eye treatment
Panama is a centre for optical tourism, and you will find a wide range of treatments available in the country, from corrective laser surgery to cataract treatment. Prices are competitive when compared to those in the USA. Contact individual clinics for quotes, as costs will obviously vary, but some sample prices are as follows:
• LASIK (both eyes): US$3750 to US$3800 (including hotel and airport pickup)
• Cataract surgery: US$2500
• Glaucoma treatment (per eye): $2,500 (compared to $4,800 to $7,500 in the USA)