Panama Health Insurance
The complete guide!

How does the state health insurance system work?

MINSA operates public sector healthcare and the Caja de Seguro Social covers public health insurance. Both currently offer only basic coverage and many expats opt for private coverage instead, or choose to pay out-of-pocket. Health insurance is not compulsory, but it is estimated that around 3.49 million people are in fact covered, out of a population of 3.9 million. Of these, 1.6 million are actual contributors, while 1.8 million are dependents.

Panamanian health insurance operates on a reimbursement model and if you are covered 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 the public hospitals, especially when compared to the USA, but it is becoming more expensive (expats have quoted $20 for a GP visit and $60-65 to see a specialist). A hip replacement, for instance, will cost you $5000. Cataract surgery has been quoted at around $2000.

In addition to public insurance policies, Panama also has Health Maintenance Organisations (HMOs). These are medical insurance groups that provide health services for a fixed annual fee. Discount care plans run by individual hospitals are also available throughout the country. There are no age restrictions or 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.

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Who is eligible for state healthcare?

Everyone who is making contributions into the social security system, whether employed or self-employed, will be eligible. Panama is aiming at universal coverage.

How do you apply to join the state health insurance system?

If you are employed, your employer should register you with the CSS, but check that this has been done.

It is also possible to make voluntary contributions into the national health insurance schemes, for example, if you are self-employed. To do this, you will first need to contact the CSS. They may need to see the following documents:

  • personal identity card, 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, contact the CSS and check if it is possible to pay contributions into the system on an independent basis.

What is covered by the state health insurance system?

The state health insurance schemes cover:

  • general and specialist care
  • surgery
  • hospitalization
  • laboratory and X-ray services
  • medicine
  • maternity care

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. However, there is no provision for parental leave in the country.

Panama has plenty of pharmacies and you should have no difficulty accessing prescription 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 a retiree, check with the pharmacist if you are entitled to a pensioner’s discount.

If you opt to sign up with a hospital discount plan, costs will vary between institutions but can be as low $18.00 per month and can include benefits such as 100% reimbursement for emergency room services, 70% reimbursement for diagnostic tests, and 50% reimbursement for routine screenings.

Are retirees covered by state medical insurance?

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 visits to the doctor, hospital stays, and prescription drugs. The Pensionado discount applies to Panamanians; expats with a Pensionado visa; or expat women who are over 55 or men who are over 60 who have a residency visa.

Are students covered by state medical insurance?

As an international student in Panama, you will need to take out private cover. Some institutions insist that you provide proof of coverage when you enroll, and some, such as the Florida State University in Panama City, provide their own contracted health insurance. Otherwise, some stipulate that your home health insurance complies with certain requirements: for instance, that it is compliant with the Afforable Care Act if you are coming from the USA.

Will your family be covered by your insurance?

If you are covered by the CSS, your insurance will include your dependents.

Is dental treatment covered by state health insurance?

Basic dental care, dental prostheses and appliances are covered under the national scheme. You may also opt for private dental cover or to pay out-of-pocket. Panamanian dental care is of a high standard and relatively cheap. You will pay around $50 to get your teeth cleaned and under $1000 for a dental implant.

What are the contribution rates for state health insurance?

As an employee, your contributions will be paid by your employer and yourself, and deducted directly from the payroll. You will pay 9.25% of gross monthly earnings and your employer will contribute 4.25% of gross monthly earnings. If you are self-employed, you will need to pay 13.5% of your monthly salary to cover social insurance. If you are a public sector worker or private employee, and your gross monthly earnings exceed 500 balboas ($500), you will have to contribute another 8.16% of your earnings above that limit to your individual account.

The minimum earnings used to calculate contributions are 9,601 balboas ($9601) per year.

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.

Why buy private health insurance?

Although basic healthcare is cheap in Panama, costs can escalate if you have a serious illness or an accident. Public and private healthcare are of a high quality in the cities, but public hospitals can also be crowded, with long waiting times.

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 choose to opt for private cover, for speed of access and added comfort. Some plans, for example Cigna Global, will also give limited coverage for the USA as well as Panama.

You will need some or all of the following documentation to sign up with a local private 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, while women may need a recent mammogram
  • proof of residency or documentation to show that you live in the country for 10 months per year
  • Remember to check with your insurance provider if you require any pre-approval for surgery or major treatments.

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What is covered by private health insurance?

Private health insurance will cover a full range of primary and secondary care, in addition to elective cosmetic surgery and more advanced dental treatment.

How much does private health insurance cost?

Your premium will obviously depend on factors such as your age and any pre-existing conditions, and on how extensive the plan is. For basic coverage, you can get a local plan as low as $30-$40 a month, or for slightly more advanced cover, $75 – 200 per month. You may however choose cover from one of the larger international providers, but remember to check if your local private medical institution will accept this.

Note that if you take out local health insurance rather than international cover, you are likely to need a medical examination first, which will cost in the region of $100.

Which companies offer private health insurance?

The main international insurance providers cover Panama, including:

  • AETNA International
  • Allianz Worldwide
  • AXA XL
  • Bupa Global
  • Cigna Global
  • Geo Blue
  • IMG Global
  • Pacific Prime
  • Pacifica Salud
  • PanAmerican Life Insurance of Panama
  • Worldwide Medical Assurance Corp

Glossary of health insurance terms

Caja de Seguro Social/CSS - the Social Security Fund

Ministerio de Salud (MINSA) - Ministry of Health

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