Discover all about health insurance in Panama in our special feature
Panama, as a dynamic country in Central America, offers modern healthcare facilities and internationally recognized quality of care in its urban areas. However, it would be misleading to believe that healthcare costs in Panama are affordable, as within the local expatriate community, they are often compared to North American rates, where medical care is exceedingly expensive. As a result, expatriates from Europe may be unpleasantly surprised and are strongly encouraged to sign up for expatriate insurance in Panama to manage their budget and adequately cover healthcare costs in the private sector.
| Healthcare expenditure par capita and per year | $ 723 |
| Annual indexing of health care expenses | 9.7% |
| CFE hospitalization reimbursement rate | 67% |
| Number of insurance companies available | 15 |
| Annual cost of hospitalization coverage for a 30-year-old | € 672 |
| Cost of hospital coverage for people 50 years old /year | € 1284 |
Panama has an efficient three-tiered health system: 2 public and 1 private. Opinions on the public system are divided and summarized in the phrase "you get what you pay for." Depending on your health criteria, the public services you may eventually have access to may or may not suit you.
In most regions, access to healthcare is easy in Panama thanks to numerous public hospitals and private clinics. This stems from massive investments made since 2010, as well as the more recent growth of the private sector. The hospital facilities of the Caja de Seguro Social (CSS) and the private sector are equipped with state-of-the-art technology and high-quality equipment. Medical teams are also highly qualified, with most doctors having received their training abroad. This excellence is attracting more and more medical tourists.
Medical tourism has become one of the country's preferred development axes. Panama follows the example of Costa Rica before it, offering much more affordable rates than in the United States while providing impeccable quality of care. The most demanded specialties are orthopedic and dental care.
Health challenges in Panama include access to healthcare for populations in the most remote regions, the fight against endemic diseases (yellow fever, dengue, malaria), as well as managing the evolution of the obesity rate (60% of the population overweight according to the WHO in 2012) and cardiovascular diseases. The country also faces an increase in serious illnesses such as cancer. All of this represents a financial burden for a two-tiered public system, with the MINSA (Ministry of Health) and the CSS, and an opportunity for growth for the private sector.
In Panama, the quality of physicians is high, whether in the public or private sector. This is because doctors practicing in the private sector are required to fulfill a certain number of service hours in public hospitals. The main difference lies in the quality and modernity of ancillary services and facilities, favoring the private sector.
In the public sector, the usual rule is "first come, first served," and there is no option to choose your doctor, contributing to differences in the patient experience. Additionally, the sector is subject to many waiting times. Although hospital websites are only available in Spanish, many doctors are multilingual, especially in the private sector. Expatriates affiliated with the CSS regularly use public facilities for basic and non-urgent medical care due to their moderate fees. However, for major, urgent, or specialized treatments, they prefer high-end private hospitals and clinics.
Healthcare is not completely free in the public network of the MINSA, and only CSS affiliates have access to this secondary public network. In the event of hospitalization in the public sector of the MINSA, individuals must rely on themselves or their families for all needs related to nursing care, such as sheets and pillows for the bed, or even toilet paper and toiletries. The level of service improves slightly in CSS (CAJA) establishments.
If you value your comfort, privacy, and do not want to be subject to waiting times in the public sector, private healthcare facilities are the best option. About fifteen years ago, only 17.8% of healthcare expenses were covered by private insurance, with 82% of residents paying their bills out of pocket. Since then, healthcare needs have evolved, with patients demanding fast and high-quality services, which has greatly contributed to the development of the private sector and the use of insurance.
The four major private international hospitals are: the Hospital Nacional (HN), the Centro Medico Paitilla, the Hospital Punta Pacifica (HPP), and the Clinica Hospital San Fernando (CHSF). Evidence of the excellence of these establishments is that some of them are associated with large hospitals abroad, such as Hospital Pacifica affiliated with Johns Hopkins in the USA. HPP is the only hospital with a website in English. The hospital offers specific packages for medical tourists and has a hospitality section equipped with brand-new suites and operating rooms. If you need to visit this establishment, health insurance will be necessary.
Simpler and more accessible structures are also available, such as MiniMed clinics, specialized in primary care without appointments. Generally, for non-urgent consultations in the private sector, a "pre-admission" form must be completed, and your insurance details are required. If you do not have insurance, the consultation must be paid in advance. Doctor selection may be restricted if you have taken out local insurance that imposes its list of practitioners. Expatriate health insurance allows you the freedom to choose your doctor.
Receiving advanced treatments provided by quality medical personnel comes at a cost. In Panama, healthcare costs have evolved in parallel with quality, especially in the private sector. Nowadays, having health insurance is advisable to manage your budget effectively. It's important to keep in mind that the United States and Canada are considered the benchmarks for health costs. For Europeans, who are not accustomed to the astronomical prices in these countries, healthcare in Panama, especially in the private sector, may seem expensive.
It's worth noting that hospitals in Panama require a payment guarantee before initiating treatment, even in emergencies, and even if you are unsure of the final bill amount. It's crucial to remember that hospitalization for a major health issue can be excessively costly; ensuring the support of health insurance is paramount. Moreover, the private sector, with its high fees, is often the only alternative for expatriates who are not affiliated with the national healthcare system.
The cost of a specialist consultation in the MINSA network is around $ 50, while a visit to the emergency room ranges between $ 30 and $ 100. Prices are much higher in the private sector. For instance, an MRI costs at least $ 500, and an emergency room visit starts at a minimum of $ 100 but can reach $ 9,500 for a nighttime visit followed by surgery and a few hours of recovery in a hospital room. Regarding popular aesthetic procedures among medical tourists, a facelift costs approximately $ 1,700.
Prescription drugs may be more expensive than in Europe and as much as in the USA. Moreover, some expensive medications may not be available in the public MINSA or CSS networks. However, many common medications are readily available and can be obtained without a prescription, provided you know the names of the molecules and generics of your treatments.
Note that a prescription will be required for any reimbursement claim with your insurance. The teleconsultation options offered by expatriate health insurances can be very useful for prescription renewals, allowing you to be reimbursed without any issues.
Regarding dental fees, a dental implant in the private sector costs between $ 700 and $ 1,000, while basic dental treatments, such as a cleaning, can range from $ 20 to $ 100 depending on the provider. Evaluate your needs carefully to determine if optical-dental coverage would be beneficial for you.
Retirees are privileged in Panama, as in some cases, they can benefit from discounts of 20% to 25% on their healthcare expenses.
Maternity-related expenses can be quite reasonable in urban areas, with hospitals offering costs ranging between $ 1,200 and $ 2,500 for a 2-day stay. With a cesarean section, prices increase to reach $ 5,000 to $ 6,000. Private hospitals with comprehensive maternity services are located in Panama City, David, and Colon. It's not uncommon for establishments to insist on a cesarean section, as it can be more profitable for them.
Home births are quite common in Panama thanks to specific midwifery services. However, it's advisable to have a nearby healthcare center in case of complications. Once again, bills can skyrocket in case of birth complications for both the mother and the child; expatriate health insurance covers these emergencies and relieves you of the financial mental burden.
The Social Security System in Panama provides for the payment of maternity and paternity leave benefits for employees who contribute to the CSS.
If you are a EU citizen living in Panama, the Caisse des Français de l’Etranger (CFE) allows you to benefit from a French-style social security coverage for health. The health insurance provided by the CFE reimburses all types of expenses, such as medical, surgical, hospital, dental, optical, laboratory, and other services, within the limits of the rates and tariffs applied in zone 4 of the CFE.
The CFE operates as a primary reimbursement basis and does not cover all of your medical expenses. This limitation should be taken seriously in Panama, where the reimbursement base for hospitalization is only 31% of the total bill, and 45% for pharmacy expenses (which may be capped at the rates applied in France). Therefore, at least 69% of hospitalization costs and 55% of pharmacy costs remain your responsibility.
Depending on your needs and financial means, you have several options: use the local public system if you have access to it, opt for CFE coverage alone with the resulting out-of-pocket expenses, subscribe to a complementary plan with the CFE, or a first-euro contract. Supplementary expatriate insurance in addition to the CFE (or first-euro coverage) guarantees 100% coverage of your hospitalization expenses, regardless of the healthcare facility, and provides additional reimbursement for your routine expenses, particularly for those seeking high reimbursement rates in the private sector.
The CFE contribution is calculated based on your age and the number of people to be covered (individual or family). The CFE provides coverage internationally for its MondExpat members. Apart from the Youth contract, the CFE does not offer repatriation assistance.
There are two main players in public health coverage in Panama, which enable the country to offer almost universal health coverage.
The Ministry of Health (MINSA) administers public health for unemployed citizens and, generally, for all residents who are not covered by the CSS. MINSA has its own network, consisting of 18 hospitals and 844 health centers, spread throughout the country and with good representation in rural and indigenous areas. This public health system lacks funding and personnel, but remains the primary healthcare provider for the most vulnerable. Equipment is often aging, wait times are long, and the quality of service is very limited. The main hospitals of MINSA are Hospital Santo Tomas, Hospital San Miguel Arcangel, Hospital Oncologio, and Hospital del Nino.
The Caja de Seguro Social (CSS or CAJA) is Panama's social security fund that covers employees and voluntary contributors. Its funding comes from taxes paid by employees and employers, ensuring a better balance between CSS expenses and revenues compared to MINSA. The CAJA healthcare network consists of 80 hospitals and health centers. CSS health insurance covers doctor consultations, surgery and hospitalization costs, as well as laboratory and simple imaging fees, certain medical expenses, and maternity costs.
Contributions from insured individuals enable the CAJA to claim the best public health infrastructure, with modern equipment and better quality of service. CSS manages the country's largest hospital complex, Arnulfo Arias, as well as Susana Jones Hospital and Hospital de Especialidades Pediatricas.
The employer's contribution to Social Security is approximately 12.5%. The employer covers up to 18 days of sick leave per year. Beyond 18 days of absence, Social Security takes over. Companies also contribute between 0.33% and 6.25% for workplace accident insurance, as well as for unemployment insurance and retirement.
For expatriates, permanent residence in Panama is obtained after two years of temporary residence. During this period, if you are not employed and do not voluntarily contribute to health insurance, you must bear all your health expenses. In this case, expatriate health insurance ensures you good coverage.
Among the most well-known insurers in Panama are MAPFRE and Family Medical. The cost of local insurance varies depending on the age of the insured and the type of coverage desired, ranging from $ 50 to $ 125 per month. Basic coverage typically only includes emergency care, without coverage for preventive care (check-ups, routine visits) or chronic illnesses.
Panamanian local health insurances generally offer two types of coverage: coverage limited to hospitalization and an HMO-type coverage, with a specific network of care providers where rates are negotiated. Plans may include partial reimbursement of medical expenses, with an average coverage of 70% of costs, or discounted rates at affiliated healthcare providers.
It's important to note that local insurances commonly exclude pre-existing medical conditions! Moreover, there may be long waiting periods before approval for surgery. Additionally, annual coverage limits are often very restrictive and may lead to unpleasant surprises when facing health issues.
In Panama, individuals aged over 65 benefit from preferential treatment and dedicated rates. For example, a dermatologist consultation at Punta Pacifica costs around $ 65. Basic dental care is affordable, and laboratory fees are more economical when performed on Sundays. The exclusion of pre-existing medical conditions is a major issue for retirees seeking to purchase local insurance to cover their out-of-pocket expenses.
In the private sector in Panama, you will find the most qualified practitioners, the latest cutting-edge treatments, and the most modern facilities. This directly impacts the premiums and coverage of local insurances. It is crucial to carefully review the terms of your contract before signing up. For optimal coverage and a secure contract, expatriate health insurance is a preferred alternative to local insurances.
Panama offers quality healthcare in the public sector for employees through the CSS network, but its most efficient and high-performing healthcare sector is its private sector. If you are not employed or do not contribute to the CAJA voluntarily, you may not have access to these facilities, and the coverage conditions of MINSA could be too limited for an expatriate.
Healthcare expenses can be very costly in the private sector, especially in the event of serious medical issues such as illness or long-term hospitalization. Therefore, it is highly recommended to subscribe to expatriate health insurance, either as a complement to CFE or as primary coverage.
By choosing international insurance, you are covered worldwide, including in France if you wish to maintain a coverage base there. Expatriate health coverage is not limited to your country of residence; you are covered during occasional business or personal trips, such as vacations in Mexico or Costa Rica.
Furthermore, unlike local insurances, no network or healthcare facility is imposed on you with an expatriate health insurance plan. A contract with expatriate health insurance allows you to access the four most renowned hospitals in Panama without difficulty, such as the Punta Pacifica Hospital.
Purchasing an expat insurance in Panama can be done at any time. International insurance offers flexibility, allowing you to choose coverage options that meet your needs and are adapted to the level of healthcare costs in your expatriation country. The guarantees offered are similar to those you are familiar with, eliminating uncertainties related to local operations.
However, it is important to note that the enrollment procedures for expatriate coverage are generally more complex than for a traditional health insurance plan. Therefore, it is recommended to subscribe at least 30 days before your departure. This allows you to settle in peacefully, without worrying about health issues, and to address any incidents or accidents that may occur upon your arrival in Panama.
To sign up to expat insurance, you need to complete a health questionnaire. A medical advisor must review it before providing you with feedback, which may result in additional processing time for your enrollment request. You may also be required to provide additional medical documents or have a form completed by your physician.
On our website, you have the option to conduct online simulations to obtain quotes and compare coverage. This helps you form an opinion and choose the insurance that best suits you.
Our advisors are available to refine proposals with you, guide you through the enrollment process, and support you throughout the lifespan of your contract. They are here to answer your questions and navigate you through the world of expatriate insurance.
If you contribute to the CSS, you benefit from almost free coverage in this public network. However, it is essential to keep in mind that healthcare costs in Panama remain relatively high. Moreover, if you prefer to be covered in the private sector, to have freedom in your choice of providers, and access the best services and facilities, it is strongly recommended to subscribe to an expatriate health insurance plan that covers your hospitalization and medical expenses.
The minimum recommended coverage in Panama for an expatriate is hospitalization coverage and repatriation assistance. This option ensures comprehensive hospital coverage in the private sector, in addition to routine or non-urgent care received in the public sector (especially for CSS affiliates). This is especially advisable for expatriates who are not affiliated with the local social security system, as hospitalization represents a considerable financial risk in Panama. Furthermore, due to its geographical location, a repatriation assistance option will be justified in the event of a serious medical problem.
If you have regular optical or dental needs, you can also select a plan with optical and dental coverage, but make sure this option is truly justified as it comes with a cost. In Panama, some basic dental care remains affordable for expats.
For expectant mothers who are not covered by the CSS, it is recommended to subscribe to maternity coverage to cover childbirth expenses in a private clinic, as well as in case of complications (which can be very costly). Given the waiting periods of 9 to 12 months, plan to add this option as soon as possible (from the start), especially if you have a short or medium-term family planning. Indeed, no insurer covers pregnancies that have already begun, including the CFE.
Due to the country's geography, medical evacuation is essential in Panama, despite the local quality of care. Repatriation assistance guarantees transportation to the most suitable hospital for your situation, especially if you reside outside the capital Panama, or to your home country if necessary.
Repatriation assistance also provides "comfort" services particularly useful in times of hardship. This may include covering the travel expenses of a relative who would come to your bedside, organizing childcare or transferring your children, as well as providing access to medical advice and consultations, etc.
As a reminder, in the event of a medical emergency, neither your embassy nor your consulate is responsible for organizing or covering your medical repatriation. If you prefer not to handle the bill alone (which can reach €50,000, for example), the option with repatriation assistance and hospitalization coverage is the minimum recommended for any traveler or expatriate in Panama.
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