Considering Panama For Retirement? Part 2

In this post I will visit some observations related to healthcare. These observations are strictly based on my experiences in Chiriqui. Being a Warden for the U.S. Embassy and visiting U.S. Citizens in the local hospitals, I see some things that others never see.

Things will be a little different in Panama City. There will be more healthcare options there, but most of the options will also carry a higher price tag.

If you are considering Panama because of the rising healthcare costs in the U.S. Then in many cases you may not find any improvement in Panama. Healthcare is sort of a mixed bag. This is one area when it is very good to have Panamanian friends to help advise you on the doctors to chose and use or not choose and avoid. It is also a good idea to get references from foreigners as well, because those may be different than locals. It will be up to you to determine who to believe.

The capability of the healthcare system in Panama is pretty high. However costs are getting higher and the increase of foreigners coming to Panama with insurance plans are helping the price to increase. If you chose the wrong doctor you may be viewed more as a dollar sign than a patient.

This is not a general statement of all doctors, but there are more falling into that category every day. This is why you need to an experience base of other users to know which doctors to use and which ones not to use.

I find general healthcare to be reasonably priced. If you have a cold, break an arm, need lab work done, or have a physical then you should be pretty happy with the prices. You can go to many general practitioners for about a $6 office visit. That is the same if you use the doctor on call in Chiriqui Hospital. I also find that dental and eye care are reasonable compared to the U.S. A specialist will be around $30 for an office visit and you may have to wait a couple hours to see the doctor. That is better than the U.S. Where you may have to get an appointment a couple weeks latter.

It is when you get into the area of needing an operation that things can start getting dicey. While the capability of doing most operations should be adequate, the costs may not be much better than those in the U.S. If you have no insurance, it may be worse. Medicare is not accepted in Panama.

I will give you a recent example. One of the U.S. Citizens I have gotten involved with is currently in the Regional hospital. He has a colonoscopy in the Chiriqui Hospital that discovered a couple problem areas. He underwent surgery which resulted in a temporary external bag until the surgery healed. He was in the Chiriqui Hospital for less than a week when it was decided that he should be transferred to the Regional hospital to have reduced costs. His short stay plus surgery was around $26,000.

One of the expenses is a hyperalimentation intravenous feeding that is needed since he can’t have solid food until his colon heals and the external bag is removed. My understanding is that he was told the feeding would be $1,500 a day in Chiriqui Hospital and $500 a day in the Regional Hospital. He has been in the Regional hospital for over a month now without a clear understanding of when he should expect the next operation to get him on solid foods.

Let me tell you, being in the Regional hospital for over a week is a test of one’s nerves and a month can drive one crazy. He is now wondering if it is possible to get transferred to a U.S. Hospital, but that is a little tricky because of his condition and being hooked up to intravenous feeding. Had he spent the money to go to the U.S. to do the original surgery, he would most likely have recovered by now. That is my opinion, not one based on anything other than watching how things go here.

He wanted to get transferred out of the Regional Hospital to the Mae Lewis Hospital and Mae Lewis wanted a $50,000 deposit before they would accept him.

I have had people tell me that, in the last five years, healthcare costs have increased five fold in Chiriqui. I have nothing to back that up, but I know things have gotten much more expensive

Now to complicate things more, you have to consider where you live and the location’s effect on your potential healthcare needs. For general care you can probably get reasonable care in Boquete, David, Bugaba and Volcan. However if you have a serious problem, such as a stroke or heart attack or a bad car accident, you will most likely have to come to David for immediate treatment. In some cases, it may be recommended that you go to Panama City. My understanding is that a detached retina cannot be taken care of outside of Panama City.

If you happen to have this need for treatment during one of the times when a protest is going on and the roads are being blocked to all traffic you may not be able to get to David, let alone to Panama City. If you are in Boquete or Volcan or in a more rural area, late at night during the rainy season, getting to a hospital without a protest going on will be a challenge.

All of these considerations are things you need to add to your list when making your decision to move to Panama. General expenses of living are one thing, but the price of staying alive is another.

Having Panamanian friends cannot be over emphasized. One recent case I know of was a gringo who was attacked and stabbed several times in the chest. His next door neighbors found him and got him to the hospital and stayed by his side in the hospital until he had recovered and was released. I do not think I have met a gringo that would spend the night in the Regional hospital caring for a friend. If you have ever been in the Regional hospital, you will know what I am talking about.

If you are planning on moving to Panama and have a health condition, evaluate your move very carefully. Insurance in Panama is just as necessary here as it is in the U.S. You may think that you will come and take advantage of the normal healthcare needs at a cheaper rate and return to the U.S. for a critical operation, but the question is will you be able to get back to the U.S. In time? Do you feel lucky? Well, do you?

Hindsight is 20/20, but there are some things where you can’t wait for hindsight.

I have just scratched the surface of this topic. I could write pages, but this should stir up enough concerns and I am certain that some comments will add to the picture.

15 thoughts on “Considering Panama For Retirement? Part 2

  1. I would like to question the statement that “Medicare is not accepted in Panama”. I was registering at the hospital in Panama City. The administrator was telling me about the co-pays when she stopped to ask if I was on Medicare. When I said “yes”, she said there would not be any co-pays. She also made a copy of my Medicare card.

  2. As far as I know you cannot get covered by any insurance program to replace a pacemaker. Dr. Calzada in Panama City, who checks mine every three months, says it would cost about 6000.00. When the time comes I have to go to a VA hospital in US to get a replacement for the cost of an airline round trip ticket of about 600.00 if I get it early enough.

  3. Dave,
    Please follow up o the medicare question. The SSA told me medicare would not cover anything outside of the USA.

  4. That is true. I asked SSA and several “add on” plans here. Everyone in the States told me Medicare was only good in the States. I was very surprised when I registered in the hospital. One addition to what I said previously, when she said there would be no co-pays, that was if I had Medicare part “B”.

  5. Don Ray:
    As always you are right on the money. It is sad but true, some irresponsable MDs and clinics just see many gringos as a dollar sign. But still you find some honest and decent doctors out there.
    Jaime

  6. Dave,
    I am Canadian, but have a good friend from Oregon that lives in Panama City. About 2 months ago he had to have an operation on his liver. When he registered at the hospital, he too was told his Medicare would cover things. The day after his operation, and a week before he was to be released he was given a bill for $17,500, and told further charges would be coming. He was told that the Medicare did not cover him. He was given 24 hours to come up with the money or they threatened to put him out of the hospital. I do not know it they would really have done this, but he used up a lot of his savings and paid the bill. The 6 extra days in hospital cost him another $4600 which he had to pay before he left.
    I know in my case, I am getting as much info as I can, in writing from my medical plans here in Canada to see for positive what is, and is not covered.
    P.S. My friend still loves Panama though, and will stay, but says anything serious, and he will go back to the US for help.
    Don, this series of blogs will again be of great help to all people that are looking to move to Panama. I wish we had a Warden that kept us so up to date, and helped so much.

  7. It is very interesting to me at this point where the Gov’t in Panama is considering a trade agreement and releasing all the information on bank accounts, etc., BUT, nothing, AT ALL, has been mentioned to have the Medicare or other health insurance AGREEMENT. Everything here is Gringo $$$$ that we don’t have…except limited income they is disappearing … We moved here because of information sent to us by realtors and the good life and thought that it would be less expensive…. They never mention the problems.

  8. Hi Don Ray,
    I think Hospital Mae Lewis requires a $5,000 deposit, not a $50,000. Their prices have increased considerably over the last 10 years but they are, in my humble opinion, far less expensive than Hospital Chiriqui (which I have read is THE most expensive hospital in Panama). My husband was transferred to Hospital Chiriqui from Mae Lewis for surgery, as the only surgeon capable of performing angioplasty/stent insertion (outside of Panama City), works exclusively from Hospital Chiriqui. The surgeon’s fee was extremely reasonable I thought ($3,500), whereas Hospital Chiriqui’s charges were way out of sight — $9,000 plus for less than 24 hours in the hospital – then they would not transfer my husband back to Mae Lewis before the bill was paid. Subsequent dealings with Hospital Chiriqui while trying to obtain my husband’s medical records and letters confirming treatment for submittal to our insurance, took weeks and many visits. My requests were never met with a helpful attitude or any form of customer service – rather it was “we have your money, hard luck”. (I would add that the Directora Administrativa has a very superior attitude and definitely had the ability to “disappear rapidly” into suddenly called and emergency “reuniones” whenever she saw me approaching through the glass caja window.)
    Joseph, good to know about the price for pacemaker surgery – my husband is due for a “battery change” in about a year – we need to ask the cardiologist on our next visit, what he charges and what the total cost will/would be – I am sure if he divulges the total charges the figure will be enough to give not only my husband, but also me, a heart attack!!
    Dental and Eye care however – now they are wonderful and so much less expensive than the US or UK.
    Don Ray, keep up the great work you are doing, you have been a guardian angel to many people.

  9. Hi Marion. I was tols $50,000, but lets hope you are correct and it was only $5,000. However, I am not sure he wouldn’t have changed hospital’s for that amount.

  10. Don Ray-

    Ref the recent posts on medicare coverage in Panama, if a Federal Retiree can switch to the Panama Canal Area Benefit Plan then the insurance company is required by OPM/FEHB program to provide coverage at the Medicare rate and coordinate benefits with Medicare. The insurance company will still provide basic benefits if not enrolled but there appears to be addition benefits if enrolled in Medicare. Since I will not be 65 for 3-4 years have not tried this yet.

    Further info at http://www.axa-assistance.com.pa (507) 204-9200 ).

  11. I would appreciate any comments on which is better: The Panama Canal Area Benefit Plan or Blue Cross. Thanks

  12. I just can’t understand WHY Panama will not accept our Blue Cross and Blue Shield cards for payment. At this point, because we don’t have extra to pay for the medical care we are covered under in the US, we can’t get the care here because we don’t have the money up front. Talked to a friend and found out that the $$$ invoice from Panama is getting more, at times, than charged at the US and the US is not paying the overhead on the bills Panama was submitting. More corruption? More money if you are a Gringo? What?

  13. It is my understanding that Blue Cross IS accepted in Panama in certain places. The “designated” Blue Cross hospital in Panama City is the Hospital Nacional. I have never needed to use the facility but I did register there specifically as a Blue Cross patient. In David, it’s the Hospital Mae Lewis. However, finding a doctor that accepts Blue Cross seems to be a lot harder. The Hospital Nacional did provide a list of supposed Blue Cross doctors. The administrator I spoke with at the Hospital Nacional spoke excellent English.

  14. I empathize with you all regarding the health issues and hospital care in Panama, especially in Chiriqui. As a Panamanian concerned with your worries, I would suggest you form a permanent ex-pats health committee and together, with Don Ray, try to find solutions to your health coverage for future medical attentions required. As a committee, you will be able to approach the Minister of MINSA (Ministerio de Salud) in an attempt to find a solution before health emergencies and money issues become a problem. You should also meet with the Minister of Relaciones Exteriores and the Minister of MICI (Ministerio de Comercio e Industrias), these two branches of the Executive Office dealt with the TPC (Tratado de Promocion Comercial) better known in the US as FTA (Free Trade Agreement) for the acceptance of the Blue Cross Blue Shield health insurance and the over charge in medical attention and hospitalization. That is not only a problem for the ex pats but should be for the Government to solved and resolved.

    I hope that, by meeting with these Government officials, you will alert the Panamanian Government of the obstacles and discrimination (regarding the over charges) you have encountered by moving to Panama; there, for sure, will be something positive and beneficial that would come out of it, not only for you for the the Government of Panama.

    I would like to see positive results.

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