Let’s Talk Health Insurance

I am at the point that I need to investigate other insurance alternatives. I moved to Panama in 2003 and my age prevented me from looking at Blue Cross in Panama. I wound up going with MAPFRE, which, at that time, appeared to provide the best general coverage.

I have their basic plan. On reviewing my most recent VISA bill, I see that my monthly rate has grown to $845/month. I will be 73 in October and I realize that with age, coverage costs go up. However, I see no evidence that MAPFRE will ever reach a maximum limit and I am ready to start looking at alternatives.

I have only had one claim in 12 years and that was for a couple hundred dollars. Luckily my health has been good, but one never knows what is around the bend.

I consider healthcare one of the biggest risks in moving to Panama, if you don’t have a plan for paying medical expenses. I have seen too many cases of gringos being shipped from Hospital Chiriquí to the Regional Hospital, when expenses got too high, and most never walked out of the Regional Hospital.

So here is what I would like to find out from others living here. What has your research found to be the best cost effective solution? If you think you have a great plan that might work for me, I would appreciate knowing about it.

If you want to have your agent send me a plan to consider, that is great. If I can beat what I have for a better rate, then I will consider it.

I would like a international plan that provides coverage if I am on a trip. MAPFRE would pay if I were outside of Panama, but at Panama rates.

The discussions and comments that come from this post may also open the eyes of some considering Panama as their retirement home.

40 thoughts on “Let’s Talk Health Insurance

  1. I’m shocked to hear this. I guess I naively believed what I was hearing from International Living. Really, $845 per month for virtually nothing?

  2. We decided to opt out of the insurance when we arrived 9 years ago. I had a major stroke two years ago with no insurance. I also have a brain tumor.I was in the hospital for a week and had a neurologist and a cardiolgist who checked on me several times a day. Staying for one week with all the care it was less than $4000. We realized if we had been paying for insurance for 7 years, we would have far exceeded that amount. So we paid out of pocket. I would rather put my money in a savings account and earn interst than give it to the insurance company. More than half the time it doesn’t cover a thing.

  3. Thanks for taking the time to comment Karen. Hindsight is 20/20. Unfortunately site for the future is not that good. I would like to have all the money I have spent over the past 12 years and that could cover many things.

    I have seen several gringos that had a surgery in HC and would up with a bull around $40,000 and then went to the regional hospital. $4,000, I can handle. $40,000, I can’t.

  4. Don, excellent topic. Really looking forward to see what people have to say about insurance options here in Panamá. At present I have none. Hoping the money I have would cover whatever expenses occur. But, as you say, you never know what is around the bend.

  5. Here is another comment that came in via Offline Contact.

    Is it feasible to pay for an air evac plan to access Medicare treatment in the US, otherwise use cash in Panama?

    My answer is this. The last Air Vac case I am familiar with ran over $30,000 to get the patient back to the U.S., and then he died within the week. Didn’t turn out to be very good economics. I am not aware of any air vac plans. Do you know of one?

  6. Start yourself a medical saving account and place $800 a month in it and the buy the Hospital Chiriqui plan for your self and you’ll likely come out way ahead in the long run. In a mater of years you will have likely saved enough to pay cash for nearly all large surgical procedures done anywhere in Panama and most done in the USA. You would be surprised how much you can negotiate medical major surgical costs also.

  7. I am 58 and have a WorldWide Medical Insurance policy for Panama I bought through a broker in Boquete. I have a $5000 deductible (all surgeries/some cancers are exempt from the deductible).The coverage is 100%. And it covers 80% if out of the country. I pay $226.00 a month for it.

  8. Here is another submission via Offline Contact:

    We have had our international health insurance with Vumi through the agent Gonzalo De La Guardia going on our third year now. We are both 52 years old and our policy is for catastrophic purposes, so we do pay out of pocket for annual check ups. Fortunately we have not had to use the insurance yet. From our research, the best international insurances out there are: BUPA, VUMI and Worldwide Medical. Our annual Vumi premium for the two of us is: $3,474.00
    We have never met Gonzalo, as he is in Panama, but he made the whole initial application process very easy. He now has an assistant, Nelson, whose info is also below.

    Gonzalo de la Guardia
              “International Health Insurance”
                        Cel: (507) 6671-3357
                        Skype: gedelaguardia
              Panama City, Republic of Panama
    gdelaguardia@gmail.com
    Nelson Vega
    Producer Assistant

    +507 6379-5557 
    Skype: nelson.healthassist
    Panama City, Panama
    “International Health Insurance”  

  9. Because we split our time between the US and Panama I still have Blue Cross – Blue Shield in Virginia which covers me in Panama at Hospital Chiriqui and others in Panama City. Unfortunately due to Obama Care… our premiums more than doubled at the last renewal. I also carry a special evac policy available through my AMX card for $13.00 per month. It should cover any emergency evac that comes up for us.

  10. I am a vet. I have enough savings ($5000) to help pay for an emergency or a trip to a VA hospital in Miami. If I need it for an emergency, hopefully, the medical people at May Lewis can get me past it till I get to Miami. Anything else I save and pay cash for. We have been all frightened out of saving for insurance but it’s really a good way to handle it. Take whatever you might pay for a plan and save it instead. The only insurance I have are frequent check ups, preventive maintenance. If I can see it coming then I can control the outcome

  11. Everyone will tell you that Medicare does not apply outside the U.S.. HOWEVER, if you have Blue Cross, Medicare A, and Medicare B, there are virtually no charges for anything here if you use a Blue Cross hospital and its associated Blue Cross affiliated doctors. There are no deductibles or co-pays and no charge for covered prescriptions. I paid nothing out of pocket for a recent colonoscopy. I have been using Hospital Nacional in Panama City which has been absolutely excellent although a little awkward for me since I live in Penonome. I have been told that the Mae Lewis hospital in David is also a Blue Cross hospital.

  12. $845 sounds huge to me. does it include yourself only or both of you. I had quote four years ago when mark and I were 56 and it was $186 each. the insurance company was PALIC (pan american life). Theres is also ALICO, IS (internacional de seguros).

    I agree with saving the money and getting hospital chiriqui. Your experience with mapfre reminds me of our experience with KAISER PERMANENTE in California. We paid $750 a month for 10 long years just because I was afraid of “what if”. I only used for medications, The if never happened. So lost almost $90,000. Then, I noticed there was a clinic down the street that only charged $ 15 a consultation, So, we decided to cancel kaiser and have periodical check ups and follow ups. This is the best insurance, having check ups with your doctor.

    As far as hospital chiriqui, yes I have heard bad stories, but also heard good stories, like my best friend, who went for a mammogram and was told to go see immediately a doctor. She went that same day and the doctor, who also works at hospital regional told her to make an appointment with him the next day at the regional, so he could schedule her surgery there. I was skeptical and she said I won{t worry. The surgery went really well and she is fine getting her chemo treatment as scheduled. I think that if we saved 800 a month, we would be able to cover any treatment in panama. you can also negotiate the price. if you cant afford 40,000 you can say so and the call a social worker, who analises the situation.

    if you dont trus hospitals in chiriqui, you can get stabilized and then asked to be transfered to a hospital in Panama city,.

  13. The $850 is only for me. If I remember right, it was around $400 in 2003. It has doubled in 12 years.

    I typically go to Hospital Corporativo if I have a cold of something minor. $6 to see the doctor. I have also used the ER of Hospital Chiriqui. Luckily, I am rarely sick.

  14. February 7, 2015 at 10:50 pm David Rosenfeld wrote(in part):

    “HOWEVER, if you have Blue Cross, Medicare A, and Medicare B, there are virtually no charges for anything here if you use a Blue Cross hospital and its associated Blue Cross affiliated doctors.”

    It’s all about the definition of “travel”. Would coverage of “emergency foreign travel” apply in a person’s place of residence?

    If the above is a reference to “Medigap” insurance then the documents filed at the “CENTERS FOR MEDICARE & MEDICAID SERVICES” site apply.
    One of the documents, https://www.medicare.gov/Pubs/pdf/02110.pdf reads:

    “Some Medigap policies also cover certain benefits Original Medicare doesn’t cover like emergency foreign travel expenses.”

    If the above is a reference to Medical Advantage, see recent news coverage of “http://www.miamiherald.com/news/local/crime/article4014757.html”.

  15. If you are a permanent resident of Panama (as I am), Medicare will not work. Medicare pays nothing outside the U.S. I am confident the Medigap insurance has clauses that protect them from paying outside the U.S. unless it is for a vacation or short trips.

    Living permanently in a foreign country doesn’t qualify as foreign travel.

    You can always pay to return to the U.S. and then use your medicare, as long as you are capable of being transported back.

  16. February 8, 2015 at 9:23 am Don Ray wrote(in part):

    “I am confident the Medigap insurance has clauses that protect them from paying outside the U.S. unless it is for a vacation or short trips.”

    Exactly.

    An MA plan (if it is doing businees by the book) must monitor residence changes because a change in state may cause a change in service area.

    Medigap plans may not become aware of the insured’s change of residence until an overseas claim is filed. At that point, it is in their interest to verify residence.

  17. Medicare has also been covered in our Warden meetings at the Panama U.S. Embassy and they have clearly stated that Medicare does not pay in Panama.

  18. What and where is Hospital Corporativo? I searched Google maps and I ended up at Hospital Chiriqui. thanks

  19. I was not referring to Medigap or Medical Advantage or anything else, just plain Medicare A & B. Yes, Don, like I said, everyone will tell you that Medicare does not apply outside the U.S. and they are correct to a point. This is not a Medicare thing, it is a Blue Cross thing. To repeat, if you have Blue Cross plus Medicare A & B, you pay nothing (no deductibles, no co-pays)(if you use the proper facilities). If you want to verify this, call the International Office (also known as the Tri-Care Office) at Hospital Nacional. No, I have nothing to do with Tri-Care, just Blue Cross.

  20. The ER in mae lewis costs $10 a consultation plus any treatment, medications etc. all jubilados get 15% discount for medical care, xrays, medications, labs. it also applies to women 55 an over and men 60 and over who are not jubilados. .

    i hear good reviews about hospital cooperativo. Actually, the doctor who did the surgery to my friend is from hospital cooperativo, but the surgery was done in hospital regional because he works in both hospitals. Usually, all doctors work in goverment hospitals in the morning and private practice in the afternoons or vice versa.

  21. February 8, 2015 at 9:23 am David Rosenfeld wrote(in part):

    “If you want to verify this, call the International Office … at Hospital Nacional.”

    Or get in touch with BCBS of Panamá for things like plans, prices, providers and … age limits.

    For example, they have this document online:

    http://isweb.iseguros.com/bcbs/archivos/planes/requisitos_medicos_2015.pdf

    “BLUE CROSS AND BLUE SHIELD OF PANAMA”
    “Requisitos – Pólizas de Salud – 2015”

    The requirements for “E X T R A N J E R O S” are devided into three columns:
    Extranjeros de 18 a 30 años (Hombre/Mujer)
    Extranjeros de 31 a 49 años (Hombre/Mujer)
    Extranjeros de 50 a 62 años (Hombre/Mujer)

  22. Here is another comment left via Offline Contact.

    I just read your most recent post about the rising cost of healthcare here. I have a policy with ANCON. They have a wide array of plans, some provide international coverage. I chose a plan that provides excellent coverage, and a low decutible, on surgery. That was my main concern and I’ve been happy with it. I can’t remember my agent’s name! (I never call him). But if you are near the Romero supermarket in Doliguita, stop in at the main office, just about three doors down. (Near where vet. Don Henry once had his office). Good luck,

  23. HI: I am in that position now as my husband is 79 and suffering a fall and his legs are getting black and blue, face swelling and I have been in touch with Hospital Chiriqui to have him admitted. He has B/C, B/S and Medical/surgical w/Medicare Part A.in the US .SO, got in touch with our insurance agency in US and they went out of their way for all my husband’s benefits, BUT, I have to pay $500 up front for a deposit until the hospital releases all information on my husband’s medical problem…I know that our B/C and B/S will take care of a lot, but, I need help now and if I pay the $500 up front, nothing left for food or bills at the end of the month…..DUH. Been advised to go to Regional Hospital, but, it is not what I feel is good for my husband…If I call the Ambulance I have to go with him to explain his problem but, no spanish – only english..A problem again….He has to get out of bed ASAP. and taken care of..Has been in the bed since Friday night and can’t get out and walk. .He has dimentia and mental problems.seeing people all over the walls and ceilings and snakes and chickens in the BR..After 44 yrs of marriage, I can’t believe our life is what it is on this schedule. ……

  24. If you come here are on a tourist visa and no longer have a home in the state you came here from, what happens with your Medicare as far as being able to sign up for the Blue Cross type plans or drug plans? Are you considered a resident of the state you came from? Also, if you open some type of business in Panama, do you get a Panama social security card, and are able to use the social security hospitals and get medications?

  25. Too many unknowns to answer all of your question.

    If you have an E-Cedula or a Pendionado Visa, then you are classified as a permanent resident of Panama and Medicare is of no benefit in Panama. Medicare will only provide coverage in the U.S.

    If you are on the simple tourist visa, living permanently in Panama, but making 180 day runs across the border and then returning. You will not be a resident of Panama.

    If you are receiving Federal Retirement benefits, yo are required to notify the SSA if you are out of the U.S. over 30 days.

    My understanding is that only citizens of Panama will be eligible for citizen benefits. Anyone can use the Regional hospital, but you will pay. Many medical benefits are available to residents of Panama and this in the upper ages get discounts on medicines and medical treatments.

    I doubt that that answered your question.

  26. Thanks for this post, Don. My husband and I are getting ready to make the move to Panamá and I’m researching health insurance right now. Funny, I just got a quote from Gerry at MediBroker! So far, all the quotes I’ve been getting (my husband and I are in our mid-40s) have been adding up to about $10,000+ a year – either $4000+/year in premiums and a large deductible or giant monthly premiums and no deductible. Either way, I’m thinking we’d hit that $40,000 mark in a few years, so it might be better to get the savings account. Having worked in healthcare most of my adult life and seen what an “unexpected health event” can do to a family, it’s a tough call since I don’t have an idea what real costs are for healthcare in Panamá. Getting cancer in the US without insurance would break someone financially, but could it be covered in Panamá with savings? A heart attack?

  27. It is a concern. I still haven’t decided what I am going to do. I have to decided before hitting 74, since that is the age most insurance companies stop taking applications.

  28. Well, let us know, I’ll keep an eye out for a future post to see what you decided. Are you aware of any way to find out what common medical procedures cost in Panamá? Thanks for all your posts, they are so helpful.

  29. Hi. Trying to find out if Clinica Mae Lewis takes PPO Blue Cross Blue Shield. Of Florida. Just had my husband admitted 11 pm. Had to pay $1000.00 upfront and suppisedly the rep will tell me later on.

  30. US insurance being accepted in Panama is not very likely. I would be very surprised if a PPO BCBS would be accepted. Under any circumstance, I can’t see the hospital filing any forms for you. TriCare is a little of an exception.

    It would be wise to pressure the rep every day to understand what you are up against.

    Good luck, but I would think you would be better off in the US if you can get there.

  31. Jim Scheiderlein in hospital Chiriqui needs blood urgently… A+

    I could not find how to post this … please help

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