S.O.L in Paradise

UPDATED May 15, 2015. The Embassy response is at the end of this post.

I had an interesting call from a physician in David with a growing concern. His concern is related to the large number of immigrants coming to Panama without a plan for health insurance.

I am going to express what I think I understood from the conversation. I have also written the U.S. Embassy and asked if they can verify the official policy for the Regional Hospital.

Let me preface by saying that since my moving here in 2003 and from my experience working on Embassy cases, I have seen many people be transferred to the Regional Hospital after they ran out of funds in the Private Hospitals.

From what I was told, that is going to change. Persons without insurance or proof of payment, will no longer be admitted to the Regional Hospital. People without insurance will only be admitted to the public hospital in Panama City (Santo Tomas).

Getting from David to Panama City may not be possible in many health situations.

I had not heard of Santo Tomas Hospital and asked Lilliam about it. She said it had recently been on the news for not having enough beds to handle the needs or supplies and many surgeries were currently not able to be done. Not a pretty picture.

The price of poker just went up. I have harped many times that a plan for one’s healthcare needs to be in place before moving to Panama. I believe that is truer than ever before.

I hope I can get an official interpretation of the hospital policy from the Embassy, but in the meantime, you have been forewarned. If you don’t heed the warning, you may be S.O.L. in paradise.

As a side note, the information may only relate to coronary care since the doctor that called was a heart surgeon and after July 1, would only work in Hospital Chiriqui. I think he is currently the only certified coronary doctor practicing in Hospital Regional.

However, I thought I had recently heard of another case that was turned away from the Regional Hospital.

I will update this post when I hear back from the Embassy.

Following is the response I received from the U.S. Embassy:

Good morning, Mr. Williams,

After several attempts, we finally got contact with the Legal Office at Hospital Regional in Chiriqui few minutes ago.

We asked the attorney there to please clarify if persons without insurance (referring to PNM Social Security Insurance -CSS) could be treated there.  The attorney replied that Hospital Regional provides medical services to both the CSS beneficiaries and the non-CSS individuals, in the last case, referring to all individuals in Chiriqui that require medical attention.  The attorney emphasized that it is expected that the non-CSS individuals pay their medical bills (–the attorney added that even if the individual does not have funds to pay, the Hospital is willing to accept partial payments until bill is totally paid).

We also asked the lawyer about the Hospital Regional sending or referring non-CSS individuals to Hospital Santo Tomas in Panama City.  The lawyer denied this possibility saying that it is not true.  Per the lawyer, Hospital Regional’s principles is to provide medical assistance to any person that needs it regardless of that person’s nationality.

Please let us know if you have any other questions regarding to this issue.


25 thoughts on “S.O.L in Paradise

  1. Don- whats the best , bar none- insurance company available in Panama? your opinion is it cost effective to have a Panama policy or an American based policy?

    dave / Guarare

  2. I do not have an answer and have to this point not changed my insurance. It is a project I need to get back on. The companies mentioned in the previous post are eligible candidates. Unfortunately as we get older, the price will go up on all policies.

    The younger doctors want to retire at 50 and therefore are less willing to provide the same service in a public hospital as the private where they can charge more. The private hospital rates are going up as well.

    I is a difficult problem and unfortunately it is also a life and death problem.

  3. For some of us, insurance costs are out of reach. A combination of factors including age and pre existing conditions made the cost prohibitive. The lowest cost we could find was $1700 a month with a $5,000 deductible.

  4. yep, this is the hatter thing for us to address, what about if we make a plan for our self, where those than need it will pay like a $100 per person a month and won be able to be insured until the first year, if only one hundred of us do that we will have $120,000 next year, for emergencies, until we be able to be treated in the US, and the Medicare, pay %80 of the cost of an emergency while you are out of the area, then that %80 can be to repay your emergency’s from the account here, the hospital do not do that because they don’t want to way the time to collect they money, Please Don Rey I have confident in you and whit your help we may be able to do some thing like this where we all can have and immediate help until we may be able to travel to our home in the States, Me I have not insurance, and right now I have to go to the States for an operation, bat it is not a matter of life or death situation, bat it cut be, and then what??? is not the first time I try to let people on this community know the necessity of a plan of this cane, more or less, where you don’t be broke all the time to make insurance payment, there are many like me ho do not came here whit our pocket’s full of money, we just live a month at a time, if you know what I mean, thanks and like always God Bless.

    At your service, Joe, Cuban Joe.

  5. What bothers me is that even WITH insurance it is not covering even a 1/4 in some cases. I know someone who had to have major surgery and had insurance and they still paid $20,000 out of pocket. Most of us can’t afford that. Then what?

  6. I believe the largest influx of uninsured immigrants clogging the Panama hospital system, as well as the native population, are coming from Columbia, Venezuela, Nicaragua, and Costa Rica. US immigrants are not even close to the major contributor to this problem. What does the physician in David have to say about these latin american immigrants taxing the Panama hospitals, or are we the minority one’s they hit up for the money cause the others can’t pay?

  7. As I wrote, what I was told was that to be served in the Regional hospital you would have to have insurance,have the ability to pay or be a Panamanian with paid Social Security. If not, you would have to go to Santo Tomas. That is what I am asking the Embassy to verify.

    Again, it may be that if you need to have coronary stints or the like, the only option may be Hospital Chiriqui and that will require insurance.

  8. Hosp regionl de david is part of sistema intgrado. It belongs to both seguro socil sn ministerio salud. In psnama city there is seguro social and santo tomas. Here both are integrated into one. Just for what the dr said i kind of think it could be dr adame and wonder what is the truth behind this. He is the only interventionist here in david and works in hospital chiiqui as well ss regional. No matter where you go in david, he is the one. Snd he takes advantge charging a lot compared to panama city where you can find many reputable interventionist cardiologysts. We should be really concerned about neurologyst surgeon. The only excellent one died. The new one is that new. Still to see.

  9. Hi Don. Do you know of anyone using any of the “big” national plans in Panama? BCBS of Panama, MAPFRE, etc? Do they work well or is it better to get an internationally-based plan (expensive) or go local (cheap)? Their websites are pretty bad so it’s tough to get info on costs, residency requirements and benefits (at least from here in the US). Thank you for all the great information – it is very helpful!

  10. I wanted BCBS of Panama when I moved here, however, they had an age limit that excluded me. I went with MAPFRE. My costs have doubled since i moved here, which is why I am still considering alternatives.

    Everyone has different needs and capabilities of paying various premiums so there is no perfect answer that covers all.

  11. From what I understand, Hospital Chiriqui insurance is really not an insurance, it is a discount program. That is how it was presented to me years ago, and I don’t think that it has changed.

    Meanwhile, the earlier reader is correct that the mass of immigrants that are flooding the system are not from the States, but from neighboring Latin American countries, yet North Americans are being targeted as a drain on the system. It appears that the tide is changing toward ex-patriates, given the recent xenophobic comments out of the Panamanian National Assembly, and the more recent news that Ecuador is thinking of denying medical care to uninsured North Americans, Given the fact that many North Americans were solicited to come here to supply much, much needed U.S. Dollars to the sluggish Panamanian economy years ago, it now appears that we are now not needed as the latest social policies, such as the doctor passed on, seem to reflect this sentiment.

  12. Santo tomss the white elephant i once mentioned. Great service but not big enough for Panamanians plus immigrants and i agree from venezuela costa rica colombia etc. At least americans pay until their insurance can’t pay any more.

  13. I can recommend ALICO (american life insurance) i used it for many yesrs before moving to usa. I am in conversations with IS (internacionl de seguros). I love mapfre car insursnce but dont knowvsbout health. If they provide same quality as their car i would go with mspfre. Havent quoted yet.

  14. Ability to pay, that is only fair considering how inexpensive Regional is compared to Chiriqui. I have no experience with Dr Adames but based on anecdotal information he would feel cheated if you did not see him
    In Chiriquí

  15. I asked a friends wife who works in asamblea legislativa. She is a lawyer too. NOT TRUE. Im anxiuos to know what embassy finds out. Lee, right on. I have my personal anecdote about him. Wont tell but $$$$$$.

  16. I spoke to anther Cardiologist who works at Regional and he said this is not true. I think Dr Adames is leaving Regional and wants everyone to bring their checkbook to Hospital Chiriqui.

  17. Which they may have to do because he is the only one in David capable of doing heart procedures.

    However, I also spoke with another individual that was having to go to Puerto Armuelles to have gallbladder surgery because he was told there were no beds in Hospital Regional.

    It is becoming more difficult to plan pn the public hospital, so one better be able to afford the private hospitals.

  18. not having beds available is due to reduced number of beds and not to what that doctor said. I met an intern at regional and asked him about this and he said not true. I dont appreciate doctors who scare people with a motive to have them as customers. Dont worry, regional will get another surgeon. it will take a couple months. most likely will send him from Panama. I have no respect for this type of doctors.

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