Healthcare Reality in Panama and The Cost of Living

No talk about the cost of living should exclude the topic of healthcare and planning for it. I have no problem with publications saying that healthcare is cheaper in Panama than the US, however, comparisons in quality are seldom mentioned.

If you live in Chiriquí, where I live, there are two reasonably large private hospitals. There are other private clinics and there are public clinics and hospitals. The availability of having places to go is not the problem. It is what is going to happen once you get there.

I volunteer as a Warden for the U.S. Embassy representing the David, Chiriqui area. This puts me in touch with many cases, usually at the public Regional Hospital (The Social Security Hospital).

That is because most accidents or other serious emergency cases are either taken there immediately or sent there when they are refused admittance at a private hospital.

Another reason is that the Regional Hospital has the largest “Blood Bank”. I put that in quotes because there is always more need for blood than is available. There are a couple sources that maintain lists of donors, but sometimes it is a touch and go situation.

One current Embassy case was a result of minors breaking into a house and shooting the owner. Neighbors brought the victim to David, because 911 was taking too long. Upon going to the private hospital, they were told they would have to go to the Regional Hospital because there was no blood at the private hospital.

Luckily, the driver had the correct blood type and the surgeon agreed to accept the patient if blood was donated. I think that the victim has a good chance of not being alive, had the circumstances not played out like they did. The driver also had to put several thousand dollars on his credit card as initial payment.

I have had other comments come into my blog (Chiriquí Chatter) lately about people being rushed to the other private hospital having a heart attack or other problem and not being admitted until their credit card paid $4,000. Without the initial payment, the patient would have been shipped to the public hospital.

No one moves here thinking they are going to need to be hospitalized. There are accidents that happen everyday and you may not have caused the accident, but you may be the one needing major surgery.

As you can see, there had better be a plan ahead of time to cover such a situation. Even a planned excursion to Panama to check it out for a retirement home should include a plan for an emergency.

I have another Embassy case that is in play that shows another potential problem. An individual came here with the plan of retiring. I think there was enough Social Security funds to meet the Jubilado requirements. That was a year ago.

I got a call from the individual asking for help. I was told that the lawyer had taken $1,600 up front and the Jubilado Card had still not been obtained. During that time the individual was a 6 month border hops to keep the passport visa up to date.

I told the individual that there was nothing I or the Embassy could do. The Panama government decides if a person gets the card or not. Some lawyers are good and some just take money. Sometimes the same lawyer can viewed by different people either way.

To complicate the situation, this individual fell victim to a stroke recently. The individual’s Panama Visa has expired and now the individual is illegal in Panama.

While the monthly Social Security was plenty to pay for food and lodging when healthy, it is not sufficient with medical needs.

I sometimes get chastised for warning people to think twice about moving to Panama without a healthcare plan. Sometimes I am told that I should lighten up and let people come and enjoy their retirement years.

Well, I have been on the end of helping families arrange cremations and body transportations because there was no plan.

I have loved my 12 1/2+ years here. Panama has certainly lost much of the Cost of Living advantages of the past, but I still enjoy the pace of life. I love the people. I love the climate.

I recently saw a discussion going on related to Cost of Living and thought it was time to remind people to include healthcare costs and insurance into the equation. It is a large part of my budget and one I would like to reduce. Unfortunately, at my age, options are few.

I apologize for being a party pooper.

19 thoughts on “Healthcare Reality in Panama and The Cost of Living

  1. We self insured for two years and just took a health insurance plan with Magda Crespo. It provides good coverage in and out of Panama and cost less than $200 per month per person. It’s not cheap but it is much cheaper than what we used to pay in the US. As guest in this country, I would not expect that I should tax their frail medical system with my problems. One exception though! In case like Marion’s where people are criminally attacked and badly hurt, Panama should have some kind of victims’ compensation plan that handles their medical expenses.

  2. Has anyone tried to be reimbursed from SS after paying their Panama hospital bill? I was told to submit paid bill to SS then they would submit it to your supplemental insurance. You would still need to have funds to cover medical expenses upfront.

  3. Hi Don, I’m curious which hospital you consider the best for medical care and emergencies, assuming one has the proper funds/insurance?

  4. We are from Europe and we appreciate Don’s honest opinion. It is shocking to read that sites like international living are promoting Panama as dirtcheap. That is simply not true. It is a great place to retire, the people here are heartwarmingly friendly to us, we try our best to mingle and speak the language, difficult as it may seem. But cheap it is most definitely not. And on top of it all, living here without proper health plan seems utterly unwise to me. Magda Crespo is a great person who advised us well in our health insurance, not cheap, but unwise not to take.

  5. Dude,

    That is not an easy question to answer. You will get people that like HC and those that like ML. You will also get people that hate HC and hate ML.

    Many people might use the one supported by their doctor, assuming the doctor doesn’t go to both hospitals.

    I would have possibly said HC, but I think the care that Marion has been getting has been reasonable at ML.

    For some emergencies, the care may only be in Panama City. If that is the case you have to hope you have time to get there.

    I have a friend that had a special cancerous tumor found in HC and was advised to go to Colombia.

    These are the types of role play questions people should be asking themselves during their test time here.

  6. “For some emergencies, the care may only be in Panama City. If that is the case you have to hope you have time to get there.”
    I will also include that the additional cost, and availability of getting a flight to Panama’ – in the case of emergency – is a great consideration.

  7. Don, my medical SS supplement does reimburse me up to certain limit when I’m out of the country. Its a Plan F through Mutual of Omaha….the limit is $50K but you must pay first and submit bills like the one man said above…

  8. No Supplemental or Medicare Advantage Plan covers you for more than 61 days when travelling outside the USA! Supplemental coverage assumes you are a US Resident with an address there.

    That is why one should consider carefully not buying into the IL type retire on nothing and live like royalty on less than $1500/month including cheap Healthcare.

    If you can afford a cheap address in the US via a child in a state/county that has an premium free Medicare Advantage Plan (like AARP United HC or many other companies offer), then your monthly premium would be about $230 for two if deducted from your SS check. You then would have coverage in Panama, retroactively reimbursed for an emergency during the first 31 days (other MA Plans would expand to 61 Days). Note that the US plans have no lifetime or annual maximums, no exclusions and MA Plans also include Rx coverage. So if you can go back to the US annually for a MD visit to have your Rxs sent to a mail order Pharmacy, you can get generics cheaply and have them sent via your mailing service (not, injectibles or Scheduled Drugs). See this link for a good overview of US Medicare (highlight and then click):

    Otherwise, it is imperative to self insure, buy another Panama based plan with lower lifetime limits.

    To a certain extent you get the Healthcare that you have access to and pay for. Probably world class (depending on specialty) in PC, not so much in David, even at private. There is the MD and luck of the draw aspect comes into play. Absent an independent outcomes based registry of MDs/Hospitals in Chiriqui….Some of the recent tragedies are examples of this outcomes roulette. Yes. it may turn out OK and yes the clinical experience may be a caring one.

    So as Don indicates, it isn’t cheap, requires good advocacy and knowledge to be assured of the best outcomes and good insurance, especially in an urgent or complex medical condition is presented clinically. Otherwise your home country may be the best and evacuation insurance is cheap in about $150 for two per year is affordable to you. The writer is a conventional clinical therapy believer with training and expertise.

    Anyone retiring to anywhere in the ‘golden’ years should assume that their potential for a medical event is real and probable at some time and should consider this particularly as the years and quality of “surthrival” are more precious with each passing year.

  9. Don, what’s the absolute best, bar none insurance company/ plan for Panama if cost were no option or are they about the same all around? I have a pension plan that will allow me a certain amount towards health coverage and I can spend it as I wish- so far no need but its nice to plan ahead.

  10. I really can’t say. All companies are going to be rate based on age and pre existing conditions. I am also wanting to do some comparison shopping and haven’t had the time to start.

    I would say I consider Blue Cross one of the best, but my age prevented me from getting it.

  11. If cost is no object, you can get a policy with zero deductible that covers you in Panama and anywhere else in the world. These international policies are underwritten by countries with headquarters in the US, Britain, and elsewhere, not in Panama. But they have service in Panama and at least some of them have sales people here who know the ropes. The cost of the coverage is usually lower than if you bought the same policy in the US because you usually can’t be a US resident to purchase it, the insurer presumably knowing that if you are living in Panama, you will not be going abroad for medical care very frequently. Similar policies that exclude US treatment completely but cover you everywhere else (except possibly in Singapore) will be significantly cheaper (but I am answering the question about the best you can buy without regard to cost).

    Names to Google could be Worldwide, BUPA and VUMI, but there are others, I believe.

    It is wise to heed Don’t advice and keep in mind that in small town North America, your local hospital may not have specialized doctors or specialized equipment that you might need, whether in an emergency or not. There is a general rule that the more a doctor has experience with an ailment, the better the average result. Panama, much less Chiriqui, doesn’t have a large population so it is very possible that if you have a somewhat rare or delicate medical problem, you may have to travel to get more practiced care.

  12. For some of us, health insurance is not an option. The lowest cost we found was $1700 per month for a $5,000 deductible. I am a 20 year Type II Diabetic and my wife is a Breast Cancer survivor. I have VA, so if something happens, I will go back to the U.S. In the meantime my wife will continue to self-insure until she reaches 65 and then we will obtain Medicare with a supplement and she also will go back to the U.S. for treatment.

  13. Very important subject.. I keep my Costa Rica national coverage and can pop across the border. I also have a cancer policy from David > Beverly Hills Plaza national Ins company. I did have a plan with Chiriqui Hospital,but, I just don’t like that place.

    But a quality name for Ex-pats is Cigna

    You can check it out along with the other names listed here.

    Thanx all, Sampson

  14. If you want accurate answers to your insurance questions, call Magda Crespo’s office and make an appointment. Asking questions and receiving consultation is free.
    Magda Crespo Insurance, 720-3240

  15. The following is from my Facebook group, “The REAL Boquete”

    It is very important to not move here only for the “perceived cost of living”, and the “weather”. Many people move here, and cannot afford to move back home, for various reasons. Then, they are stuck, and really miserable.

    A comment from another expat site warning about the importance of having a good health insurance policy here.

    “If I have to pay $100+ per month, I will not be able to afford food! Not all expats are “rich” and are here just because of the weather. Cost of living was my first need when I moved here.”

    A reply to this comment, “Think twice on that, Being old and uninsured is not a happy situation. An emergency cardiac stent here in Panama can cost an arm and five legs. I have friends who went back to the states for major cardiac surgery on Medicare and they are alive today.”

    And it only gets worse, the next comment was, “I had a heart attack at age 60 which is why I retired early from a stressful job. I have a cardiologist here and a stress test is $175.00. If I need anything like a stent in the future I will go to the regional hospital where my cardiologist doe’s his required pro-bono work. I am on the right meds and am doing well so far. I was born in Canada and always have that to fall back on if needed.”

    This woman has zero idea what a strain she is putting on the Panamanian medical system. The Dr. works pro-bono, he volunteers his time, and should not have to treat expats, taking the time away from the local people, many of whom are elderly, or have sick children, and are extremely poor.

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