Do you need health insurance in Panama? That’s a question we get asked a lot, and the best answer we can give is that it depends entirely on your own circumstances and your tolerance for risk. One of the biggest determining factors for us, at least for the moment, is our ages (late 50s and early 60s). As U.S. citizens, we have a few years to go before we qualify for Medicare. We are not comfortable going without some type of coverage (also known as self-insuring), particularly since we travel often and spend a fair amount of time in the States visiting our family.
When we first moved to Panama over two years ago, we talked about our initial forays into the insurance market in this blog post. We initially settled on a global policy from VUMI International Health Insurance, which luckily we never had to use. From the initial yearly premium of $4,890 (total for both of us) the rates have crept up steadily as we’ve aged – and this year’s renewal notice was $5,683. Even with no claims, that’s an $800 increase over two years! The VUMI plan had a $5,000 deductible, per person, and excluded both of us for certain pre-existing conditions.
We had always heard great things about World Wide Medical (WWM), but initially purchased the VUMI policy based on some incorrect advice we got from our previous insurance agent. She told us we had to be in the residency application process in order to qualify for WWM. For a lot of involved reasons that we talk about here, we had decided to put off the residency process for two years.
Come to find out, we qualified for WWM all along. When our auto insurance came up for renewal, we decided to move our
business to Detresno Insurance Agency out of David. Gloria and Pedro Destresno came highly recommended from several friends, and they’ve been in the business for over 20 years. Since they have a weekend home up here in Boquete, they also makes house calls on the weekends (BONUS!). Not only was Gloria able to save us $400 on our car insurance (with better coverage and complete 24/7 roadside assistance) and also save us money on homeowners’ and home contents coverage, but she was also able to write us a WWM policy for $4,830 (the first year’s premium for both of us, with the same $5,000 deductible and two-year exclusion on the pre-existing conditions). We know of several folks here that have used WWM and they’ve reported excellent service, with quick response and timely payment of claims. Our WWM policy covers us for up to $2 million per year in any hospital in the world, including the U.S. Of course, surprise – surprise, our rates will increase as we age.
In addition to WWM, we continue to subscribe to MS Panama, which works more like a discount program for services in private Panama healthcare facilities including hospitals, doctors, dentists, and labs. Since there’s no deductible, we use MS Panama for routine doctor visits including checkups. Cost for both of us is $183 a month, which gives us one free dental cleaning a year and 50% off all doctor visits, lab tests, medical procedures, in-hospital care, and (god forbid) emergency room visits. (This is on top of the automatic discount of 20-25% for pensionado visa-holders). We have filed several claims with MS Panama and have always been reimbursed within 3-4 weeks with an automatic deposit into our Panama bank account, together with an email notification that the claim was paid. Prescription drugs are not covered by our plans, but the pensionado discount also applies, and many prescription meds are significantly less expensive here than in the states.
Not only is healthcare significantly less expensive here, but the quality is (more or less) on par with services in the U.S. — with a LOT more personal attention. You don’t have to wait weeks for an appointment; most of the time you can book for the next day or just show up at the doctor’s office and wait your turn. This also applies for lab tests and any type of imagery such as x-rays, MRIs or mammograms, and in most cases you get your results that day or the next. In the U.S. I was paying a $20 co-pay and my insurance was being billed $170 for an EKG. Here an EKG is $40, for which I am reimbursed by MS Panama for 50%. Although sometimes your “appointment” might turn into a bit of a wait, the doctors really take the time to listen to you and they’re not in a rush to see the next patient. In fact, visiting the doctor here feels more like what we remember from our childhoods in the 60s and 70s, when U.S. healthcare wasn’t so corporate, doctors weren’t obsessed with malpractice suits, and they weren’t in the pockets of the pharma companies. So far we have no complaints with Panamanian healthcare.
Going forward, we’ll continue our WWM coverage until it’s simply not affordable anymore, at which time we’ll (hopefully) have reached that magic Medicare age of 65. We’ll be able to access Medicare if we need care in the U.S. (that is, if the powers that be haven’t gutted the program by then) and we’ll buy an inexpensive international medical travel insurance policy for coverage in other countries.
Our takeaway advice: Don’t plan a move to Panama without thinking through your healthcare strategy. It’s way less expensive here, but it’s not free. If you want to self-insure, are you prepared to incur thousands of dollars in expenses, should you have a serious injury or illness? We do know folks that are taking that gamble, but it’s too risky for us. Bear in mind that the private hospitals require payment up front, and they’ll often charge you the entire estimated cost of your procedure before you will be admitted. If you can’t pay, your only other option is to go to one of the regional public hospitals, where the level of care might be significantly less.
Susan and John, what a great post! Really enjoyed reading it.
This is very helpful even though we are not planning to move to Panama. But it is a reminder of the intricacies of health care no matter where you are. Right now, I am trying to get an MRI. I am on Medicare with a PPO supplement so I can go anywhere — yet it has been a long, convoluted process . And we just switched orthopedists for Sean — what a journey! glad you have everything covered.
I’m sorry you’re having to go through that, Karen! The layers of bureaucracy and the sheer complexity of accessing healthcare is one thing we DON’T miss about living in the U.S. It is so much simpler here.
Hi, Dagmar – thanks! So great to hear from you. Hope you and Andy are well 🙂
Thanks so much. I will save this.
Our pleasure – hope it’s helpful!
Finding affordable healthcare was one of the biggest reasons we decided to leave the US in 2012 because, quite simply, it was the only thing that stood in our way of retiring early. Healthcare costs are too expensive in the US and the uncertainty of what the US government will provide for citizens in the future is too dismal to even think about. Healthcare becomes even more important as we age and it just isn’t wise to go “naked” or, as you put it more succinctly, “self-insure.” This is a great post with a wealth of information for new expats! Anita
Thank you, Anita. Healthcare is a BIG reason why we’re pretty certain we’ll never live in the U.S. again. We don’t understand how so many other countries, Panama included, are committed to guaranteeing healthcare for all but the U.S. just can’t figure it out. People’s health shouldn’t be a political football. Sorry, I’ll get off my soapbox 🙂
Please stay on your soap box! Your information is invaluable! I recently had my first experience with Medicare in the states for my eye surgery. I was pleasantly surprised at how simple the process was and how little I had to pay, which was 20% of the doctor, facility, and anesthesiology. Why Oh Why don’t we have single payer for all???
We have WEA international health insurance for Nicaragua, but basically the deductibles are so high because of our ages..over 62, that it is really only for something catastrophic. I have my second eye surgery scheduled in Nicaragua, and I hope I can file a claim and get a little money back from WEA. We weighed the costs of airline tickets back to the states, car rental, and at least two weeks of expenses for the recuperation period before I can fly back to Nicaragua. Then, I made an appointment with a retina specialist in Managua and I was pleasantly surprised at his expertise and patient centered care, so it made more sense for us to stay in Nicaragua for my second round.
Thanks again for your insight!
Good article. I am with World Nomads through January 2018 (and they have been excellent), but I understand they are changing their policies so I may be looking for a new insurer. I’ll keep WWM in mind.