Health insurance for retirees is available in Panama. Most of the health insurance that people have in the States is no good here.  Medicare is no good and VA insurance is no good. There are one or two hospitals that provide medical treatment under Tricare for military retirees.
 
You can get private insurance in Panama.  In addition, in Panama, some of the health networks offer their own insurance.  Just one example is Santa Fe Hospital, which is where I have insurance for my son.  They have a special program for people over 60 or 65 (I forgot the exact threshold) that runs US $50 or $60 a month.  Santa Fe Hospital is not in the upper tier of hospitals in Panama, but they have everything you need, I believe.
 
There are one or two other places where you can get private insurance if you’re over 60.  I don’t know what they cost but I believe one of them is out of South America and I believe the Spanish company Mapfre may have health insurance here too.
 
In addition, Blue Cross and Blue Shield are in Panama.  However, whether you can carry what you have in the States I couldn’t say.

In Panama, we have a policy through Worldwide Medical Insurance, which, as long as we’re based in Panama and with restrictions on how long we stay in one country, covers us anywhere in the world.  It carries a US $5,000 deductible, with no deducible for emergencies.  There is no lifetime cap and we can’t be canceled until we’re 99.
 
I can give you a rough idea of price of an insurance policy to cover us here in Panama.  When my wife and I purchased the plan from Worldwide Medical Insurance I just described, we were in our late 60s and paid $7,200 per year total, for both of us.
 
Panama has adopted very strict regulations on their insurers because Panama sees the benefits of having insurers provide a good level of service.  The benefit to insurers is that it can be very profitable for insurance companies to operate in Panama, which is why they comply.   
 
You can also get insurance through a local hospital.  For example, we had insurance through Chiriquí Hospital in David, which is near where we live in Boquete.  This plan covers everything you can think of, including ambulance, and will pay out up to $25,000 or $30,000 maximum yearly total, with individual maximums for individual expenses.  You have to remember that $30,000 in medical expenses in Panama is many times more medical care than $30,000 of medical care in the US.
 
The Chiriquí Hospital Plan will not be denied to anybody, whatever age you are.  If I walk outside of my house now and break my leg, the Chiriquí Hospital ambulance that will pick me up and take me to their hospital.  If they can’t do the surgery there, they will take me to Panama City.  The cost for the plan is around $1,000 per year for me and my wife total, which covers most things, with a co-pay.  Cancer coverage was an additional $100 for both of us, total.  Pre-existing conditions are excluded for 2 years. 

 

The cost for health insurance in Panama is not expensive.
 
Here’s an example: when my mother-in-law came to visit with us here in Panama, she had a surgery for $6,800 while she was on Blue Cross, but she could have been insured with good coverage in Panama for $94 per month after just a blood test and a urine sample.  She was 84 years old at the time.
 
Here’s another example: a friend of mine here in Panama does complete hip replacements for $5,000 if you pay out of pocket.  If you have an insurance policy, you would likely pay just the deducible, which is $500.  For a comparison, I recently spoke with an American who just moved to Panama who told me that, with her insurance in the US, she paid a $7,500 deductible from her insurance for her hip replacement.  This means that she could have paid for her entire hip replacement in Panama out of pocket and without having insurance less than she had to pay for her deductible for the same procedure in the US, with insurance.

To explain the cost of health insurance in Panama, I can give you an example for me.  I'm a young adult and healthy.   My medical insurance is about $40 per month for Blue Cross for a single policy.  If I go to a specialist without pre-authorization, for example, a gastroenterologist will charge about $40 for an office visit in the best hospital here in Panama City-- Punta Pacifica (the one associated with Johns Hopkins in the US).  In most cases, my insurance covers me fully.  If I do obtain authorization, the cost to visit the same gastroenterologist is zero.  My deductible is about 10% to 15%.  My coverage is for anywhere in Panama that accepts medical insurance.
 
If you go to a doctor without health insurance in Panama City and just pay directly, it will cost you, in general, about 50% less than what it would cost you in the US.

The main issue determining the cost of health insurance in Panama is your age.  If you are pre-retirement age, you work in Panamá and you are covered by your work private medical insurance , you only pay your co-payments.  If you are a tourist for a limited time, you are 100% covered for the first 30 days, totally free of charge, by the Tourism Authority.

 

If you are retired and spend most of your time in Panama, you are not covered by any Panamanian state insurance nor Medicare (people from the US) as they do not have  any agreement yet, meaning you will have to get your own private insurance with any of the many major insurance corporations, or brokers.  If you are over 50 years old, the premium is pretty high.

 

There are also some hospitals, like Santa Fe and others, that offer individual coverage at a pretty low price and cover everything, but the monthly payment will increase based on your usage.  There are also hospitals, like Clinica / Hospital Nacional, that offer a variety of options for foreigners including Blue Cross and Blue Shield, but sometimes paperwork is done after the service has been paid.

 

The good news is that Panamá offers tremendously good prices for private medical services, on an individual basis, as well as modern clinics and hospitals, that every day are getting more and more sophisticated.  Sometimes an office visit could cost as little as $15 in good neighborhoods, and specialists charge around $50 to $175, depending on the service.  X-rays and lab work is also available at a low cost, as well as surgeries, that easily could be half of the price of other countries, or less.  For example, a cataract surgery is $2,000 in the best and most modern clinic in Panama City.  One thing to take in consideration, though, is that some specialists do not accept credit cards in their private clinics.

 

If you do not have private insurance, and God forbid have a major emergency and an expensive or delicate situation, if you are from the US, you can always take an airplane and use your Medicare in the US.

 

In the "interior" of Panamá , for example, Boquete, Santiago, Chitré, Soná, Colón and other major small cities you can find hospitals and good doctors as well.

 

[Editor’s note: According to a press release August 1, 2014, the Panama Authority of Tourism stated that no charge tourist insurance coverage is no longer being offered.]

• Are you looking for comprehensive, basic or catastrophic coverage
• Coverage worldwide or excluding the U.S.
• If you elect U.S. coverage do you have a limit on the amount of time spent in the U.S.
• Do you want coverage for life or only up to a certain age
• Will benefits be reduced after a certain age
• Deductible / maximum out of pocket expenses per year per person

The price of health insurance varies from person to person based on a number of factors, such as :

I always recommend speaking with a insurance broker so you can identify the policy that meets your needs.  For example, some people only want a policy that covers them in case of a major event, so they will purchase a plan with a high yearly deductible, like $10,000.  This keeps the cost of their monthly premium down, but they also know that they will be paying the cost of the medical appoints, lab work, medications, etc.  The challenge is to identify a plan that meets your needs and budget.

Health insurance in Panama can be purchased when you are an employee of a company working in Panama, or even as an individual.  When my husband and I first moved here, we bought our own policy which was a general health policy and it cost about $1,500 that year. 

When my company provided health insurance to me as an employee, then I bought it that way, and that costs anywhere from $30 per month (as an individual) to $85 per month for a family without kids.

 

The good news is that the insurance system in Panama is getting more sophisticated, even than it was six years ago when we moved here. Most of the insurance systems have low co-pays for doctor visits ($8, $12, $25 for specialists) and then cover 80-100% of procedures after the co-pays for their in-network providers. 

 

The drawback to the insurance here is you have to document everything and it's all done by paper. No online systems here yet. This can be time consuming and painful.  Think like we did it in the US in the 80s and early 90s until things were computerized.

 

Otherwise, some people prefer just to pay cash for medical here because it's cheaper. And that's true. My husband just had knee surgery. We paid a $75 co-pay and the insurance covered the rest of the costs (about $3,500).  The same surgery in the US would have been $10,000 - $12,000. The surgery here did however require a pre-authorization which took 3 weeks.