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.]