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Joseph Bowersmith – Best Places In The World To Retire User Account
I have just recently experienced the healthcare in Jinotega at Hospital Victoria Moto.  It was very basic.  Wards that are just big rooms with beds and that is about all the hospital provides.  Care was given by student nurses and interns which were only responsible for providing I.V. medications, taking blood and starting I.V.s (which they did very poorly, usually taking more then 3 attempts.)  It is expected here that you will have a partner that will provide for all your needs, such as bedding, food, bathing, change of clothes and to go for medications.  A hospital stay would be very difficult for a person alone here.
After this experience I would say that the only acceptable hospitals for expats are in Managua.
Eddy Marin-Ruiz of The Mortgage Store Nicaragua – Best Places In The World To Retire User Account
AIM Ambassadors in Mission Nicaragua trip – Best Places In The World To Retire – International LivingVivian Pellas Hospital (or what’s commonly known as “The Metro”) is a hospital in Managua that you could compare to any US hospital. It has great facilities and that is the biggest hospital here in Nicaragua. The national hospitals are scattered throughout the departments but I would personally take my children to Metro. 
There are plenty of small practices that offer great medical service. I would establish with a medical provider or a doctor here. You will find that you could have a checkup for US $20 and they are very good. I personally would not be comfortable going to the smaller hospitals in Nicaragua, however, although a lot of our friends are missionaries here and they are perfectly comfortable going to the smaller hospitals.
If lived in Granada, it would be very easy to go to Managua because it is close enough (around 40 minutes away by car) to go to Vivian Pellas. If I was in San Juan Del Sur, which is about 1.5 to 2-hour drive to Managua, I would definitely get stabilized there first and then make my way to Managua.
I have friends who are expats in San Juan Del Sur who come to Vivian Pellas for their routine checkups. If they need to go to PriceMart here in Managua, they also plan their visit so that they drop by and see their doctors at Vivian Pellas before they head back to San Juan Del Sur. If you live in Granada or Leon, you can go to Vivian Pellas on an ongoing basis since these places are within an hour’s drive to Managua. 
However, Leon is a b it different as far as medical care is concerned because Leon has one of the best medical universities in Leon. A lot of people who live in Leon seek healthcare in Leon.
I wouldn’t be concerned that something bad might happen to me even if I had an emergency like a heart attack or a stroke. I don’t want to be nonchalant about it, but the reality is that if you have something life threatening, you could be located just outside Vivian Pellas or any good hospital and still pass away. In the process of moving here to Managua, I met with someone from the embassy and that was an example that they used. They asked me, considering the distance to Managua and a life-threatening situation, if I would want to be far away. I’ve had this conversation with some of the developers who are building on the Pacific Ocean. They want to put some sort of a medical facility within their own developments if they are catering to the retirees or expats. To me, it wasn’t a deciding factor to live in Managua and it is not a deciding factor to live outside of Managua.  
(Missionaries from AIM, Ambassadors in Mission, on their Nicaragua trip, pictured.)
Frank Martínez of DISCOVER Real Estate – Best Places In The World To Retire User Account
For general medical care, the doctors in Nicaragua are equally good as the doctors in the US. However, if you need specialized care and a particular medical need, sometimes those medical needs cannot be catered to in Nicaragua so then you have to go to the US. For general medical procedures, the higher end medical care in Nicaragua is the same as the US.
Many people go to Miami or other places in the US to have their check ups or to undergo complicated surgeries or other specialized procedures. If you are going to the general physicians here in Managua, you will find that they are really good.
The medical staff in the two big hospitals here in Managua is above average-- Vivian Pellas Hospital and Hospital Bautista. Hospital Bautista is run by the Baptists from 80 years ago and it is one of the best hospitals in Nicaragua. I have seen many expats come here for their medical checkups, which is indicative of two things: we have good medical staff and we have good prices.
Jeffrey Soderlind of Horizon Group – Best Places In The World To Retire User Account
Nicaragua healthcare varies from location to location and it's very important to understand the quality of service in order to determine the best facility for your needs.
The best healthcare in Nicaragua is without a doubt in Managua.  There are a handful of quality hospitals, with Metropolitano Vivian Pellas being the best.  They have state-of-the-art equipment, many doctors were trained in the US (or other countries known for quality healthcare), there are many doctors who speak English and, to top it all off, the cost is very inexpensive.  They also offer memberships, which provide discounted care and medications.
As you travel outside of the capital, you will find small health posts and clinics in the rural areas.  These tend to offer average (and sometimes below average) care and should only be used for basic injuries (stitches) or illness (colds, flus, etc.).  You will find larger hospitals in the major cities of Rivas, Granada, Leon, Chinandega, etc.  These definitely offer better service than the health posts and clinics and are a good option for basic care if Managua is not an option.
Indiana Siu of Operation Smile Nicaragua – Best Places In The World To Retire User Account
On a personal level, I feel comfortable that if I can’t get to the hospital where I’m registered, you could take me to any public hospital in Nicaragua, because most of the best doctors in Nicaragua practice at least in part at the public hospitals.
The only bad thing about public hospitals is the waiting list.  However, if you’ve got an emergency, most of the doctors at the public hospitals during normal working hours are among the best doctors in the entire country of Nicaragua.
Because of working at Operation Smile, I work with the best doctors in Nicaragua and know them first hand.  Operation Smile works with a lot of credentialing from the US, and we only work with the best.  We don’t care about anything except how good the doctor is.  Some of them work for Vivian Pellas (the best known and highest regarded private hospital in Nicaragua) but most of them work for Ministry of Health for one of the public hospitals.  In my opinion the Ministry of Health has the best doctors in Nicaragua.
Many foreigners find it surprising that the public hospitals in Nicaragua have such high quality doctors.  There are several reasons for this. In Nicaragua, doctors know that they can get a steady income by being on a payroll.  The Ministry of Health does this very well, so it has many very high quality physicians working for it who work at the public hospitals.  They work from 7 AM to 3 PM in the public hospital and then after 3 PM, the physicians are allowed to work in private sector.  As a result, most of the good doctors are well paid by the Nicaraguan Ministry of Health and they get to do private medicine.   Therefore, you could go to Vivian Pellas (the best known private hospital in Nicaragua) or you could go to a public hospital and see the same doctor and pay much less at the public hospital.  In Nicaragua, the income for physicians is not that high, so many of them have two or three other jobs at other hospitals.  Some of them may work at Vivian Pellas and then at other hospitals.  Compared to Vivian Pellas, the other hospitals are quite inexpensive. 
Of course, Vivian Pellas is very popular among foreigners, but I don’t think that Vivian Pellas is the only option for great medical care in Nicaragua.  Every hospital has its specialty.  If I’m in an accident I would feel very comfortable if my mom takes me to a public hospital just because it is closer.
Here’s a list of good hospitals in different parts of the country and for different needs:
  • In Granada, I would go to Hospital Amistad Japon Nicaragua
  • In Managua, there are several public hospitals to choose from, each one with a different main focus:
    • Trauma (including orthopedics) or heart-- Hospital Manolo Morales
    • Pediatric-- Hospital La Mascota
    • Burns and orthopedics-- Velez Paiz
    • Maternity hospital-- Bertha Calderon
    • Trauma-- Lenin Fonseca
    • The Military Hospital is expanding dramatically and will be among the best.  They are investing substantially in infrastructure and equipment more than any other hospital in Nicaragua.
  • In the private sector in Managua, we have these good hospitals:
    • Hospital Salud Integral, which has very complete and high tech equipment.
    • Vivian Pellas, which is the most popular among foreigners but, by Nicaraguan standards (certainly not North American standards), is quite expensive.
  • In Estelí you have a public hospital called San Juan de Dios that’s very modern.
  • In Chinandega they have Hospital España Esteli.
When, on behalf of Operation Smile, I have to choose the best doctor, not just the most expensive one.  For example, if I were looking for a physician to do a nose surgery, I would rather choose the one who does the highest quantity of surgeries and therefore, has the most experience.  In my opinion, as long as the hospital meets base requirements, the doctor is the most important factor in your healthcare.
I personally go to the Military Hospital.  They are currently investing heavily in medical equipment and will bring in many more specialties over the next year that are not now in Nicaragua.  When my grandfather got sick, I went to every hospital and ended up sending him to Hospital Manolo Morales, which is also a public hospital.  The reason I chose Hospital Manolo Morales is that  was the only place in Nicaragua that could give him a pacemaker in less than 48 hours with the requirements we needed.  The other hospitals wanted to do exams, etc., which would have taken too long.  We chose the doctor that implanted a pacemaker every two days.  To do so, we took my grandfather out of a private hospital and put him in Hospital Manolo Morales, which did a great job.    
For me, with very few exceptions, in Nicaragua, there are no good or bad hospitals; there are only good and bad doctors.  You should be focused more on your specific needs rather than the specific hospital.  Get the right doctor.
All the hospitals in Nicaragua meet the minimum requirements, so you can focus on getting the right doctor.  Operation Smile is a US NGO that works only at public hospitals that meet the minimum requirements and most of the hospitals I see meet the criteria for the US.  Maybe from a North American perspective they are a little bit dirty in the waiting room (which may cause you to worry), but in the ORs, the beds, the pre-op and post-op, they’re very clean and very professional.
The same doctor would charge you double to see you in some private hospitals as compared to seeing you in a public hospital.  Here’s an example of the cost.  My husband and I had the same virus.  (I know it was the same virus because I gave it to him.)  He went to the best-known private hospital and I went to the Military Hospital.  For medication, x-rays, and IV fluid, with no insurance, I paid $200 out of pocket.  Even after his insurance, my husband paid $400, without IV fluids and x-rays.  I don’t know how much it would cost in Seattle, which is where I lived when I was in the US.
To see a good doctor for a checkup in Nicaragua, it would cost you between $40 - $60.
Juan Carlos Espinosa of Hacienda Puerta del Cielo Ecolodge & Spa – Best Places In The World To Retire User Account
Within the last six or so years, in Managua, Nicaragua, they just opened the largest hospital in Central America, a private hospital called Hospital Metropolitano Vivian Pellas.  By North American standards, it’s very inexpensive and its very, very good; state-of-the-art.
To give you an idea of the care you can receive in Nicaragua at Hospital Metropolitano Vivian Pellas, I recently came back from a trip that included a very long plane ride, which caused me some symptoms of numbness.  I went to the emergency room of the hospital and saw medical personal immediately.  Three hours later, after putting me through several tests, including a scan, they determined that nothing was wrong with me.  The total cost to me was $46.  The care was first rate.
Lucy Valenti of Liv Nicaragua – Best Places In The World To Retire User Account
The best hospitals in Nicaragua are in Managua.  Hospital Metropolitano Vivian Pellas Nicaragua – Best Places In The World To Retire – International LivingHospital Metropolitano Vivian Pellas is right now, the best one, and is internationally certified even in the United States.
There is another huge hospital being built in Managua that belongs to the military but that also will serve private patients scheduled to accept patients in the beginning of 2015.  We are told that it will be the largest hospital in Central America. The cost to build the hospital is over $50 million, which for Nicaragua and Central America, is a big investment.
Hospital Salud Integral Nicaragua – Best Places In The World To Retire – International LivingHospital Salud Integral is another private hospital in Managua that is in good standing where people from other countries come to have certain surgeries done. 
The good hospitals to have surgeries done are in Nicaragua are all in Managua. This may seem inconvenient until you consider that the distances in Nicaragua between the major population centers and where expats are most likely to live are short.  You can come from Granada to Managua in 40 minutes.  You can come from San Juan del Sur to Managua in an hour and forty-five minutes.  You can come from Leon to Managua in one hour.
All the main cities have small local hospitals and clinics, which are public.  However, there are also private medical facilities in the small cities.  You have private doctors who have their clinics in Granada and Leon, and in San Juan del Sur I’m sure there are one or two private doctors who can at least assist in an emergency.  
Mike Cobb of ECI Development – Best Places In The World To Retire User Account
Medical care in Nicaragua can be excellent or it can be poor. There are 3 excellent hospitals in Managua, the Vivian Pellas being the newest and nicest. It received the JCI accreditation and was the 13th hospital in all of Latin America to earn this ranking.
Managua has the best hospitals. Smaller cities like Granada, Leon, Chinadega, and Rivas on the western side have OK facilities. The doctors are by and large very good, especially for run of the mill injuries like broken bones, but may lack experience in specialized procedures.

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