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Kent Payne of Gran Pacifica – Best Places In The World To Retire User Account
There are several insurance strategies for Vivian Pellas Metropolitano Hospital Managua Nicaragua – Best Places In The World To Retire – International Livingliving in Nicaragua.  Remember that most of the hospitals here are good but not necessarily great… exception being the Vivian Pellas Metropolitano Hospital (pictured to the right).  It is absolutely world-class and accepts several types of insurance.  You can go to their website and bring up info in Spanish or English about the types of insurance accepted.  Since this market changes, I’ll defer info for you to go the website.
Before we moved here to Nicaragua, I was “COBRA”d through my former employer and paid about $800 / month for the health service.  Now, my personal insurance is through Vivian Pellas Metropolitano Hospital's Club Salud (Health Club), which covers my wife and me while we are in Nicaragua.  When we relocated, I signed us up for the ‘gold’ version of the insurance….at about $100 / month total for my wife and me.  So, for $1,200 / year (and a discount by prepaying a year in advance) we had what I call ‘catastrophic’ insurance.  ER services were covered 100%, with most procedures covered from 50% to 80%, with pre-existing conditions under special review.  As with most insurance, you have to be covered for quite a while (18 months to several years) before an existing condition can be covered.  My high blood pressure and other small ailments did not warrant review.
The premiums had moved up to $61/month/person, though we still get a 10% discount by prepaying.  Cheap by any standards.
So your next question is, “at this price can it be any good?”.  A quick personal testimony:
  • Most of the doctors in the hospital are members, so a regular fee of $30 is reduced to $10 / visit.
  • Most of the doctors speak English, and were trained in the states or at accredited Central American locales.
  • I had elective surgery on both feet at once.  In the states, it would have been out patient, with surgery and recovery rooms utilized, about $18,000.  My total bill here was $1,700 to the doctor's office and $800 to the hospital…and two nights in a private room!
  • I had non-elective colon surgery……potentially bad stuff.  The doc said it could have developed into colon cancer, but we caught it early with an upper an lower GI procedure.  Total cost, surgery center, recovery, and five days in a private room: about $3,600 out of pocket after the insurance covered the hospital portions.  I have NO IDEA what this would have been in the states.
Only drawback:  We are covered only in Nicaragua, so any trips abroad are a risk.  I’ll qualify for Medicare in about 2 years, so I’ll sign up at that time.
Andrew Jernigan of International Care – Best Places In The World To Retire User Account
Sandboarding, Cero Negro, Nicaragua – Best Places In The World To Retire – International LivingAs healthcare is often quite inexpensive many choose to live without an international health insurance policy. I have seen way too many situations where a medical plan should have been purchased so that an emergency was covered to evacuate the person to another country or even to their home country for care. There are policies available that are reasonable.
If I were watching my expenses to keep them at a minimum but also take care of hospitalization costs, there are several good options.
Do consider adding a bit of expat life insurance to your strategy.
(Sandboarding, Cero Negro, Nicaragua, pictured.)
Barry Oliver of Surfing Nahua – Best Places In The World To Retire User Account
Claria Life and Health Insurance logo – Best Places In The World To Retire – International LivingI used to have a health insurance program out of London called IMG, but I have since moved to an insurance program out of Florida called Claria that has a very high deductible. For my entire family, our premiums are about $3,000 a year.
Even though my insurance company is in Florida, for any healthcare claims here in Nicaragua, I just have to submit any bills you I have. Our insurance company covers full blood work and full checkups every year. They cover $700 each for my wife and I, and $200 each for the kids. We pay for the exams in the hospital, send the receipts in, and we get a check back within 30 days. 
Normal doctor visits in Nicaragua are just so inexpensive at $10 - $30, so it really doesn’t make any sense to have insurance that will cover them. It makes a lot more sense just to have insurance if there’s some type of drastic thing that happens, in which case you’ll be covered. That’s our strategy for health insurance here in Nicaragua, which seems to work well for us. Claria, the insurance that I have, covers us outside of Nicaragua, too. 
I spoke to a good insurance guy before I switched to Claria. He looked over the insurance plan that I used to have and told me, “Do you know that if you get in a surfing accident or a mountain biking accident, your policy does not cover anything?” I surf and mountain bike a lot. I told him, “No, I didn’t know that. That’s good to know.” That’s when I switched to Claria.
Now that I’m with Claria, I’m happy because it covers anything anywhere, and it has worked out great thus far. As I wrote above, they also cover the exams every year for a total premium payments of a little over $3,000 a year, sot that’s good, too. We spend over $1,500 a year in exams that Claria takes care of. That means a little over $100 a month for these exams for me and my wife. I’m in my mid 40’s, and my wife’s in her late 20’s. Her plan is actually a little more expensive than mine because she’s still in the age group that’s more expensive when you’re having kids.  
(Claria Life and Health Insurance logo, pictured.)
Zachary Lunin of Aurora Beachfront Realty – Best Places In The World To Retire User Account
Logo for Seguros America – Best Places In The World To Retire – International LivingThere are several options for health insurance here in Nicaragua. One option is to keep your insurance in the US and you pay as you go here in Nicaragua. In Nicaragua, It’s costs about US $40 to $60 to see a specialist. You can usually get a same-day appointment.
Another options is Seguros America, which provides great health insurance. The health insurance plan for my family, which includes myself, my wife, my 5-year old and 3-year old kids costs about $1,500 a year and provides us a benefit of up to $25,000 per patient per year of coverage with a $200 deductible. If you go over the $25,000 limit, then you pay out of pocket. $25,000 goes a long way in Nicaragua. Seguros America is a company that provides health coverage throughout Central America so you have coverage in Panama, Honduras, Costa Rica, Guatemala, Nicaragua, and El Salvador. Within that medical community, there are specialists in Costa Rica and in Panama that you have access to as well. So, if for some reason you are not satisfied with the care that you are getting here in Nicaragua, they can send you for care in Costa Rica or Panama, which is an option.
Another option for health insurance (and I’ve recently decided to upgrade to this) is through BMI, which gives me health insurance coverage worldwide for my family for about $4,000 a year.  You could also have a catastrophic policy, which I suggest.
The reason I changed insurance is for coverage in the US. Seguros America does not cover in the US under the Basic Plan. They have a more comprehensive plan that does but at that time, I was using their Basic Central American Health Insurance. I travel 3 or 4 times a year to the US. I have already made some ER visits with my young boys there and I anticipate more emergency room visits over the years. So for me, BMI is the better plan.
(Logo for Seguros America, pictured.)
Jewel Hoff of Tierra de los Suenos – Best Places In The World To Retire User Account
Aspirina  – Best Places In The World To Retire – International LivingUnless you have something like cancer or severe heart problems, you can get insurance that would cover you in different parts of the world that is designed especially for expats. 
Personally, I’m blessed with good health. So if I go visit a doctor it’s going to cost anywhere from $8 to $20. As a result, I don’t find the need of healthcare insurance here.   There are expats here in Nicaragua who pay out of pocket for normal healthcare expenses and just have insurance in the case of a catastrophe. In the case of a catastrophe, I like where I’m at because it’s a 3-hour flight to Miami, to get US healthcare, which I would use if I needed highly specialized care.  Otherwise, I would get care here.
One of my friends has medication that I believe costs US $6,800 a month on her Medicare. Back here in Nicaragua, she was paying, I believe, $200 for 3 or 6 months supply. That’s another thing.  The medication is so cheap here, you don’t really need insurance.  You can buy aspirin for about 60 cents, whereas in the US it would be from $3 to $6.
(Aspirina, pictured.)
Eddy Marin-Ruiz of The Mortgage Store Nicaragua – Best Places In The World To Retire User Account
US-TRICARE-Logo – Best Places In The World To Retire – International LivingThere are several US health insurance providers here in Nicaragua. My family’s health care is TriCare, which is something that I got overseas. 
It is a viable option for retirees to have insurance companies other than the ones here in Nicaragua.
However, health care in Nicaragua is generally inexpensive. You would find a lot of retirees who just pay out of pocket for their healthcare needs.  
(Logo for TRICARE, formerly known as the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS, pictured.)
Esmerelda Vargas of Schuvar Tours – Best Places In The World To Retire User Account
Hospital Bautista, Nicaragua – Best Places In The World To Retire – International LivingThere is insurance that you can buy so that if you go to any private hospital, you will just pay 20% of the total fee. For example, the insurance that I have for my family has an annual fee of US $1,000 and I can go any time I want to any doctor. I will just pay 20% of the total of the amount. That is $1,000 a year for myself, my husband, and my kids and this is insurance that will cover everything. I have a deductible of $100 per person. After that, they will reimburse 80% of what I have spent. Normally, going to the doctor here, the appointment for one visit can go between $30 and $45. The insurance will pay everything for the first appointment and then you pay 20% of the difference.
With this insurance, we can see any doctor. The total amount the insurance company will pay out in one year is $25,000.  With this insurance, you can go wherever you want. You can go to the hospital or to the private doctors. You just need to pay and the insurance will partially refund you the amount you paid, as per the policy I just described.
If you need a knee operation, for example, it would be very expensive, and would cause you to go over the $25,000 per year total amount the insurance company is liable to pay. In order to deal with this situation, I have insurance in the US, for which I pay $5,000 a year. As per this insurance plan, I have to pay the first $5,000; that’s a deductible. Then I have $1 million limit the insurance company will pay out in one year.  I just have that for the US and I use it only on big emergencies but for not very serious illnesses, I use the other insurance we have in Nicaragua. Not serious illnesses would include going to the doctor if you have a cold or if you have general problems like a stomachache.
(The logo for Hospital Bautista, a private hospital in Managua, Nicaragua, pictured.)
Darrell Bushnell – Best Places In The World To Retire User Account
The majority of the expats here in Nicaragua pay as they go and have no health insurance. Nicaragua, of course, has universal health service for everyone including expats, but most expats would not be happy with that quality of medicine.
There are a few health insurance plans available here in Nicaragua.  The cost range depends on what they cover and where they cover it but as a general rule, the cost ranges from US $50 to $100 per month, per person. Our largest hospital here, Hospital Metropolitano Vivian Pellas, has a discount plan starting for around $50 per month under which you enjoy very large discounts on healthcare services.  You pay based on age; once you go over 65 years old, it can cost $60 to $70 per month.  There are two levels. The higher level covers a lot of things 100% and other procedures, like surgeries are covered at around 70% to 80% discounts, so your net cost for care is very inexpensive.
Some expats use international insurance plans and others have very good pensions under which their healthcare coverage continues even into retirement. Hospital Metropolitano Vivian Pellas accepts Blue Cross and Blue Shield and other health insurance providers similar to that.
If an expat from the US has a catastrophic illness, they usually go home and use their Medicare. Most Americans keep Part A of their Medicare and self-insure here in Nicaragua for the rest, so if something really bad happens, then they can go back to the US and still be covered under Medicare.
Alonso Cornejo of ASA, Inc. – Best Places In The World To Retire User Account
The best strategy for health care in Nicaragua is to evaluate the different options available. Most countries have “local” policies which are available to both their citizens and foreign visitors. However, these policies will more than likely not provide coverage outside the country and do not give you free choice of doctors/hospitals.

For these reasons the majority of retires living abroad select an international health insurance policy. These policies provide worldwide coverage and free choice of doctors/hospitals.  
Everyone’s situation is unique; therefore it is important to speak to an experienced insurance agent who can discuss your particular situation in detail and the pros and cons of the different strategies.

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