Coronary Disease, Stroke and Diabetes

There is inequity in who gets healthcare and who gets great healthcare in Panama. In urban areas, the facilities are world-class and easily accessed, but in the more remote sections of Panama, some types of healthcare are not available at all. Life expectancy for individuals in Panama City is around 80-years (81.2 yrs. for females) but in the more remote areas, it is 71-years. Coronary disease, stroke, and diabetes are the leading cause of death in Panama.

Most foreign nationals receive treatment at private hospitals, doctors’ offices, and clinics. There are also ten MiniMeds, http://minimedpanama.com/ which are walk-in clinics, located throughout Panama City. The MiniMeds provide everything from internal medicine, MRIs, pediatrics and laboratory tests, to psychiatric services. There are also multiple physician practices throughout the country, but the largest and most specialized are in Panama City and especially in Costa del Este. Coronado and David also have robust offerings.

Medical Tourism

Medical Tourism has elevated care in Panama City and more and more procedures are being offered at prices a fraction of the cost in the United States. For example the average cost of a hip replacement in the United States is $44,816. The Punta Pacifica Hospital offers “expat packages” for a flat $20,000. The offering in Panama includes a five-day stay in the hospital and physical therapy, however physical therapy and a hospital stay of more than one night would be an additional cost in the United States. Recently a 67-year-old female in the United States received a “revised” bill for her 23 hours in a “recovery bed” rounded up to $11,647.38. Since she was responsible for 20% after Medicare, she had to write a check for $2,329.48 just for the 23 hours of bed-space. An MRI in Panama tops out, and is routinely less expensive, at $900. The same imaging, with the same machine will cost $2,000 in the States.

Other treatments vary even more widely. The average cost of In Vitro Fertilization (IVF) treatments in the United States is $12,400 but in Panama the same procedure offered at the San Fernando Hospital, a Joint Commissioned facility, the cost is $3,500. Dental procedures such as a crown start at $250 in Panama, but averages $1,600 in the United States.

Considering the Whole Picture

It isn’t easy to piece together all the moving parts of obtaining good healthcare. It’s not just the doctor visits or the hospitalization, it’s also the prescriptions, the physical and mental therapy, the dentist and prescription eyeglasses, the testing and laboratory work and emergencies. Some government insurance covers everything while other governments only cover the physicians and hospitalization. Prescription medication costs are absolutely dizzying. A few dollars for insulin in Panama as opposed to hundreds in the United States. It’s necessary to look at all the pieces of the puzzle and know what everything costs individually and collectively.

Comparing medical costs is difficult for foreign nationals from places other than the United States, because the US is almost exclusively the only developed nation that does not provide citizens with healthcare. For example, Germany has had universal healthcare since 1941 and a recent knee repair from a skiing accident for a 40-year-old cost him a little less than 50 euros.
Canadians do not receive “free” healthcare because it is generally paid from taxes. On average a Canadian pays $6,604 annually in taxes that go toward their healthcare and not everything is covered. Physiotherapy, prescriptions and other medical services are typically not covered and can be relatively expensive compared to what it would cost out-of-pocket in Panama.

While most healthcare providers must be Panamanian to practice locally a high percentage of medical professionals have received some training in Canada, the United States and Great Britain and speak English fluently. MRI and mammogram machines are generally the exact ones you would find in any first-rate healthcare facility worldwide.

One unfortunate thing about Panama is that an ambulance will require a cash payment before transport to a hospital. One horrified expat who was experiencing heart issues was taken to an Automatic Teller Machine (ATM) before being taken to a hospital. There are other anecdotal stories where that was not the case and great care was taken to get the patient aide as soon as possible, it’s just important to note, nowhere is perfect!

Coronado **Greta- for Coronado, San Fernando closes daily at 5pm so it’s not a great solution for emergencies. The San Carlos hospital would be choice #1 for most people at the beaches and for something you know to be more serious, La Chorrera. It is $1 to see the Dr at the hospital in San Carlos lol**

Coronado has a strong medical community that also services Neuva Gorgona and El Valle. The San Fernando Clinic is a satellite facility of the larger Hospital San Fernando in Panama City. https://www.hospitalsanfernando.com/servicios/clinica-san-fernando-coronado
The facility located in the popular expat beach community offers comprehensive care including an intensive care unit (ICU), maternity, emergency department, and radiology. There is a wide range of other medical options including dentists, vision, and primary care physicians. Pharmacies include the Arrocha, MetroRX, and an Express pharmacy inside the clinic. Both the El Rey and Super 99 grocery stores have pharmacies.

Coronado

Coronado has a strong medical community that also services Neuva Gorgona and El Valle. The San Fernando Clinic is a satellite facility of the larger Hospital San Fernando in Panama City. https://www.hospitalsanfernando.com/servicios/clinica-san-fernando-coronado
The facility located in the popular expat beach community offers comprehensive care including an intensive care unit (ICU), maternity, emergency department, and radiology. There is a wide range of other medical options including dentists, vision, and primary care physicians. Pharmacies include the Arrocha, MetroRX, and an Express pharmacy inside the clinic. Both the El Rey and Super 99 grocery stores have pharmacies.

David

In David, the second-largest city in Panama, there is the private facility, Hospital Centro Medico Mae Lewis. https://www.hospitalcmml.com/en/ This facility is popular with expats and locals alike because of its high reputation and 24-hour availability. This facility is where individuals in the popular expat community of Boquete go for medical care. Another highly regarded facility in David is Hospital Chriqui, a large provider with approximately 70 years of operation.  https://hospitalchiriqui.com/. A women’s and children’s specialty hospital, Hospital Materno Infantil Jose Domingo de Obldia, is located in David and provides wide-ranging medical procedures including emergency care, maternity, pediatrics and orthopedics for children https://www.obaldia.sld.pa/

The CSS hospital in David, The Regional Hospital Chirqui, is where most local Panamanians receive care, but foreign nationals may also use the facility.  http://prensa.css.gob.pa/ On September 29, 2020, the United States Government sent three field hospitals to this facility in the fight against COVID-19.

Panama City

There are many options for hospitalization and healthcare in the capital city. Expats tend to go to the private hospitals and the best of the best is Punta Pacifica Hospital https://www.pacificasalud.com/home located in Punta Pacifica. Generally regarded as the most advanced in terms of technology, this hospital is also ready to welcome a sister facility, opening of a new 269,097 square foot facility in 2021 located in Costa del Este and part of the umbrella healthcare system, Pacifica Salud. The Costa del Este hospital has connections on the upper floors to a medical complex with physician offices, dental laboratories and dentists, ophthalmology offerings. Once open the Costa del Este facility will be among the most advanced in Latin America.

All facilities that cater to expats and foreign nationals accept most national and international insurance. It is important to note that patients who are hospitalized are expected to pay their balance in full before discharge. One recent American, with a twelve-day hospitalization, paid her bill in full for $17,894.17 with her American Express card. Twelve days and less than $18,000 before insurance is considerably less of a co-pay in the United States.

The facilities most popular with expats in the capital city:

Punta Pacificia

A full-service private hospital that has world-class equipment, globally trained physicians and immaculate facilities. Through their affiliation with Johns Hopkins Medicine, their 375 medical providers receive continuous training and education. Located in the upscale Punta Pacifica area, the hospital is situated in one of the most beautiful and well-appointed areas of Panama. Physician practices, laboratories and diagnostic facilities are readily available. Address: Boulevard Pacifica and Via Punta Darien, Panama City, Panama. 1-507-204-8000 for general information and 1-507-204-8185 for emergencies. https://www.pacificasalud.com/home.

Hospital Nacional

Conveniently located off Balboa Avenue and is managed by the United States-based, American Hospital Management. A 120-bed acute care multi-speciality facility with an additional 75-suite medical offices, the care is exceptional and known for their outstanding nurses. Affiliated with the Kendall Medical Center in Florida and the University of Nebraska Medical Center, professionals have been trained world-wide. Address: Avenida Cuba, between 38th & 39th Street, Panama City, Panama. 1-507-207-8100 or 1-507-306-3300. Doctors’ Services 1-507-227-5444. International Office/Insurance Liaison 1-507-207-8354. https://www.hospitalnacional.com/

Centro Medico Paitilla

Full-service facility that provides a wide range of medical services including laboratory, oncology, internal medicine, radiology, cardiology along with most other specialities. Physician practices are locally housed next to the Centro Medico Paitlla. Address: Avenida Balboa and 53rd Street, Marbella, Panama City, Panama. 1-507-265-8800. Emergency 1-507-265-8888. Medical Doctors Offices’ 1-507-269-5222. https://hospitalpaitilla.com/

Clinica Hospital San Fernando

Full-service private facility that offers all major and minor procedures in a modern and well-appointed facility. They have a smaller hospital in Coronado by the same name which offers a wide range of specialities for the expat communities by the “beaches” area in Panama. Address: Via Espana, Las Sabanas, Panama City, Panama. 1-507-305-6300 (you’ll need to #2 for English). Emergency, 1-507-305-6305 and International Relations/Insurance Liaison, 1-507-305-6408. https://www.hospitalsanfernando.com/

Santo Tomas Hospital

The main public hospital in Panama City and is to a lesser extent a favorite facility for foreign nationals and expats. Founded in 1702, St. Thomas provides medical care in addition to oncology, cardiology, obstetrics and maternity, ophthalmology and mental health services. Surprising to many expats is the price list posted on the website which clearly states what services will cost. For example, a Ketamine intravenous infusion will cost $40 as opposed to between $400 and $2,000 in the United States. Address: Calle 37 Este, Panama City, Panama. Open 24 hours, the main telephone number is 1-507-507-5600.

Hospital del Ninos

Provides care for the children of Panama City along with the Pediatric Hospital of San Fernando. At the Children’s Hospital, all minors must be referred to the speciality facility by a pediatrician, purchase a $1.00 “control card” and pay a fee of $2.00 for the visit. At the Hospital of San Fernando, which is located within the larger San Fernando facility, you can check out all the specialities offered as well as obtain a price prior to making an appointment.

In June of 2020, the Panama Ministry of Health signed a $614.2 million contract to build a 720-bed medical complex replacing the current Children’s Hospital. With 14 operating theatres and 700 underground parking spots, there will be two towers, connected by a bridge. https://hn.sld.pa/

What To Consider When Considering Healthcare In Panama

Just because great medical care exists in Panama does not mean there are no decisions to be made which will directly impact the ability to access and pay for superior medical treatment. Remember care in Panama is both private and public. As a foreign national, at least for the first two years, most expats will access the private facilities. While planning for health upon a move to Panama, some things to consider include:

Location

Where a foreign national chooses to live has a direct impact on how available good healthcare is on both a routine and emergency basis. The best care, in all disciplines, is in Panama City. David, on the border of Costa Rica also has good healthcare and since Boquete is 24 miles from David, good healthcare is accessible. Bocas del Toro is a bit farther away from David, but still easily accessible. The San Fernando Clinic in Coronado provides good healthcare in the beaches area of Panama and it is affiliated with a major hospital in Panama City. Since it is approximately an hour’s drive into the capital, this expat haven is a good choice for retirees and their healthcare needs as even ambulances are readily available. If you decide to locate in a more remote location, then access to superior healthcare facilities is also more remote.

Payment Plans

Medicare and most US-based insurance plans are not honored in Panama or any other country, so you will probably need to decide how you will pay for medical treatment. Canadians are directly impacted since their first-rate options are also not available or honored in Panama, however there are many options to pay for care so it’s important to figure what’s right  individually.

Out-Of-Pocket

It is not required to have health insurance in Panama so it’s possible to go it alone. Healthcare in Panama is less expensive than almost anywhere else on the globe when discussing developed countries, so paying as you go might be acceptable albeit risky. A primary care physician will cost $20-$25 a visit, but a serious accident such as a broken leg requiring surgery will run around $15,000. The specialist will cost $50+ for a visit.

• International Insurance–There are policies designed just for international travelers and they provide coverage globally. With this policy, coverage is excellent, accepted at most facilities as well as  up to 93% of the physicians in Panama. This option will not be inexpensive and not available to everyone, but it is certainly worth investigating. GeoBlue https://www.geobluetravelinsurance.com/ is an excellent option in Panama as well as Cigna Global Insurance Plan. https://www.cigna.com/international. Both of these policies offer three levels of care and they cover dental, vision and flight evacuation. Best Doctors is a low-cost carrier providing international health insurance. https://bestdoctorsinsurance.com/ which is especially attractive to families. IMG is an option for international health insurance with flexible deductibles.: https://www.imglobal.com/international-health-insurance/global-medical-insurance When selecting the appropriate policy, check closely for what is covered and what care will cost out-of-pocket. For example, a 65-year-old Canadian female just paid $714 USD for an annual plan with Best Doctors Insurance with a high deductible. Allianz, however, quoted $7,178 annually or $598 per month but provided coverage for pre-existing conditions, dental, vision, plus a $205 cash allowance for each day for family expenses in which the patient was in the hospital. All billing is managed by Allianz directly. https://www.allianzcare.com/en/personal-international-health-insurance.html. Most of these policies also provide for emergency repatriation to home countries, just check to make sure to what you are entitled to.
• Panamanian Based Insurance–There are several plans available in Panama and they are sold through brokers who are not employed by the provider or the insurance company. It’s pretty easy to secure a policy for $50-150 monthly if you are not 65-years-of-age or older. Premiums go up even further if you are over 74. Hospitals require payment upon discharge. If you want a referral, please visit our experts page or link to the videos where insurance is explained in detail.
• HMOs–This is not the same system as in the United States, but it is similar. It’s more like you belong to a hospital’s “club” so when you enter you get discounts on services from 50 to 70 percent. You can’t take your membership to other healthcare facilities and you can’t even join if you are over 65-years-of-age. The best place to use the HMO is if you are located in David or Boquete.
• Foreign Medical Program (FMP)–If you are a retired service person, or a dependent,  from the United States, you have the option to access a handful of facilities that accept US Veterans much like the VA Hospitals in the United States. In Panama City, that facility is Hospital Barsas http://www.vsooverseas.com/hospital-brisas/. You may also qualify for health insurance through Tricare https://tricare.mil/ or enrollment in CHAMPVA, a VA managed program for healthcare.

Dental, Vision and Homeopathic

Dental care is exceptional in Panama City and the expat communities of Coronado, Gorgano, Boquete, and David, but less available in the interior. Root canals start at $150 but you may pay twice that at the dental clinic located in the Punta Pacifica Hospital, the most technologically advanced medical provider in Latin America. A routine filling there will cost $15. Orthodontics is offered at Punta Pacifica beginning at $1,994. Vision services are similar to those in the United States, Canada, and Europe. The medical complexes of Punta Pacifica and Costa del Este, will provide everything from routine eye exams to surgeries, top-of-the-line branded glasses as well as inexpensive options. Vision health can be found all over Panama, but again the most comprehensive is in Panama City. A trip to a well-trained ophthalmologist will cost around $60. Other medical care such as chiropractic, massages (starting at $35 an hour for a home visit!), physical therapy, and acupuncture are available, inexpensive, and oftentimes covered by insurance. Stores offering herbal and alternatives are mostly in the larger cities including Coronado and David in addition to Panama City.

Prescriptions

Your over-the-counter as well as prescription drugs, will be readily available at most large chain groceries such as the Super 99 and El Rey, but there will also be free-standing pharmacies throughout Panama with Arrocha being the largest. Many medications requiring a prescription in the United States will be considered over-the-counter medications in Panama. For example, insulin for Type 1 Diabetes does not require a prescription and is considerably less than in the United States. Other medications such as Retin-A will cost $24 for the same tube in the US going for $100. On September 29, 2020, a 20-count box of Tylenol was on sale in Panama for $3.55 and the same day, on-line at Walgreens in the US for $5.79.

Professionals

It is relatively easy to find and secure an appointment with a highly trained medical professional. Most doctors, dentists and pharmacists speak English and did, at least part of their training, in the United States, Canada or Europe. It is not unusual for a medical professional to provide their cell number so you can call and follow up with questions or concerns. Doctors are rarely in a hurry and will spend a great deal of time discussing your healthcare. Of course, that also means the patient scheduled behind you will sit longer in the reception room!

Stem Cell Institute

If treatment is needed for chronic health problems such as autism, cerebral palsy, multiple sclerosis, osteo and rheumatoid arthritis, spinal cord injury, and autoimmune disease, Panama offers therapies in one of the world’s leading stem cell research centers. The Stem Cell Institute, located in Panama City, works in partnership with other research facilities worldwide to develop treatment protocols with allogeneic human cord stem cells and autologous bone marrow. Patients and their families from all over the world come to Panama for specialized treatment. https://www.cellmedicine.com/

The Gorgas Memorial Laboratory

Located in the City of Knowledge within Panama City is this internationally acclaimed research center that improves healthcare in Panama, Central America, and the world. The work at Gorgas is centered on tropical diseases, but because of it’s more than 100-year history, it is often called upon to refocus work on vaccines such as the one being developed and tested there for COVID-19. Medical students worldwide come to Panama to study tropical diseases at the Gorgas Institute.

Vaccinations

Most people come to Panama having regular vaccinations such as Hepatitis A and B, Typhoid, and Yellow Fever. There is little threat of contracting the diseases, but it’s precautionary. Malaria is not a problem unless you are going into the Darien or other isolated places.

Easier For Canadians

It is not difficult to access superior healthcare in Panama, it just takes a bit of organization and planning. If you moved from Toronto to Montreal you would need to find new physicians and care providers and it would be similar in Panama. What would be different is that you cannot use the universal coverage provided by the Canadian Government and that is a concern for many Canadians. It is certainly not uncommon for Canadians to live only part-time in Panama–mostly during the high season in Panama and the winter in Canada–which allows them to maintain and access healthcare in their home country.

Because the United States does not have universal healthcare, moving to Panama, if not over 65-years-of-age, is actually easy and much less expensive. Almost all other developed countries have universal healthcare and everyone should develop a plan for paying and accessing healthcare.

A Reference List Of Hospitals Outside Panama City

All CSS facilities can be accessed here: http://w3.css.gob.pa/

Colon

Hospital Manuel Amador Guerreo, which is a public, social security hospital

Chiriqui

Hospital Centro Medico Mae Lewis (David)
Hospital Chiriqui (David)
Hospital Materno Infantil is the pediatric facility in David
Hospital Regional de Chiriqui

Herrera

Hospital Cecilio A. Castillero (Chitre) is the large public facility used by both locals and foreign nationals

Los Santos

Hospital Dr. Joaquin Franco, located in Las Tablas and is the facility for both public and private care.

Veraguas

Hospital Regional de Veraguas, located in Santiago and is the facility for both public and private care.