Healthcare for Expats

Panama has a three-tiered healthcare system, which consists of the following:

1. The public healthcare system, which is funded by the government and provides free or low-cost healthcare services to all citizens and permanent residents of Panama. The public healthcare system is divided into two agencies: the Ministry of Health (MINSA), which operates primary care facilities, rural health centers, and some regional hospitals; and the Social Security Fund (CSS), which operates secondary and tertiary care facilities, such as specialized hospitals and clinics. The public healthcare system covers basic and preventive care, as well as some specialized and emergency care, depending on the availability of resources and personnel. However, the public healthcare system also suffers from some limitations, such as long waiting times, overcrowding, understaffing, underfunding, and lack of equipment and supplies.Therefore, many expats prefer to use the private healthcare system for their medical needs, especially for elective and complex procedures.

2. The private healthcare system, which is funded by private insurance companies and out-of-pocket payments and provides high-quality and comprehensive healthcare services to those who can afford them. The private healthcare system consists of several private hospitals and clinics, mostly located in urban areas, such as Panama City and David. Many of these facilities are affiliated with international organizations, such as Johns Hopkins Hospital, and offer state-of-the-art technology and equipment, as well as English-speaking staff. The private healthcare system covers a wide range of medical services, such as consultations, diagnostics, treatments, surgeries, and rehabilitation. However, the private healthcare system also has some drawbacks, such as high costs, limited coverage, and exclusions for pre-existing conditions. Therefore, expats who use the private healthcare system need to have adequate health insurance or sufficient savings to cover their medical expenses.

3. The traditional healthcare system, which is based on the indigenous and folk medicine practices of Panama’s diverse ethnic groups, such as the Ngäbe, the Buglé, the Guna, the Emberá, the Wounaan, the Bri Bri, and the Naso. The traditional healthcare system uses natural and herbal remedies, as well as spiritual and ritual healing, to treat various physical and mental ailments. The traditional healthcare system is mostly used by the rural and indigenous populations of Panama, who have limited access to the public and private healthcare systems. However, some expats also seek the traditional healthcare system for alternative and complementary therapies, such as acupuncture, massage, and aromatherapy.

Health insurance is not mandatory in Panama, but it is highly recommended for expats who want to have access to the best healthcare facilities and services in the country. Health insurance can also protect expats from unexpected and costly medical bills, especially in case of emergencies or chronic conditions.

Expats have several options when it comes to health insurance in Panama, such as:

1. Self-insure option:
Some expats choose to self-insure, meaning that they pay for their medical expenses out of their own pocket, without relying on any insurance plan. This option may be suitable for expats who are young, healthy, and have enough savings to cover their medical costs. However, this option also involves a high risk, as expats may face unforeseen and expensive health issues that could deplete their savings or force them to return to their home country.Therefore, expats who opt for self-insurance should have a contingency plan and an emergency fund in case of a medical emergency.

2. International coverage:
International health insurance, in my opinion, is the best option for most expats in Panama. It is a comprehensive and flexible insurance plan that covers expats for medical services in Panama and other countries, depending on the policy. International health insurance allows expats to choose their preferred doctors and hospitals, both in Panama and abroad, and offers a wide range of benefits, such as consultations, diagnostics, treatments, surgeries, hospitalization, dental care, vision care, maternity care, and repatriation. International health insurance also covers expats for pre-existing conditions, chronic conditions, and emergency evacuation, which are often excluded or limited by other insurance plans.However, international health insurance also has some drawbacks, such as high premiums, deductibles, and co-payments, as well as complex and lengthy claims processes. Therefore, expats who choose international health insurance should compare different plans and providers, and read the fine print carefully before signing up.

3. Local coverage:
Local health insurance is an insurance plan that covers expats only for medical services in Panama. Local health insurance is usually cheaper and easier to obtain than international health insurance, and it may also offer some benefits that are not available in the public healthcare system, such as private rooms, ambulance services, and wellness programs. However, local health insurance also has some limitations, such as restricted network of doctors and hospitals, low coverage limits, and exclusions for pre-existing conditions, chronic conditions, and emergency evacuation.Therefore, expats who choose local health insurance should be aware of the scope and conditions of their plan, and supplement it with travel insurance or emergency fund if they plan to travel outside Panama.

4. Travel coverage:
Travel health insurance is a short-term insurance plan that covers expats for medical services while they are traveling outside their home country. Travel health insurance is usually cheaper and easier to obtain than other insurance plans, and it may also cover expats for some benefits that are not available in the public healthcare system, such as emergency evacuation, repatriation, and lost luggage. However, travel health insurance also has some limitations, such as short duration, low coverage limits, and exclusions for pre-existing conditions, chronic conditions, and routine care.Therefore, travel health insurance is not suitable for expats who live permanently or long-term in Panama, and it should be used only as a temporary or supplementary insurance plan.

Panama has a large and diverse network of healthcare facilities and providers, both public and private, that offer a range of medical services to the population. However, the quality and availability of these facilities and providers vary greatly depending on the location, the sector, and the specialty. Expats who live or travel in Panama should be aware of the differences and options that exist in the country, and choose the ones that best suit their needs and preferences.

Here are some of the main types and examples of healthcare facilities and providers in Panama:

1. Public hospitals and clinics: Public hospitals and clinics are operated by the Ministry of Health (MINSA) or the Social Security Fund (CSS), and provide free or low-cost healthcare services to all citizens and permanent residents of Panama. Public hospitals and clinics are located throughout the country, but they are more concentrated and better equipped in urban areas, such as Panama City and David. Public hospitals and clinics offer basic and preventive care, as well as some specialized and emergency care, depending on the availability of resources and personnel. However, public hospitals and clinics also suffer from some limitations, such as long waiting times, overcrowding, understaffing, underfunding, and lack of equipment and supplies. Therefore, many expats prefer to use private hospitals and clinics for their medical needs, especially for elective and complex procedures.

3. Doctors and specialists: Doctors and specialists are healthcare professionals who provide medical services to patients, either in public or private facilities, or in their own offices or clinics. Doctors and specialists in Panama are required to have a medical degree from a recognized university, as well as a license from the Ministry of Health or the Medical Association of Panama. Doctors and specialists in Panama may have different levels of experience, expertise, and reputation, depending on their specialty, training, and practice. Expats who need to see a doctor or a specialist in Panama should do some research and ask for recommendations from their friends, colleagues, or insurance company, and choose the one that best suits their needs and preferences.

Expats who live or travel in Panama should follow some practical and useful tips to stay healthy and safe in the country, such as:

• Get vaccinated: Expats should make sure that they are up to date with their routine vaccinations, such as tetanus, diphtheria, pertussis, measles, mumps, rubella, polio, and influenza. Expats should also consider getting vaccinated against some diseases that are prevalent or endemic in Panama, such as hepatitis A, hepatitis B, typhoid, rabies, and yellow fever. Expats should consult their doctor or a travel health clinic at least four to six weeks before their trip to Panama, and obtain a yellow fever certificate if they plan to visit yellow fever-risk areas or travel to other countries that require it.

• Use insect repellent: Expats should protect themselves from mosquito-borne diseases, such as malaria, diphtheria, zika, and yellow fever, by using insect repellent that contains DEET, picaridin, IR3535, or oil of lemon eucalyptus. Expats should also wear long-sleeved clothing, avoid stagnant water, and sleep under a mosquito net or in an air-conditioned room. Expats who travel to malaria-risk areas should take antimalarial medication as prescribed by their doctor, and seek medical attention if they develop symptoms of malaria or any other mosquito-borne disease.

• Drink bottled or boiled water: Expats should avoid drinking tap water or ice cubes in Panama, as they may be contaminated with bacteria, viruses, or parasites that can cause diarrhea, typhoid, hepatitis A, or cholera. Expats should drink only bottled or boiled water, or use a water filter or purifier. Expats should also avoid brushing their teeth with tap water, and use bottled or boiled water instead.

• Wash your hands frequently: Expats should practice good hygiene habits, such as washing their hands frequently with soap and water, or using alcohol-based hand sanitizer, especially before eating, after using the bathroom, and after touching animals or public surfaces. Expats should also avoid touching their eyes, nose, and mouth with unwashed hands, as this can spread germs and cause infections.

• Peel or cook your fruits and vegetables: Expats should avoid eating raw or undercooked meat, seafood, and dairy products, as they may be contaminated with bacteria, viruses, or parasites that can cause foodborne diseases, such as diarrhea, typhoid, hepatitis A, or cholera. Expats should also peel or cook their fruits and vegetables, or wash them with bottled or boiled water, as they may be exposed to pesticides, fertilizers, or animal feces that can cause health problems.

• Have an emergency plan: Expats should have an emergency plan in case they need urgent medical attention or evacuation in Panama. Expats should know the emergency numbers, such as 911 for police, fire, and ambulance, and 104 for the Red Cross. Expats should also know the location and contact details of the nearest hospital, clinic, or pharmacy, and have their health insurance card and policy number handy. Expats should also have a list of their medical conditions, allergies, medications, and blood type, and carry it with them at all times. Expats should also inform their family, friends, or embassy of their whereabouts and health status, and have their contact details ready.