Written by Steffan Grund · Insurance specialist (Versicherungsfachmann BWV) · Updated Facts checked: | Topic | 2026 fact |
|---|---|
| Insurance for the Pensionado visa | Not required; a health certificate is |
| Public option for foreign residents | CSS voluntary insurance, group B2 (foreign citizens): sworn income declaration, minimum base B/. 500 a month, CSS medical exams paid 100% by you |
| CSS B2 contribution rate | Not published in any official document we found |
| Pensionado health discounts (Law 6 of 1987) | Doctors 20%, medicines 20% (Law 30 of 2008), dental 15%, optometry 15%, prostheses 20%, private hospitals 15% only without hospitalisation insurance |
| Out-of-pocket share of health spending | 40.5% (2023, WHO via World Bank) |
| Local private insurance | Supervised by the SSRP under Law 12 of 2012; each policy model needs prior approval; entry and renewal ages set per product |
| Medicare in Panama | Does not pay, except narrow cases; some Medigap plans pay 80% of emergencies in the first 60 days of a trip |
| UK cover | No S1 (EU, EEA and Switzerland only); no NHS cover in Panama |
| Care Expat World zone for Panama | Zone 1: worldwide except the USA, China and Singapore |
| Exchange rate used | ECB: 1 euro = 1.1150 US dollars (27 October 2026); B/. 1 = USD 1 |
Sources: Migration Service (SNM) pensionado requirements, Law 6 of 1987 and Law 30 of 2008, CSS voluntary affiliation page, Law 12 of 2012 and SSRP resolutions, WHO Global Health Expenditure Database, Medicare, GOV.UK, ECB, Care Expat World terms.
Self-pay applies the pensionado discounts of Law 6 of 1987 (as amended by Law 30 of 2008): 20% on doctors, 20% on medicines, 15% on private hospital bills. Insured: Care Expat World Zone 1 premiums from our price registry (age = calendar year minus year of birth), plus what you pay yourself until the yearly deductible is used up; doctor and medicine bills keep their 20% discount, but hospital bills are counted at full price, because the 15% hospital discount applies only without hospitalisation insurance. The bill amounts are your own estimates: we found no official price list for private care in Panama. Dental care and evacuation are not modelled. Underwriting can add a surcharge or an exclusion.
You have five realistic options in Panama: CSS voluntary insurance, a Panamanian private health policy, a long-term international plan, Medicare kept for care in the US plus separate cover for Panama, or paying your own bills with the pensionado discounts. None is forced on you by the residence rules: the Migration Service's requirements for the Panama Pensionado visa ask for a health certificate, not insurance. The table puts the five side by side for someone aged 50 to 64.
| Option | Cost basis | Where it pays | Health check | Main catch |
|---|---|---|---|---|
| CSS voluntary insurance (group B2, foreign citizens) | Contribution on a declared income of at least B/. 500 a month; rate not published | CSS facilities in Panama | CSS medical exams, paid 100% by you | Acceptance after exams; 2016–17 press reported enrolment for foreigners suspended |
| Panamanian private health insurance | Premium in US dollars, product rate table approved by the SSRP | Panama; some products more (check the policy) | Insurer's application questionnaire | Entry and renewal ages set per product; at least one closes to new applicants before 60 |
| Long-term international insurance (for example Care Expat World) | Monthly premium in euros by age band; Zone 1 from €140 at 50–54 | Worldwide except the USA, China and Singapore (Zone 1) | Video health interview, records from the last 5 years | Start cover by 1 December of the year you turn 64; no cover in the home country for US and UK citizens |
| Medicare plus separate cover for Panama | Part B USD 202.90 a month (2026) plus a Panamanian or international plan | Medicare: the US; Panama only in narrow cases | Depends on the Panama plan | Only from 65; Medigap abroad capped at USD 50,000 for life |
| Self-pay with pensionado discounts | Each bill minus 20% (doctors, medicines) or 15% (private hospitals) | Any private provider that honours the card | None | No cap on what you pay; no official price list; evacuation USD 20,000–200,000 |
The options can be combined. Panama's insurance regulator has told insurers to respect a policyholder's right to use their health policy when more than one insurance applies, so CSS membership and a private plan can sit side by side. Which mix makes sense depends on your health today, how far you live from Panama City's private hospitals, and how often you return to the US or the UK. For the lifestyle side of the move, see retiring in Panama; for a full monthly budget, see the cost of living in Panama.
Yes, on paper: the Caja de Seguro Social (CSS) lists "Grupo B2: Ciudadanos extranjeros" among its voluntary insured groups, so a foreign resident can apply. The conditions on the CSS voluntary affiliation page are short, and the gaps in them matter as much as what they say.
| CSS group B2 rule | What the CSS says | What it means for you |
|---|---|---|
| Who | Foreign citizens (group B2) | Bring your residence card; ask which permits are accepted |
| Income | Sworn income declaration with a minimum taxable base of B/. 500 a month | Your contribution is calculated on the income you declare |
| Residence | Proof of residence | A lease or utility bill in your name |
| Health | CSS medical exams | Acceptance depends on the results |
| Exam cost | B2 pays 100% of the total cost of the exams | No official price list found; ask first |
| Cover | "Modalidad tres": disability, old age and death plus sickness and maternity | You pay into a pension risk as well as health |
| Contribution rate | Not found in an official document | Ask the CSS for a written quote |
| Maximum age | Not stated | Ask before you rely on it after 65 |
Two warnings. First, official sources and the press disagree on access: the CSS page describes group B2 as open, while Panamanian press in 2016 and 2017 reported that voluntary enrolment for foreigners had been suspended. We found no newer official notice either way, so treat CSS as possible, not certain. Second, CSS cover is cover in Panama. It does not pay for treatment on visits to the US or the UK and is not a substitute for evacuation cover. CSS can serve as a low-cost base or back-up rather than your only plan; whether that fits depends on the quote the CSS gives you and on the CSS facilities near your home.
We found no official answer: neither the Ministry of Health (MINSA) nor the CSS publishes, in anything we could read, a rule or fee schedule for treating uninsured foreign residents. What exists is indirect. An emergency department head at Hospital Santo Tomás, a public hospital in Panama City, told La Estrella that patients are attended whether they are insured or not; that is an interview, not a tariff, and it does not mention foreigners. Guides written by insurance brokers describe MINSA clinics as low-cost and open to residents, but they are secondary sources with a commercial interest.
What official sources do say is about capacity. GOV.UK's travel advice states that Panama City has some good private hospitals and clinics, but medical facilities outside the capital are limited. The World Bank's WHO-based figures show 1.63 doctors per 1,000 people in 2022, and Panama scores 82 on the WHO service coverage index, against 88 for the UK and the USA. Government sources paid 51.2% of health spending in 2023 and patients paid 40.5% out of pocket. For a retiree, the practical reading is that public care is a safety net for emergencies, not a plan; for planned care, ask the hospital what you will be charged before treatment. Our healthcare systems by country table puts these figures next to other destinations.
No: the discounts cut routine bills by 15% to 20%, but they put no ceiling on a large bill, and the 15% hospital discount disappears once you have hospitalisation insurance. Law 6 of 1987 gives holders of a jubilado or pensionado card (and resident foreigners above the law's age thresholds) a list of health discounts, shown with their condition below.
| Pensionado health discount | Rate | Condition |
|---|---|---|
| Doctors' fees (general and specialist) | 20% | None stated |
| Prescription medicines | 20% | Law 30 of 2008 (originally 10%) |
| Private hospitals and clinics | 15% | Only when the cardholder is not a beneficiary of hospitalisation insurance |
| Dental services | 15% | None stated |
| Optometry | 15% | None stated |
| Prostheses | 20% | None stated |
The trade-off in numbers. Take a 61-year-old with these hypothetical yearly bills at list price: USD 1,500 at doctors and USD 2,400 on medicines (our example figures, not Panama prices, since no official price list exists). In a quiet year, self-pay with discounts costs 80% of USD 3,900: USD 3,120. Care Expat World Comfort with a €1,200 deductible costs €655 a month at 60–64, which is €7,860 a year, about USD 8,764 at the ECB rate of 1.1150, plus the deductible of about USD 1,338 that you pay yourself: about USD 10,102 in total. In a quiet year, self-pay is cheaper by about USD 6,982.
Now add one private hospital stay billed at USD 15,000. Self-pay rises to USD 15,870, because the hospital bill is cut by only 15%. The insured total stays at about USD 10,102, because the deductible is already used up and the insurer pays the rest (the 15% hospital discount is lost, but that no longer matters to you). On these assumptions, insurance becomes the cheaper choice once a year's private hospital bills pass about USD 8,214 at list price, and every dollar above that is a dollar self-pay costs you and insurance does not.
| Year (hypothetical bills, list price) | Self-pay with discounts | Insured: Comfort, €1,200 deductible, age 60–64 | Difference |
|---|---|---|---|
| Quiet: doctors USD 1,500 + medicines USD 2,400 | USD 3,120 | USD 10,102 | Self-pay USD 6,982 cheaper |
| Hospital: the same plus a USD 15,000 hospital stay | USD 15,870 | USD 10,102 | Insurance USD 5,768 cheaper |
Our calculation. Premium from the price registry (€655 a month), converted at 1.1150 US dollars per euro (ECB, 27 October 2026). Bills are illustrative, not official prices. Doctor and medicine discounts are assumed to apply under the deductible too; the hospital discount is assumed lost when insured, following the law's wording. Change any figure in the calculator above.
The comparison leaves out two things that favour insurance: a hospital bill can be far larger than USD 15,000, and a medical evacuation, which the US State Department says can cost USD 20,000 to 200,000, gets no pensionado discount at all. It also leaves out one thing that favours self-pay: the premium rises with each age band, and from 65 you cannot join this plan at all. The decision is less about this year's bills than about whether you could absorb one very large bill.
Panamanian private health insurance is sold by local insurers in US dollars under products that the insurance regulator must approve before sale, and each product sets its own entry and renewal ages. The regulator is the Superintendencia de Seguros y Reaseguros de Panamá (SSRP), which supervises insurers under Law 12 of 3 April 2012. Article 140 of that law requires prior authorisation of policy models before they are marketed, and Article 146 requires rates that are equitable, sufficient and not unfairly discriminatory.
Two SSRP resolutions matter to an older buyer. In Resolution DG-SSRP-004 of 21 August 2018, the regulator told insurers to apply only global rate increases it had approved on individual health policies, not individual increases outside the approved product, and ordered unapproved increases of the previous twelve months refunded. In Resolution DG-SSRP-020, published in the Official Gazette on 8 January 2025, it told insurers to respect the policyholder's right to use a health policy voluntarily when more than one insurance applies. What we did not find is any statutory maximum entry or renewal age for health policies; those limits live in each product's conditions, and at least one local product we saw closes to new applicants before 60.
| Question to ask a Panamanian insurer | Why it matters after 50 |
|---|---|
| What is the maximum entry age, and is renewal guaranteed for life? | Entry and renewal ages differ by product; get both in writing |
| How is my premium set at each age, and when are global increases applied? | The price at 70 matters more than the price today |
| Which pre-existing conditions are excluded, and for how long? | Waiting periods and exclusions are product terms |
| Deductible and co-insurance per claim? | Both decide what you still pay for a hospital stay |
| Which hospitals are in the network, in Panama City and near my home? | Facilities outside the capital are limited |
| What does it pay outside Panama, and in the US? | Domestic products may be built for Panama only |
| What happens to the 15% pensionado hospital discount? | With hospitalisation insurance, the law withholds it |
A local dollar policy has one clear advantage for an American: no currency risk, because Panama uses the US dollar at par with the balboa. A long-term international plan is priced in euros, pays across a worldwide zone, and in the case of Care Expat World has no end date once you are accepted. Neither is automatically better; compare the renewal clause, the price at 70 and the cover outside Panama, not only today's premium.
A long-term international plan pays private treatment in Panama and across its cover area, under a contract that does not end at a fixed age once you are in. Care Expat World, the plan priced on this site, places Panama in Zone 1, which covers the whole world except the USA, China and Singapore. It comes in three levels: Basic covers hospital and outpatient treatment and prescription medicines, Comfort adds dental care, check-ups, physiotherapy and 15 therapy sessions a year, and Premium adds 25 sessions, inpatient psychotherapy and higher refunds. Cancer treatment is capped at €50,000 in Basic and €100,000 in Comfort and unlimited in Premium, which our plan details page sets out with every other benefit.
You join after a video health interview that looks at your medical records from the last five years; the insurer may add a surcharge, exclude a condition or decline. You pick a yearly deductible of nothing, €1,200 or €3,600. Claims are paid in euros, and dollar invoices are converted under the terms; we make no direct-billing claim for this plan, so expect to pay a Panamanian private hospital and claim the money back, and keep a card with room for a deposit. For how premiums rise at every age, see what international health insurance costs, and for the general mechanics, our expat health insurance guide.
No: Zone 1, the zone that covers Panama, excludes the USA, and a US citizen is never covered in the USA by Care Expat World, in any zone. The reason is the home-country rule in the binding German terms: your home country is never part of the cover area, and cover there applies only when the home country is an EU or Schengen state. Trips from Zone 1 into a higher zone are covered for medical emergencies only, for up to 42 days per trip, but for an American the USA is the home country, so even that does not apply there.
| Care Expat World zone | Area | Price | For someone living in Panama |
|---|---|---|---|
| Zone 1 | Worldwide except the USA, China and Singapore | Shown on this site | Full cover in Panama; emergencies only on trips to the USA, China or Singapore, up to 42 days per trip (never in your home country, so not in the US for US citizens) |
| Zone 2 | Adds China and Singapore | From €560 a month at 60–64 (Basic, €3,600 deductible); see the price index | Only if you spend time in China or Singapore |
| Zone 3 | Adds the USA | From €960 a month at 60–64 (Basic, €3,600 deductible); see the price index | Full US cover for non-US citizens, such as a Briton visiting family in Florida; still no cover in the USA for US citizens |
So an American in Panama should plan US medical needs separately: Medicare from 65, and before 65 whatever US cover can be kept or bought for visits. Paying for Zone 3 does not help a US citizen in the USA. Our guide to health insurance for Americans living abroad covers the US side, including Part B and the marketplace, in detail.
No: Medicare does not pay for care in Panama except in narrow cases set out in its fact sheet on coverage outside the United States, such as an emergency that begins in the US when a foreign hospital is closer than the nearest US one. Living in Boquete or Panama City fits none of them.
| US cover | What it pays in Panama |
|---|---|
| Original Medicare (Parts A and B) | Only the narrow exceptions above |
| Medigap foreign travel emergency (plans C, D, F, G, M, N) | 80% after a USD 250 deductible; USD 50,000 lifetime; emergencies in the first 60 days of a trip |
| Medicare Advantage | Some plans cover more abroad; ask your plan in writing |
| Part B premium (2026) | USD 202.90 a month standard, paid whether or not you use it abroad |
| Part B late-enrolment penalty | 10% extra for each full 12 months without Part B, unless a Special Enrollment Period applies; re-enrol 1 January–31 March |
| Under 65 (no Medicare yet) | Nothing: you need CSS, local or international cover, or savings |
From 65 you can keep Part B to protect care during visits or a later return to the US and cover Panama separately, or drop it to save the premium and accept the penalty risk. That choice is personal; a Medicare or benefits adviser can help. Note that Medicare is US-only: the pensionado discounts still apply to the bills you pay yourself in Panama, whatever you do with Medicare.
British expats need their own cover in Panama, because the S1 only works in the EU, the EEA and Switzerland and we found no UK health agreement with Panama. GOV.UK's guidance on moving abroad adds that travel insurance is not intended to cover your healthcare costs if you live abroad permanently. That leaves CSS group B2, a Panamanian policy, an international plan or savings. A Care Expat World plan does not cover a UK citizen on visits to the UK, because home-country cover is limited to EU and Schengen home countries. Our S1 form guide explains where the S1 does work.
A long-term international plan for Panama costs from €140 a month at 50–54 and from €325 a month at 60–64, rising with level and falling with a higher deductible. CSS and local insurers do not publish comparable figures that we could verify, so the table shows the registry premiums with a US-dollar equivalent.
| Age | Basic, €3,600 deductible, per year | Comfort, €1,200 deductible, per year | Premium, no deductible, per year | Comfort per year in USD (about) |
|---|---|---|---|---|
| 50-54 | €1,680 (€140/month) | €4,020 (€335/month) | €6,120 (€510/month) | USD 4,482 |
| 55-59 | €2,400 (€200/month) | €6,060 (€505/month) | €7,860 (€655/month) | USD 6,757 |
| 60-64 | €3,900 (€325/month) | €7,860 (€655/month) | €9,600 (€800/month) | USD 8,764 |
Care Expat World Zone 1 premiums from our price registry; yearly figures are our calculation (12 × monthly); USD at the ECB rate of 1.1150 dollars per euro on 27 October 2026. CSS B2 contribution rate and local premiums: not published in sources we could verify.
Three cost drivers are easy to miss. The deductible: with a €3,600 deductible you pay the first €3,600 of bills each calendar year yourself, so your worst case is the premiums plus that sum. The age bands: Care Expat World moves you into the next band from 1 January of the year you reach it. And the currency: euro premiums cost more dollars when the euro strengthens. For a budget including rent and utilities, see our Panama cost of living guide; all ages and levels are on the Care Expat World overview.
Linda, 57, from Arizona, moves to Boquete on a Pensionado permit with her Social Security and a small private pension. She takes a daily cholesterol tablet. Her pensionado card gives her 20% off doctors and medicines, but a hospital stay in David or Panama City would be cut by only 15%. She applies for Care Expat World Comfort with a €1,200 deductible: €505 a month at 55–59, €6,060 a year (about USD 6,757), and a worst case of €7,260 including the full deductible. She discloses her medication in the health interview. Because she is a US citizen, the plan does not cover her in the USA, so she arranges separate cover for her visits home until Medicare starts at 65.
Ian, 62, from Leeds, settles in Panama City. He has no S1 or NHS cover in Panama. He is healthy, has savings and wants low premiums, so he chooses Basic with a €3,600 deductible: €325 a month at 60–64, €3,900 a year, worst case €7,500. Comfort with the same deductible would be €495 a month and add dental care. He also asks the CSS for a group B2 quote as a possible low-cost base. When he visits his son in Texas, Zone 1 pays for emergencies only, up to 42 days per trip; if he starts spending months there, he will ask for the Zone 3 price.
At 65 or over you cannot join Care Expat World, so your options in Panama narrow to CSS group B2, a Panamanian policy that still accepts your age, Medicare for care back in the US, and self-pay with the pensionado discounts. Already 65 or older in the year cover would start? This plan is closed to you; we are preparing a comparison of plans without an entry-age limit.
| Age 65+ option | Status |
|---|---|
| CSS voluntary insurance (B2) | No maximum age stated on the CSS page; acceptance after CSS medical exams |
| Panamanian private insurance | Only products whose maximum entry age you still meet; read the renewal clause |
| Medicare (Americans) | Pays in the US; in Panama only narrow cases and Medigap travel emergencies |
| Self-pay with pensionado discounts | Available at any age to cardholders: 20% doctors and medicines, 15% private hospitals |
| Care Expat World | Closed to new applicants aged 65+; existing members keep their cover with no end date |
If you are 63 or 64 now, the deadline is close: the entry age is counted as calendar year minus year of birth, so you are treated as 65 from 1 January of the year of your 65th birthday.
Panama is in Zone 1 like the other countries covered on this site, so the international premium is the same at the same age; what differs is the public system and the discounts. Mexico offers IMSS voluntary insurance with a published fee table, as our guide to expat health insurance in Mexico shows, and Costa Rica requires residents to join its CCSS: see expat health insurance in Costa Rica. Further afield, compare Colombia, Portugal and Vietnam.
In Panama (Zone 1), with a €1,200 yearly deductible, a 50–54-year-old pays from €220 a month and a 60–64-year-old from €390. The price depends only on age band, level, deductible and zone, not on the country inside the zone.
| Age band | Basic | Comfort | Premium |
|---|---|---|---|
| 50–54 | €220 | €335 | €400 |
| 55–59 | €265 | €505 | €545 |
| 60–64 | €390 | €655 | €700 |
| 65–69 * | €530 | €955 | €1,170 |
| 70+ * | €985 | €1,295 | €1,570 |
Monthly premiums, €1,200 deductible per calendar year, before any surcharge from the health interview; insurer's premium table, all prices in our price index. * New cover must start by 1 December of the year you turn 64; the 65–69 and 70+ bands apply to people who are already insured. A new age band applies from 1 January of the year you reach it.
The plan featured on this site. We earn a referral commission if you take it out, at no extra cost to you (how we are paid); this is information, not personal advice. Lowest prices (Basic, €3,600 deductible): €140 at 50–54, €200 at 55–59, €325 at 60–64; €40 for ages 0–24.
Lowest price, for people who mainly want protection against large medical bills.
Per month, Zone 1. Lower price with a €3,600 deductible, higher with none.
Adds dental, check-ups, physiotherapy, psychotherapy and pregnancy cover to Basic.
Per month, Zone 1. Lower price with a €3,600 deductible, higher with none.
Highest refunds, including more psychotherapy and 80% for dentures.
Per month, Zone 1. Lower price with a €3,600 deductible, higher with none.
Panama is in Zone 1 (worldwide except the USA, China and Singapore). Zone 1 does not include the USA: trips into a higher zone are covered for medical emergencies only, for up to 42 days per trip. Zone 3 adds the USA, from €960 a month at 60–64 (Basic, €3,600 deductible; see the price index). Your home country is never part of the zone, and the terms give home-country cover only to EU or Schengen citizens, so Americans are not covered in the USA and Britons are not covered in the UK. We make no claim that the Migration Service requires or accepts this plan. Already 65 or older in the year cover would start? This plan is closed to you; we are preparing a comparison of plans without an entry-age limit. Full benefits are in the plan details and prices for all ages on the Care Expat World overview.
Each of our Panama guides covers one part of the move:
Before you apply, check the age limits on international health insurance, how insurers treat pre-existing conditions, and the options for covering a partner or family. Who qualifies for cover on visits home is explained in international health insurance with home-country cover.
No single plan is best for everyone. CSS voluntary insurance is public and needs CSS medical exams; Panamanian private policies are priced in dollars but set their own entry and renewal ages; long-term international plans pay across a worldwide zone; and self-pay leans on the pensionado discounts. The options table on this page compares them for ages 50 to 64.
A mixed one. The public side is the Ministry of Health (MINSA) and the social security fund, the Caja de Seguro Social (CSS); private hospitals and clinics sit alongside, and GOV.UK notes that facilities outside Panama City are limited. In 2023 government sources paid 51.2% of health spending and patients paid 40.5% out of pocket.
The CSS lists voluntary group B2 for foreign citizens. You sign a sworn declaration of income with a minimum base of B/. 500 a month (USD 500), show proof of residence and pass CSS medical exams, which you pay for in full. Acceptance depends on those exams; press reports from 2016–17 said voluntary enrolment for foreigners had been suspended, so confirm with the CSS before you count on it.
We could not find the current contribution rate for group B2 in an official CSS document, so we publish none. What the CSS page does say is that B2 contributes in “modalidad tres”, which covers sickness and maternity as well as disability, old-age and death. Ask the CSS for a written quote on your declared income.
You do. The CSS states that group B2 applicants pay 100% of the total cost of the medical exams. We found no official price list for these exams.
We found no official MINSA or CSS rule or fee schedule for uninsured foreign residents. An emergency chief at Hospital Santo Tomás told La Estrella that patients are attended whether insured or not, but that is an interview, not a tariff. Ask the hospital what you would pay before planned care.
On a plain reading of Law 6 of 1987, yes: the 15% discount at private hospitals and clinics applies when the cardholder is not a beneficiary of hospitalisation insurance. The 20% on doctors and medicines carries no such condition. Ask the hospital how it treats an international policy.
For routine care they help, but they cap nothing: a USD 15,000 hospital bill is still about USD 12,750 after 15%. In our example, a 60–64-year-old on Comfort with a €1,200 deductible pays about USD 10,102 a year in total, so insurance wins once a year’s hospital bills pass about USD 8,214 (list price). Use the calculator with your own figures.
20%. Law 30 of 2008 rewrote the medicines clause of Law 6 of 1987, which originally gave 10%. Press reported a bill to raise it further; until it becomes law, plan with 20%.
We found no maximum entry or renewal age in Panama’s insurance law or the regulator’s rules we could read; each product sets its own in its approved policy model. At least one local product we saw closes to new applicants before age 60, so ask for the entry and renewal clauses in writing.
The Superintendency of Insurance and Reinsurance (SSRP) told insurers in Resolution DG-SSRP-004 of 2018 to apply only global rate increases it has approved on individual health policies, not individual increases outside the approved product, and Law 12 of 2012 requires rates that are not unfairly discriminatory. Age bands written into an approved product still apply, so read the rate table.
The Superintendencia de Seguros y Reaseguros de Panamá (SSRP) supervises insurers under Law 12 of 2012 and has ordered refunds of unapproved health-premium increases in the past. For an international insurer, follow the complaints route in its own terms.
Yes. In Resolution DG-SSRP-020, published in the Official Gazette on 8 January 2025, the insurance regulator told insurers to respect the policyholder’s right to use their health policy voluntarily when more than one insurance applies.
With Care Expat World Zone 1, which covers Panama, the USA is excluded and trips into a higher zone are covered for medical emergencies only, up to 42 days per trip. If you are a US citizen, you are never covered in the USA in any zone, Zone 3 included, because home-country cover applies only to EU or Schengen citizens.
Only as travel cover. Medigap plans with foreign travel emergency cover pay 80% of emergency care abroad after a USD 250 deductible, up to USD 50,000 in a lifetime, and only in the first 60 days of a trip. That does not work as cover for someone who lives in Panama.
It is a personal decision. Part B costs USD 202.90 a month in 2026 and does not pay in Panama, but if you drop it and sign up later you pay 10% extra for each full 12 months without it, and can only re-enrol from 1 January to 31 March. Keeping it protects care in the US.
No. The S1 covers UK pensioners in the EU, EEA and Switzerland only, and we found no UK health agreement with Panama. GOV.UK also says travel insurance is not meant for people who live abroad permanently. British residents need CSS, local or international cover, or savings.
Not for the Pensionado. The Migration Service’s requirements ask for a health certificate, not insurance. We make no claim that the Migration Service requires or accepts any particular insurance plan.
GOV.UK says Panama City has some good private hospitals but facilities outside the capital are limited. From Boquete, the larger hospitals are in David or Panama City, so check that your cover pays for transfers and for the hospital you would actually use, and keep the 24/7 emergency number to hand.
Possibly, after underwriting. Care Expat World runs a video health interview that looks at your records from the last five years and may add a surcharge, exclude the condition or decline. Disclose everything: local Panamanian policies also let insurers terminate for false or incomplete statements.
If you joined Care Expat World before the year you turned 65, the contract continues: it has no end date and the insurer waives ordinary cancellation, although premiums rise with each age band. If you are already 65 in the year cover would start, you cannot join; CSS, a local product that still accepts your age, Medicare in the US and self-pay remain.
The US State Department says medical evacuation can cost USD 20,000 to 200,000, and GOV.UK notes that facilities outside Panama City are limited. Care Expat World pays medically advised transport home and rescue costs after an accident up to €5,000 (Basic), €10,000 (Comfort) or €15,000 (Premium). Check what any plan pays before you rely on it.
It adds currency risk. At the ECB rate of 1.1150 dollars per euro on 27 October 2026, a €655 monthly premium is about USD 730; if the euro rises 10%, so does your dollar cost. A local Panamanian policy is priced in dollars, which suits a US pension.
We found no official CSS contribution rate or maximum age for group B2, no statutory maximum entry or renewal age for Panamanian health policies, no MINSA fee rule for uninsured foreign residents and no official private hospital price list; where that matters, the text says so. Press reports from 2016–17 on suspended CSS enrolment for foreigners conflict with the current CSS page.
Medicare and the NHS will not cover you there, and pensionado discounts put no cap on a large bill. Long-term international cover has no end date once you are in: start cover by 1 December of the year you turn 64.
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