Contact 
Log In 
Understanding International Insurance Billing in Panama
If you’re planning to move to or visit Panama, it’s essential to understand how the healthcare system handles insurance billing.
First, it’s important to note that if you have “Panama” health insurance, it is widely accepted at private hospitals throughout Panama, providing a seamless experience for Panamanians and foreigners alike. However, getting Panama insurance may be challenging if you have pre-existing conditions.
See these Panama health insurance options. We recommend Panamanian insurance brokers for Panama insurance in the Online Panama Relocation Guide.
However, the process can be quite different for those with international health insurance or traveler’s insurance. Here’s a comprehensive look at how insurance works in Panama and recent developments that are making it easier for expats and traveler
Prepay and Reimbursement Model
In Panama, hospitals may accept your insurance even if you have international health insurance or traveler’s insurance. This means you must pay for your medical treatment upfront, then file a claim with your insurance provider for reimbursement. This process can be time-consuming and requires sufficient funds (or credit card limits) to cover the cost of medical services, especially for more extensive treatments or emergencies.
The ‘dirty little secret’ is that even if you have insurance covering you overseas, Panama hospitals may not accept it!
I first discovered this problem when I got COVID in 2020. Even though I had international health insurance that covered medical emergencies in Panama, the hospital would not accept the insurance, so I had to pay $15,000 before they would even admit me to the hospital. Then, I had to file a claim to get reimbursed. It took nine months, and I was only refunded 50% of my bill.
The hospital would not even call the international insurance company to request a Guarantee of Payment. They just said, “We don’t accept that insurance!”
Earlier this year, two clients had heart attacks. They both had Medicare Advantage insurance covering them for emergencies internationally. However, they had to pay $14,000 and $40,000, respectively, then file their claim to try to get reimbursed.
I had to find a solution!
Since my COVID experience in 2020, I have been looking for a solution: an experienced billing company in Panama to handle international insurance billing, since the hospitals wouldn’t do it. Finally, it’s happening in Panama!
Recent Improvements with Panama Hospitals
There’s good news! A billing company has recently partnered with several hospitals in Panama, where you can use Medicare Advantage for urgent care and emergencies, as well as other U.S. or Veterans’ insurance. The hospitals are:
In Panama City
*The Panama Clinic
*MiniMed Hospital (and 14 clinics)
In David
*Hospital Chiriqui in David
*Hospital Mae Lewis in David
This partnership allows certain insurance providers to verify benefits and guarantee payment to the hospital, meaning the hospital can accept these insurances directly without you having to prepay!
After your treatment, once the billing company receives the bills from the hospitals and doctors, it translates them into English, adds the proper coding, and submits the claim to the insurance company. It then follows up with the insurance company to ensure the hospitals are paid quickly.
You don’t pay a fee to use this service. The hospital pays the billing company.
This significant change is a game-changer for many expats and visitors, eliminating the need to prepay and navigate the reimbursement process.
Insurance Providers Accepted
Check your insurance policy to see whether it offers overseas coverage. Some do. But some don’t.
If your insurance offers overseas coverage, the billing company can issue a Guarantee of Payment (GOP) so you can get prompt medical care without prepaying.
Some insurance companies cover only emergencies if you are admitted to the hospital. Read your insurance policy or talk to your insurance agent for details on what is and isn’t covered in Panama.
Some insurance has a co-pay. Some do not. Before signing up for any insurance, find out what payments you could be responsible for.
See the hospital websites below for which insurance they accept. If your insurance is not on the list above or on the hospital website, it will not be accepted, so you must prepay and file a claim.
This is a sample verification of benefits:
What About Medicare, Supplements, or Medicare Advantage Plans?
Medicare does not cover you overseas. See this brochure with Medicare rules.
Medicare Supplement plans only cover the first 60 days outside the United States. There is a 20% co-pay and a $50,000 lifetime benefit for overseas medical care, so it’s not viable for someone living in Panama.
You can convert to a Medicare Advantage plan if you have Medicare Part A and B. There is no fee to convert, and in most cases it costs the same as Part B (about $200 a month). You can get a Medicare Advantage policy even with pre-existing medical conditions.
Medicare Advantage is only for US citizens. It can ONLY be used for urgent care and emergency medical care in Panama.
If you have a Medicare Advantage plan, some hospitals in Panama will accept it if it’s one of the approved insurance plans listed above. Humana is not accepted. You have two options in this case:
- Switch to an approved insurance plan that the hospital can accept directly.
- Continue with the prepayment method and file a claim with your insurance provider for reimbursement after treatment.
Expansion to Hospitals in Panama City
The billing company’s collaboration with hospitals is not limited to Chiriqui. Soon, several hospitals in Panama City will also be working with the billing company, allowing them to accept these international insurances directly. This expansion will further simplify the process for those living in or visiting the capital city.
Beware of Misleading Insurance Agents
Be cautious when purchasing international health insurance, travel insurance, Medicare Advantage, or other insurance, as some agents may claim your policy will be accepted at hospitals in Panama when, in reality, it may not be.
If your insurance is not on the approved list, you will be required to prepay the entire medical bill and then file your own claim for reimbursement. This process can be both stressful and costly, especially in emergencies. You must translate all bills
Any insurance agent living and working in Panama must have a work permit. Ask to see their work permit. Foreigners living in Panama must have a work permit to promote or sell any products or services to people in Panama.
Before you sign up for insurance, always verify directly with the nearest hospital to ensure your insurance will be accepted without prepayment.
Real Sad Examples:
For example, a Panama expat insurance agent put someone on a policy that only covered them for the first 60 days out of the United States. They had been in Panama for six months when the husband had a stroke. They were stuck paying the entire hospital bill and then filing a claim for reimbursement. But their claim was denied because they were outside of the US for more than 60 days!
Another person went to the emergency room, only to discover their insurance wasn’t accepted. Hospital Chiriqui wanted $5000 upfront before they could admit the person for emergency surgery. Depending on what the surgeon found, there would be additional fees after surgery. They could not afford to pay $5000!
It’s so sad that the Panama expat agent sold them a worthless policy that is not accepted at the hospitals in Panama.
Experienced Agents!
We work with several experienced Medicare Advantage insurance agents who specialize in helping you find the right insurance accepted in Panama. They all offer free consultations. They can help you determine if your insurance is sufficient or if you need to change to a better plan. See the list of Medicare Advantages in the Online Panama Relocation Guide.
I don’t get kickbacks or commissions if you use one of these insurance agents. You can ask them.
Key Takeaways
- Most hospitals in Panama require upfront payment, even if you have international or traveler’s insurance, and you must file your own claim for reimbursement.
- Some private hospitals now work with a billing company that allows them to accept specific insurance plans directly, eliminating the need for prepayment.
- Accepted insurance plans include United Health Care, BCBS (Commercial and Federal), Kaiser Permanente, Cigna, Tricare, FMP, ChampVA, Aetna, and GeHa.
- Some Medicare Advantage plans are not accepted in Panama, even though they cover urgent care and emergencies. You must switch to an approved insurance plan or use the prepayment-and-claim method.
- Medicare does not cover overseas medical care.
- Beware of expat insurance agents in Panama who might put you under a policy not accepted by Panama hospitals, forcing you to prepay for medical care.
This evolving system is a welcome change for many expats and travelers in Panama, providing more convenience and peace of mind when accessing healthcare services.
