Question 1

Do I need health insurance in Panama?

Accepted Answer

Panama doesn't require private health insurance, but the public system (CSS) has long waiting lists and limitations. If you can afford private insurance, the difference in quality and speed of care is enormous — for both Panamanians and foreign residents.

Question 2

What's the difference between local and international insurance?

Accepted Answer

Local insurers (ASSA, MAPFRE, SURA) operate with closed networks: you can only see in-network doctors. They're cheaper but less flexible. International insurers (PassportCard, SafetyWing, Cigna) let you see ANY doctor worldwide, cover the USA, and offer global coverage. The key difference: free doctor choice and direct payment vs. reimbursement.

Question 3

Can I have both local and international insurance?

Accepted Answer

Yes, and it's a popular strategy. Many Panamanians combine a basic local plan (ASSA Medic Care ~$71/mo) for routine visits with a catastrophic international plan for serious emergencies. This reduces total cost while maintaining complete protection.

Question 4

I'm over 55. What are my options?

Accepted Answer

Local insurers (ASSA, MAPFRE, SURA) have an entry age limit of 55. If you're over 55, your options are: PassportCard (up to 64), SafetyWing (no limit), and Cigna (no limit). PassportCard offers the best value: from $175/mo for ages 50-59 with free doctor choice and direct payment.

Question 5

What happens if I turn 55 and already have local insurance?

Accepted Answer

If you already have an active local policy, you can generally renew regardless of age. The 55 limit is only for NEW customers. However, prices increase significantly with age and terms may change at renewal.

Question 6

What is PassportCard's 'red card'?

Accepted Answer

It's a prepaid debit card (Mastercard) that PassportCard loads with funds when you need medical care. Go to any doctor you want, pay with the card, done. No claim forms, no waiting for reimbursement. It's the closest thing to paying out-of-pocket but with insurance covering everything in real time.

Question 7

Do insurers cover pre-existing conditions?

Accepted Answer

It depends on the plan. Most local insurers do NOT cover pre-existing conditions. PassportCard Comfort and Premium cover them after a waiting period. Cigna accepts them with a premium surcharge. SafetyWing Remote Health also covers after a waiting period. For SafetyWing's basic Nomad Insurance, there's no pre-existing coverage.

Question 8

Which insurance covers emergencies in the USA?

Accepted Answer

ALL international insurers cover the USA: PassportCard (all plans), SafetyWing (both products), and Cigna (all plans). Among locals, only ASSA MetroBlue Premium+ and MAPFRE Elite partially cover the USA. ASSA Basic, MAPFRE Basic/Classic, and SURA do NOT cover the USA — an appendectomy in Miami costs ~$35,000 out of pocket.

Question 9

What's the best insurance for families?

Accepted Answer

PassportCard Comfort ($200/mo) is our #1 recommendation for families: $3.5M coverage, dental included, kids free for the first 3 months, free doctor choice, and direct payment with the red card. For families who travel frequently and need home country coverage, SafetyWing Remote Health ($206/mo) is the alternative.

Question 10

How long does it take to activate insurance?

Accepted Answer

It depends: SafetyWing Nomad activates instantly (buy online, immediate coverage). PassportCard takes 2-5 business days (they send the red card). ASSA and MAPFRE take 5-10 days due to in-person process. Cigna takes 3-7 days. All have additional waiting periods for maternity (6-10 months) and pre-existing conditions (12-24 months).

Question 11

How do reimbursements work?

Accepted Answer

With reimbursement insurers (ASSA, MAPFRE, SURA, SafetyWing), you pay the doctor first and then file a claim with receipts. Timeline: ASSA 2-6 weeks, SafetyWing 2-4 weeks, MAPFRE 2-4 weeks. With direct payment (PassportCard red card, Cigna own network), the insurer pays the provider directly — no claim needed.

Question 12

Can I cancel my insurance at any time?

Accepted Answer

SafetyWing Nomad: yes, monthly cancellation. PassportCard: annual contracts, but with pro-rata cancellation policy. Cigna: annual contracts. ASSA and MAPFRE: generally annual contracts with early cancellation penalty. Always read the terms before signing.

Question 13

Who can get international insurance in Panama?

Accepted Answer

Anyone. Although brands like PassportCard or SafetyWing market themselves with names like 'Nomad Insurance', they are simply international health insurance available to EVERYONE — including Panamanians who never leave the country. A Panamanian can sign up for PassportCard Comfort and use it to see ANY doctor in Panama City. You don't need to be a nomad or foreigner.

Question 14

Do I need insurance for a residency visa?

Accepted Answer

Panama doesn't require health insurance for most residency visas. However, some visas (like Pensionado) may require proof of financial solvency. Having health insurance strengthens your application and protects you from unexpected costs.

Question 15

Why is PassportCard better than ASSA for most people?

Accepted Answer

For $200/mo (PassportCard Comfort) you get: $3.5M coverage (vs. $250K ASSA Basic), free doctor choice (vs. closed network), dental included (vs. not included), worldwide coverage including USA (vs. Panama only), direct payment no claims (vs. reimbursement 2-6 weeks), and entry up to 64 (vs. 55). ASSA's only advantage: lower base price ($71/mo) and 100% Spanish service.

Question 16

PassportCard or SafetyWing? Which should I choose?

Accepted Answer

PassportCard if you want: direct payment (red card), no reimbursements, better service. SafetyWing if you need: minimum budget ($42/mo), home country coverage, or you're over 64. PassportCard Comfort ($200) vs. SafetyWing Remote Health ($206): similar price, but PassportCard has direct payment and $3.5M vs. $1M coverage.

Question 17

Is Cigna worth it if it's more expensive?

Accepted Answer

Cigna is worth it IF you need: home country coverage (PassportCard doesn't include it), a recognized global brand for your business, or a 1.5M+ provider network with direct payment. For most people, PassportCard Comfort offers better value: $200/mo with $3.5M vs. Cigna Gold $280/mo with $2M.

Question 18

Which insurance includes dental?

Accepted Answer

With full dental: PassportCard Comfort ($200/mo), PassportCard Premium ($350/mo), SafetyWing Remote Health ($206/mo), Cigna Gold ($280/mo), Cigna Platinum ($460/mo). Partial dental: ASSA MetroBlue Premium+, MAPFRE Superior/Elite, SURA Premium. NO dental: ASSA Basic, MAPFRE Basic/Classic, PassportCard Starter/Remote, SafetyWing Nomad, Cigna Silver.

Question 19

Which insurance covers maternity?

Accepted Answer

Full maternity: PassportCard Premium ($350/mo), Cigna Platinum ($460/mo). After waiting period (6-10 months): ASSA MetroBlue, MAPFRE Superior/Elite, SURA Premium, SafetyWing Remote Health, Cigna Gold. NO maternity: ASSA Basic, MAPFRE Basic/Classic, PassportCard Starter/Remote/Comfort, SafetyWing Nomad, Cigna Silver. NOTE: PassportCard Comfort does NOT include maternity despite being excellent in everything else.