Let’s get straight to the point: Traditional Medicare (Parts A and B) does not cover healthcare services outside the United States. Period.
This is one of the biggest surprises—and concerns—for American retirees considering a move to Panama. You’ve paid into Medicare your entire working life, and now that you’re ready to enjoy retirement abroad, you discover it won’t cover your doctor visits, hospital stays, or prescriptions in your new home country.
But here’s the good news: Panama’s healthcare system is excellent, affordable, and accessible—and there are several smart strategies to ensure you’re covered without breaking the bank.
The Hard Truth About Medicare Abroad
Medicare typically does not cover healthcare services in foreign countries, including Panama. If you visit a hospital, clinic, or pharmacy in Panama, your traditional Medicare plan will not cover the bill—and you won’t be reimbursed later.
Thousands of expats have learned this the hard way.
So Why Do Most Expats Keep Medicare Anyway?
Despite Medicare not working in Panama, most American retirees continue paying their premiums. Here’s why:
- For trips back to the U.S.: Many return to see family, attend weddings, or schedule annual check-ups with their longtime doctors.
- To avoid penalties: Dropping Medicare Part B means paying a 1% monthly penalty for every year you delay if you ever re-enroll. That penalty lasts for life.
- As a safety net: If an emergency forces you to return to the U.S. permanently, you’ll have coverage waiting.
As one expat put it: “It’s better to have it and not need it than need it and not have it.”
The Game-Changer: Medicare Advantage Plans with Worldwide Emergency Coverage
Here’s where things get interesting. While traditional Medicare doesn’t work abroad, certain Medicare Advantage (Part C) plans DO cover urgent care and emergencies in Panama—and as of 2025, some hospitals now accept direct billing.
Medicare Advantage plans are private alternatives to Original Medicare that bundle Parts A, B, and often D (prescriptions), plus extras like dental, vision, and—crucially for expats—worldwide emergency and urgent care coverage.
What’s Covered?
- Emergency room visits
- Urgent care
- Hospital stays for emergencies
- Up to $250,000 lifetime cap (varies by plan)
- Coverage after a deductible (often around $130)
The Direct Billing Breakthrough
As of 2025, several hospitals in Panama now accept Medicare Advantage with direct billing—meaning you don’t have to pay upfront and wait for reimbursement. You simply show your insurance card.
Hospitals offering direct billing include:
- MiniMed Hospital and its 14 affiliated clinics (announced October 2025)
- The Panama Clinic (accepts Medicare Advantage, GEHA, and Federal Blue Cross Blue Shield)
- Hospital Metropolitano (expanding to Costa Rica and Mexico)
The Cost? Shockingly Low
Here’s the kicker: Many Medicare Advantage plans with worldwide coverage come with Part B giveback programs, meaning they reimburse part or all of your Part B premium ($185/month in 2025, rising to $206.50 in 2026).
Important Requirements
To qualify for Medicare Advantage with worldwide coverage:
- You must maintain Part B (even though you can’t use it for routine care abroad)
- You must have worked 10 years in the U.S. to get premium-free Part A
- No age limits or pre-existing condition exclusions (unlike local Panama insurance)
Don’t Skip Part D (Prescriptions)
Even if you’re not using it now, dropping Part D comes with a 1% monthly penalty forever if you re-enroll later. And if you develop a serious illness requiring expensive medications, you could face out-of-pocket costs exceeding $20,000 for a single drug.
The good news? Many Medicare Advantage plans include Part D at no additional cost. Why risk it?
Your Healthcare Options in Panama
Most expats adopt a dual coverage strategy:
- Keep Medicare Advantage for emergencies and U.S. visits
- Pay out-of-pocket for routine care in Panama (it’s incredibly affordable)
Why Pay Out-of-Pocket Works
Panama’s healthcare costs are so low that many expats don’t bother with local insurance for routine care:
- Doctor visit: $15–$50
- Specialist: $30–$65
- Blood tests: $15–$42
- X-rays: $18
- Dental cleaning: $50
- Dental implant: $600
Many expats are pleasantly surprised to find that their entire doctor’s bill in Panama—consultation, treatment, and all—costs less than a single Medicare copay back home.
Local Panama Insurance Options
If you want comprehensive coverage in Panama, you have several options:
1. Family Medical Plan
- Covers ages 30–79
- $117/month for ages 60–69
- $146/month for ages 70–79
- Covers 70% of non-emergency costs, 100% of emergencies
- Covers pre-existing conditions at 50% after 2 years
2. MiniMed Expat Health Membership
- Only $20/month or $220/year
- No age restrictions
- No pre-existing condition exclusions
- 14 clinics and a hospital in Panama City
3. Santa Fe Hospital (Panama City)
- No age restriction (covers 90+)
- $143.74/month for ages 60–69
- $175.58/month for ages 70–79
- Includes 15% retiree discount
- More lenient about pre-existing conditions
4. International Insurance
- Covers Panama and worldwide
- More expensive: $1,400–$4,500/year depending on age
- Must be living overseas (not available if you return to U.S. full-time)
The Public Healthcare Option
Panama’s public hospital system is available to everyone—no insurance required:
- Doctor visit: $2–$3
- Specialist: $5
- Emergency surgery + 6-day hospital stay: $150
- Heart attack treatment (10 days, including MRIs, CAT scans, medications): Under $900
The trade-offs? Longer wait times, older facilities, no private rooms, and potential language barriers. But many expats use the public system happily and save thousands.
World-Class Private Hospitals
Panama’s private hospital system rivals anything in North America:
- Hospital Punta Pacifica: Affiliated with Johns Hopkins Medicine International
- Hospital San Fernando: Affiliated with Tulane University and Baptist Health International
- The Panama Clinic: Temos accreditation (highest international honor)
Many doctors are U.S.-trained, board-certified, and speak fluent English.
The Pensionado Discount: Your Secret Weapon
As a Pensionado visa holder (or any expat woman over 55 or man over 60 with residency), you get:
- 25% off doctor visits, hospital stays, and lab work
- 10% off prescription medications
- 15% off hospital bills
These discounts apply at both public and private facilities.
Real-World Example: What Many Expats Do
Many retirees maintain their Medicare Advantage plan with worldwide emergency coverage for peace of mind. For routine care—annual check-ups, dental cleanings, minor illnesses—they pay out-of-pocket because it’s so affordable.
Typical costs include routine doctor visits around $20, blood work approximately $42 (with Pensionado discount), and dental cleanings about $50. Many expats report total out-of-pocket healthcare costs for the year under $800—less than two months of health insurance premiums back in the States.
Action Steps Before You Move
- Don’t drop Medicare Part B before exploring Medicare Advantage options
- Research Medicare Advantage plans with worldwide emergency coverage
- Contact an expat Medicare specialist who understands Panama
- Budget for routine care out-of-pocket or explore local insurance options
- Visit hospitals during your scouting trip to see facilities firsthand
The Bottom Line
Medicare doesn’t work in Panama for routine care—but that doesn’t mean you’re unprotected. Between Medicare Advantage plans with worldwide emergency coverage, affordable out-of-pocket costs, local insurance options, and the public healthcare system, you have multiple ways to access excellent, affordable healthcare.
The key is understanding your options before you move and creating a strategy that fits your health needs, budget, and peace of mind.
For many expats, the winning combination is maintaining Medicare Advantage for emergencies while paying out-of-pocket for routine care in Panama. The result? Access to quality, personalized healthcare with shorter wait times—all at a fraction of what they paid in the States.
Need help navigating Medicare Advantage for Panama? Contact an expat Medicare specialist who understands the unique needs of Americans living abroad. The right plan can save you thousands while giving you world-class coverage.undefined