Health insurance in Panama.
The Pensionado visa asks for a health certificate, not an insurance policy. The public system is tied to the Caja. Private care is the main option for most expats.
The rules
What Panama asks of you.
Checked against official sources on 23 October 2026. Rules change, so the broker confirms them again before you apply.
- Pensionado: a lifetime pension of B/.1,000
The pension must come from a foreign government, an international body or a private company. It must be at least B/.1,000 a month and be granted for life.
Source: migracion.gob.pa - Lower minimum with property
If you bought property in Panama in your own name for more than B/.100,000, the minimum pension drops to B/.750 a month.
Source: migracion.gob.pa - B/.250 more for each dependant
Each dependant adds B/.250 a month to the income you must show. It can come from extra pension or a local bank reference. Spouses can add their pensions together.
Source: migracion.gob.pa - A health certificate, not insurance
The official document list for the Pensionado permit asks for a health certificate. It does not list a health insurance policy.
Source: migracion.gob.pa - The permit does not expire
The Pensionado permit is indefinite and needs no renewal. So your health cover is your own choice, not a visa condition.
Source: migracion.gob.pa - Private care is mostly in Panama City
The UK government notes that Panama City has private hospitals and clinics, and that facilities elsewhere are limited. It advises travel insurance that covers local treatment and medical evacuation.
Source: gov.uk - Children 18 to 25 must be studying
A dependent child gets a temporary permit until age 25, only while they prove full-time study. They do not get the pensionado status themselves.
Source: migracion.gob.pa - Foreign dependants on the CSS
An insured person can add a foreign spouse and children to the Caja. Children aged 18 to 25 count only if they study.
Source: panamadigital.gob.pa
Public care runs through the Caja de Seguro Social (CSS). Cover comes from being insured with the CSS. The CSS can insure the foreign spouse and children of an insured person. The official pages we read do not set out a route for foreign pensioners, so ask the CSS before you count on it.
Source: panamadigital.gob.paLocal or international
We compare both. You keep the one that fits.
Private hospitals are concentrated in Panama City. A plan that reaches them, and covers care abroad, matters more than the visa paperwork.
- Local plans
Plans sold in Panama. Often cheaper, sometimes required for your visa. Filed by a broker licensed in Panama.
- International plans
Plans that cover you in Panama and beyond, and stay with you if you move again. Filed by our international broker partner.
What to look for
Choosing a plan in Panama.
Ankyro checks each of these on every plan, so you don’t have to read the fine print.
- Panama City hospitals
The good private hospitals are in the capital. If you will live outside the capital, check the plan pays for transfer to a Panama City hospital.
- Evacuation abroad
The UK government advises cover for local treatment and medical evacuation. Check who decides when you are flown out, and to which country.
- Cover for life
The Pensionado permit never expires, so the plan should not either. Ask for the maximum entry age and whether renewal is guaranteed, in writing.
- Children up to 25
Your children can hold a permit until 25 while studying. Check the plan keeps them as dependants to the same age.
Step by step
Getting covered in Panama.
- 01Get a health certificate. The Pensionado file asks for a health certificate, along with a criminal record certificate and proof of a lifetime pension of at least B/.1,000 a month.
- 02Sign a notarised power of attorney. The Pensionado file starts with a notarised power of attorney and request. It must name your parents and their nationality.
- 03Pick private cover that reaches Panama City. The UK government says the good private hospitals and clinics are in the capital and facilities elsewhere are limited. Choose a plan with those hospitals and evacuation.
- 04Add family to the Caja if you can. If you or your spouse is insured with the CSS, foreign dependants are added at the Departamento de Afiliación, Edificio Bolívar, door 108. Bring a legalised or apostilled marriage or birth certificate.
Common mistakes
3 we see all the time.
- 01Thinking the visa forces you to buy insurance. The official Pensionado list asks for a health certificate only.
- 02Skipping private cover because the permit does not ask for it.
- 03Assuming the public Caja covers you without checking how you can join it.
Real published prices, and the 6 things that move yours.
Questions
People also ask.
Do I need health insurance for the Panama Pensionado visa?+
The official document list asks for a health certificate. It does not list an insurance policy. Check with the Servicio Nacional de Migración for your case.
How much pension do I need for the Pensionado visa?+
At least B/.1,000 a month for life, or B/.750 if you own property in Panama worth over B/.100,000. Add B/.250 a month for each dependant.
Can expats use the public health system in Panama?+
Public care runs through the Caja de Seguro Social. It depends on being insured with it. Ask the CSS how it applies to you.
Does the Pensionado permit expire?+
No. The official sheet says it is indefinite and needs no renewal.
Other countries
Going somewhere else?
Most UK visas don’t ask for private insurance. You pay a yearly surcharge instead, and it opens the NHS. Here is what the surcharge buys, and what you still pay for.
02AustraliaMost visitors can’t use Medicare, and many visas carry condition 8501. Here is what each visa asks for, who gets Medicare, and what to check.
03Dubai and the UAEIn Dubai, no insurance means no visa. Your employer covers you, but not always your family. Here are the rules, and what the basic plan leaves out.
04PhilippinesThe retiree visa asks for a medical certificate, not a policy. The new nomad visa does ask for cover. Here is what each visa needs, and how PhilHealth works for foreigners.
05NetherlandsIf you live or work in the Netherlands, Dutch basic insurance is the law. A few people are exempt. Here is who must sign up, by when, and what it costs in 2026.
06CanadaEach province runs its own health plan, and some make you wait. The super visa has strict insurance rules. Here is how Ontario and BC differ, and what the super visa needs.
07Saudi ArabiaIn Saudi Arabia, no insurance means no iqama. Your employer pays for you and your family, and visitors need a policy too. Here is who pays, and what each policy covers.
08JapanIf you live in Japan, joining public insurance is the law. A private plan can only sit on top. Digital nomads are the exception.
09GermanyEveryone in Germany must be insured, and a residence permit needs cover equal to the public system. Here is how to choose, and what gets rejected.
10SingaporeThe national plan is for citizens and PRs. Hospital bills for foreigners are high, and families are often left out. Here is what to check.
11ThailandRetirement visas have hard minimums, the DTV has none, and public care is not free for foreigners. Here are the rules, and what to check.
12SpainSpain has the strictest visa insurance rules in Europe: a Spanish-authorised insurer, no co-pays, no waiting periods. Here is what passes.
13MalaysiaPublic hospitals charge foreigners full price, and work schemes only cover injuries at work. Here is what each pass asks for, and what to check.
14QatarMost visitors need a QAR 50 a month policy before Qatar issues a visa. The law covers expats too, but that part is still rolling out. Here are the rules.
15FranceThe public system is open to residents, but not on day 1 if you don’t work, and it only pays part of each bill. Here is how to cover the gaps.
16PortugalThe visa asks for travel medical cover. The public system opens once you are a resident. In between, and after, here is what to check.
17MexicoNo visa asks for it, so many expats skip it. Then a private hospital asks for payment first. Here is how cover really works in Mexico.
18ItalyWorkers join the public system for free. Retirees and nomads need private cover for the visa, then pay at least €2,000 a year to join. Here are the rules.
19South KoreaStay more than 6 months and you must join the national plan. Before that, and for your share of each bill, you need your own cover.
20VietnamOnly long local contracts come with public cover, and most expats use private hospitals anyway. Here is what the rules say, and what to check.
21Bali and IndonesiaMost Indonesian visas don’t ask for insurance. But hospitals ask for payment first, and serious cases fly to Singapore. Here is what to check.
22GreeceThe consulate takes travel cover for the visa. The residence permit then asks for full health cover. If you don’t work for a Greek employer, that means a private plan.
23ColombiaNomads and retirees need a private policy with exact wording. Residents who work must join the public EPS system. Here are the rules.
24Costa RicaResidents must pay into the Caja, whatever private plan they have. Nomads need their own cover for the visa. Here is how it fits together.
25USAThe US has no public plan you can simply join. Some visas set minimum cover. Others leave it to you. Here is what a J-1 needs, who can use the Marketplace, and what plans cost.
26SwitzerlandBasic health insurance is compulsory for everyone who lives in Switzerland. You have 3 months to sign up. Here is how it works, and what to check.
27IrelandNon-EEA students must hold private medical insurance. Everyone else gets public care once they count as living in Ireland for 1 year. Here is what to check.
28Dominican RepublicThe residence visas for retirees and rentistas ask for a medical certificate, not an insurance policy. Public care is limited. Private care is good but costly.
29New ZealandStudent visas require insurance. A work visa of 2 years or more may open public health care. ACC covers accident injuries. Here is what to check.
30IsraelIn Israel, the public system is for residents. If your life is centred there, you join a health fund (kupat holim). If not, you need private cover.
31Hong KongPublic hospitals in Hong Kong are cheap for eligible persons. Many foreigners are not on that list. Here is who is, what the rest pay, and what to check in a plan.
32ChinaIf you work in China on an employment permit, your employer must enrol you in social insurance. That includes basic medical cover. Here is how it works, and what to check on top.
33ArgentinaEmergency care is open to everyone. For other care at national hospitals, foreigners without permanent residence must show insurance or pay first. The rules are new, so check them.
34IndiaWe found no official rule that ties health insurance to an Indian work visa. We also could not confirm a public scheme for foreign residents. So the plan is yours to choose. Here is what to check.
35TurkeyA residence permit application needs valid health insurance for the whole permit. Most new expats buy a private policy. The public SGK system opens later, after 1 year of residence.
36BrazilThe digital nomad visa needs health insurance valid in Brazil. The public system is open to migrants by law. Many expats add a private plan for speed.
38South AfricaStudy and exchange visas ask for proof of cover from a registered medical scheme. Public clinics offer free primary care. Here is what to check.
39KenyaKenya’s public fund is run by the Social Health Authority (SHA). A foreigner who lives in Kenya for more than 12 months pays into it. Shorter stays need travel health insurance instead.
40TaiwanTaiwan has one national health insurance. Foreigners with a residence certificate can join. If you have a job, you join through your employer. If not, there is a wait.