Health Insurance in Panama for Expats: What Local Plans Cost and What They Cover

Not medical, legal or insurance advice. We checked the rules and figures below against the Superintendencia de Seguros y Reaseguros (SSR), the Caja de Seguro Social (CSS), MINSA, Law 12 of 2012 and insurers' own published plan documents on 2 November 2026. Amounts are in balboas (B/.), which trade at par with the US dollar. Insurers rarely publish full rate cards, so we show the few published figures we could verify, date them, and explain how to get and compare a real quote.

Who this guide is for

You live in Panama or are about to move here, and you are deciding how to pay for healthcare. Maybe you have a job that puts you in the CSS, maybe you are retired or self-employed and have no automatic cover, or maybe you hold an international policy and wonder whether a local plan would be cheaper.

Our overview, <a href="https://panexpats.com/en/guides/healthcare/healthcare-guide-panama">Healthcare in Panama: Hospitals, Insurance and Costs</a>, covers hospitals, pharmacies and everyday costs. This guide goes deeper on one question: what a local health plan actually covers, what drives its price, and how to protect yourself when you buy one.

The short version

• If you work for an employer in Panama, CSS membership is compulsory, whether you are Panamanian or foreign.
• If you are not employed here, foreign residents can apply to join the CSS voluntarily. Since July 2025, CSS says voluntary members who pay into both pension and health pay 17.86% of the income they declare, on a minimum base of B/.500 a month. That is at least B/.89.30 a month at the minimum base, and it buys pension as well as health cover.
• Private plans are sold by insurers licensed by the SSR. The SSR publishes the list, along with each company's licensed lines of business.
• Local plans are priced mostly by age, and most cap the age at which you can first buy. In the plan documents we read, entry limits were under 55 (ASSA), and 59 years 11 months or 64 years 11 months (Mapfre, depending on the plan).
• Pre-existing conditions and some surgeries come with waiting periods or exclusions. Read the plan's conditions, not only the brochure.
• Insurers cannot raise rates across an individual health portfolio without SSR approval, and the SSR publishes the increases it approves. Some were large: 29.47% for one insurer's plans in September 2026.

Three ways to be covered

CSS. The Caja de Seguro Social is Panama's social security fund. Members and their registered dependants get care in CSS facilities. MINSA, the health ministry, runs the public health network and sets health policy for the country. MINSA's own history says its medical services began merging with the CSS's in 1973, and that the integrated system came to cover most of the country, except the Panama City metropolitan region.

A local private plan. You buy a policy from an insurer licensed in Panama. It pays for care in private hospitals and clinics, usually through a network of providers that bill the insurer directly. Many local plans cover Panama only, sometimes with emergency cover abroad.

An international plan. These cover care in several countries, often including the United States, with much higher annual limits. Some are sold here by locally licensed insurers. Mapfre Panamá sells two international plans, with annual renewable limits of B/.1,000,000 and B/.2,000,000. ASSA lists three "local plus international" plans with B/.1,000,000 or B/.2,500,000 options. Bupa Panamá and Pan-American Life also appear on the SSR's list of licensed insurers.

CSS: when you are in, and when you can opt in

If you have a job in Panama, you are in. CSS states that all national or foreign workers who provide services in Panama must be affiliated, and the employer must register them within six business days of starting work. Foreign employees register with a passport or permanent residence card and a registered work contract.

If you are not employed here, you can apply as a voluntary member. CSS lists foreign citizens, including self-employed people who do not file as taxpayers, as group B2. According to CSS, the requirements are:

• A sworn declaration of income showing a minimum monthly base of B/.500.
• Proof of your address or residence in Panama.
• Medical exams by CSS doctors. Foreigners pay the full cost, which the CSS FAQ lists as B/.94.
• A passport or permanent residence card.

Group B2 pays into both the old age, disability and death fund and the illness and maternity fund. There is no health-only option for this group. The combined rate is the 17.86% above (9.36% for pension and 8.50% for health). CSS's FAQ also says first-time voluntary members must be below the official retirement age. You lose voluntary membership after three months in a row without paying. Voluntary members can register dependants in the same way as employees, and medical care starts once CSS notifies you that it has accepted you. CSS says processing takes no more than 60 calendar days.

Many expats with CSS cover still buy a private plan as well. That is a personal choice about wait times, choice of hospital and language, not a legal requirement.

What local plans cover and what they leave out

Plans differ, but the documents we read share a common structure.

Annual limit. The most the insurer pays in a policy year. ASSA's Salud Integral offers B/.300,000 or B/.500,000. ASSA Medic Care offers B/.250,000 or B/.350,000. Mapfre's Solución Basic, a low-cost plan built around emergencies and accidents, caps cover at B/.50,000 a year. Some plans use a lifetime limit instead. Mapfre's Solución Classic has B/.350,000 for life, per person.

Deductible, coinsurance and out of pocket maximum. You pay the deductible first, then a share of each bill (coinsurance), until you reach the yearly maximum you can be asked to pay. After that, the plan pays in full up to its limit. ASSA Salud Integral offers deductibles of B/.500, B/.1,000 or B/.2,000, pays 90% of outpatient care after the deductible, and caps your share at B/.4,000 a year per person.

Copays. Fixed fees per visit or per day. ASSA Medic Care charges a B/.100 daily copay in hospital for up to five days, and a B/.25 copay at the emergency room for illness. Mapfre's Solución Basic charges B/.75 per hospital event and B/.30 per covered emergency visit.

Networks. Local plans are built around a network of hospitals, clinics and doctors. Out of network care costs you more, and so does skipping pre-authorisation. Mapfre's plan conditions, for example, reimburse only 60% of eligible costs that were not pre-authorised. ASSA describes Medic Care as a closed network plan.

Maternity. Some plans include it after a waiting period. ASSA Medic Care and ASSA Salud Integral both apply 12 months. Mapfre's Solución Basic excludes maternity.

Common exclusions. Mapfre's Basic sheet lists pre-existing conditions it will not cover (such as diabetes, high blood pressure, heart disease and cancer), plus mental health conditions, maternity, dental, eye care and cosmetic surgery. Always read the full exclusions in the general conditions (condiciones generales).

Pre-existing conditions and waiting periods

This is where plans differ most.

• ASSA Medic Care's general conditions say pre-existing conditions you declared on the application, and that ASSA did not exclude permanently, are covered after two full years of continuous cover. A list of procedures (for example hernia repair, gallbladder surgery, spine surgery and some gynaecological surgery) is covered from the 13th month. HIV related conditions have a 60 month wait.
• Mapfre's general conditions say declared pre-existing conditions are covered from the first day of the 13th month, unless the policy specifically excludes them. Conditions you did not declare are never covered unless a special endorsement says otherwise.
• Mapfre's Solución Basic does not cover pre-existing conditions at all, and has a 12 month wait for a list of surgeries.

The practical lesson: declare everything on the application. Insurers define "pre-existing" broadly. ASSA's definition includes any diagnosis in your medical history before the policy starts, even if the symptoms are gone.

What drives the price

Age. This is the biggest factor. Insurers publish monthly premiums by age band, and the jump in later decades is steep. In ASSA's Medic Care rate table dated February 2024, the premium for ages 55 to 59 is more than double the premium for ages 50 to 54.

Entry age limits. Most local plans stop selling new policies at a certain age, although you can usually renew after that. In the documents we read:

• ASSA Medic Care and the ASSA plans on its current health page: you must be under 55 to buy.
• Mapfre Solución Basic and Basic Plus: up to 59 years and 11 months. Basic cover ends at age 72.
• Mapfre Solución Classic, Silver, First Class and First Class Gold: up to 64 years and 11 months.

Limits and deductible. A higher annual limit costs more, and a higher deductible costs less. ASSA's February 2024 Medic Care table priced the B/.350,000 option of Medic Care roughly 10% to 18% above the B/.250,000 option.

Geography. Plans that cover care outside Panama cost more than Panama only plans.

Medical underwriting. Insurers can accept you, decline you, or add exclusions after reviewing your health declaration and any exams.

Tax. Both ASSA's and Mapfre's published sheets say their premiums do not include a 5% tax. This is the insurance consumption tax in article 64 of Law 12 of 2012, charged on premiums for insurance on risks in Panama (fire, life policies with a surrender value and agricultural insurance are exempt). Add it to any figure you see.

Published prices we could verify

Few insurers publish rate cards. These are the only figures we found on insurers' own sites.

Mapfre Solución Basic (plan 337). Mapfre's plan sheet, version dated 1 October 2025, lists a monthly premium of B/.30.03, before the 5% tax. This is a limited plan: B/.50,000 a year, built around emergencies, accidents and a list of critical illnesses, with no pre-existing conditions or maternity covered. It is sold up to age 59 years and 11 months, and cover ends at 72. The sheet says it is illustrative and that the policy governs. It shows one premium, not prices by age.

ASSA Medic Care. ASSA's brochure still shows a rate table "in force from 1 February 2024", before the 5% tax. The SSR has since approved two increases on Medic Care, 8.20% in April 2025 and 11.12% in July 2026, so those figures are no longer today's prices and we do not repeat them. The table is still useful for its shape: the 55 to 59 band costs more than double the 50 to 54 band. New buyers must be under 55, so the higher bands apply to people renewing. ASSA's current health sales page features other plans, Salud Integral and the MetroBlue range, and does not publish their prices.

For every other plan we checked, including ASSA Salud Integral and Mapfre's Classic, Silver and international plans, the insurer publishes benefits but not prices. You need a quote.

How premiums rise over time

Law 12 of 2012, which regulates insurance in Panama, requires insurers to justify general rate increases on individual health policies to the SSR and get approval before applying them. The SSR publishes the approved increases each year. Some examples:

• 2026: ASSA, approved 22 July 2026, 11.12% on copay products (ASSA Care, ASSA Medic Care and ASSA Medic Copago are listed). La Regional de Seguros, approved 14 September 2026, 29.47% on six plans, against 30% requested.
• 2025: ASSA, approved 2 April 2025, 8.20% on its health portfolio, including ASSA Medic Care. Mapfre Panamá, 12.609% across its whole portfolio. Sagicor, 19.5% on two plans, against 50% requested. UniVivir, 19.5%, against 35% requested. Bupa Panamá, 9.5%. Pan-American Life, 7.5%.

Your premium can also change when you move into a new age band. Mapfre's general conditions say the premium changes automatically with age under its standard rate table. Mapfre also says it will not change the premium in the first 12 months except for age or family changes, and will give at least 30 days' notice of any other change.

Before you buy, ask the insurer or broker for the plan's increase history. Look the insurer up in the SSR's yearly tables, too.

Rules that protect you

These come from Law 12 of 2012, as published in the Gaceta Oficial, and from the SSR's consumer pages.

• Renewal notice. You or your broker must receive the renewal at least 30 calendar days before it takes effect.
• Grace period. If the policy does not set one, the law sets 30 calendar days after the payment date. If the policy and the law differ, the one more favourable to you applies.
• Missed payments. After the grace period, cover is suspended for up to 60 days. For individual health insurance, the insurer cannot cancel the contract until that 60 day suspension ends. A cancellation notice for non-payment must be sent in writing 15 business days in advance.
• Leaving a group plan. If you had cover under an employer's group health plan for at least five years, you can convert to an individual policy without proving insurability. You must apply and pay within 31 calendar days of the group cover ending. The premium is based on your age at that point.
• Non-renewal. The SSR says the insurer must tell you or your broker 30 business days before renewal if it will not renew on the same terms.
• Claim payment. The SSR says that once an insurer accepts a claim, it must pay within 90 calendar days, as long as you met the contract and legal requirements.
• Choice of broker. You may buy directly from an insurer or through a broker of your choice.

How to check an insurer is licensed

The SSR publishes a list of licensed insurance companies on its <a href="https://www.superseguros.gob.pa/sujetos-regulados/companias-de-seguros/">licensed insurers page</a>. It shows each company's licensed lines of business. Look for "Personas", the line that includes health. When we checked on 2 November 2026, the list included ASSA, Mapfre Panamá, Compañía Internacional de Seguros, Seguros Suramericana (SURA), Pan-American Life, Bupa Panamá, La Regional, Sagicor, UniVivir and others.

The SSR also lists brokers, and publishes sanctions against people and companies selling insurance without authorisation. If a seller is not on the SSR lists, do not pay.

When an international plan still makes sense

A local plan is usually built for care in Panama. An international plan may be worth the higher price if:

• You expect to get treatment in the United States or another country, or you spend long periods outside Panama.
• You are past the entry age for local plans and already hold an international policy you can keep.
• You want higher limits than local plans offer. The local plans we read ranged from B/.50,000 to B/.500,000 a year.
• You have a pre-existing condition that your current international plan already covers, and a new local plan would exclude it or make you wait.

One legal point to check before you rely on a policy bought abroad. Article 153 of Law 12 of 2012 says that people and companies domiciled in Panama must insure persons located in Panama with insurers authorised to operate here. The article lists exceptions, including cover that does not exist in Panama and cases where local insurers have refused you. The article also covers cases where a treaty says otherwise. It lets the SSR authorise insurance abroad once it has checked that the cover cannot be obtained from a local insurer, and those authorisations must be registered with the SSR. We did not find SSR guidance on how this applies to an expat who keeps a foreign policy after moving. Ask a licensed broker, or the SSR, how it applies to you. Several international style plans are sold through locally licensed insurers, which avoids the question.

Claims and complaints

If a claim is denied or you disagree with your insurer, the SSR sets out a two step path.

Step one: write to the insurer. Every insurer must have a complaints officer (ejecutivo de controversias). Send a written complaint with your claim number, dates, the people involved and any earlier replies, and keep a stamped copy. The insurer has 30 calendar days to answer in writing. The SSR publishes the name and email of each insurer's complaints officer on its <a href="https://www.superseguros.gob.pa/proteccion-al-consumidor-de-seguros/">consumer protection page</a>.

Step two: go to the SSR. If you are unhappy with the answer, or get no answer in 30 days, you have up to 90 business days to file a complaint with the SSR. You fill in its complaint form and bring the required documents to its office in Punta Pacífica. The SSR sets a conciliation hearing. If there is no agreement, it issues a binding decision. Law 12 gives the SSR power to decide complaints against insurers up to B/.25,000. The law lets the SSR board update that amount. The SSR's phone number is 524-5800, and its email addresses are info@superseguros.gob.pa and proteccion@superseguros.gob.pa.

Retirees and older residents

Law 6 of 1987 gives retirees, pensioners, women aged 55 and over and men aged 60 and over, Panamanian or foreign residents, discounts on medical services. The consolidated text published in 2009 also says insurers that cover illness must pass the benefit of these discounts on to the insured in their premiums. Ask any insurer how it applies this to you.

Law 562 does not repeat this insurer rule, so it may no longer apply once the new law takes effect.

These discounts are being rewritten. President Mulino signed Law 562 on 2 November 2026 (Gaceta Oficial 30647), and it takes effect six months after publication, around May 2027. Under the new text, foreign permanent residents qualify from 57 for women and 62 for men, and medicines get 20% off, with no prescription needed for over-the-counter items. See our news report, <a href="https://panexpats.com/en/news/669861cf-54ec-44e4-afd4-1f9622617e63/ley-562-descuentos-jubilados-gaceta-nov-2026">New retiree discounts start in May 2027</a>.

How to compare quotes

Get at least two or three quotes for the same person, the same annual limit and similar deductibles, so you compare like with like. A broker can quote several insurers at once. You are free to choose your broker, and you can also buy directly.

For each quote, ask for the general conditions and the plan's particular conditions, not only the brochure. Check five things: the entry age and whether cover ends at a certain age, how pre-existing conditions and waiting periods work, which hospitals are in the network, what you pay out of network, and whether maternity is included.

Ask what the premium will be in the next two age bands, and how much the plan has gone up in recent years. Then check that history against the SSR's published increase tables. Add the 5% tax to every premium you see.

Fill in the health declaration fully and honestly. An undeclared condition can mean a denied claim later. Keep copies of the application and every letter from the insurer.

If you are joining the CSS as well, count the 17.86% voluntary contribution, or your payroll deductions, as part of your total healthcare budget.

What we could not verify

• Current premiums for almost every plan. Insurers mostly quote on request. The only current published figure we found was Mapfre's Solución Basic (version dated 1 October 2025). ASSA Medic Care's table dated 1 February 2024 predates two approved increases, so we did not reprint it.
• Which ASSA plans the 11.12% increase approved in July 2026 applies to, beyond the plans named in the SSR table. ASSA had also asked for 6.62% on deductible products, and the SSR table we read does not show an approved figure for those.
• The B/.94 exam fee for foreign voluntary members. It comes from CSS's online FAQ, which also still shows the old 22% rate that CSS replaced in July 2025. Confirm the fee with CSS before you apply.
• How article 153 of Law 12 applies to foreign policies held by expats who move to Panama.

Not advice

This guide is general orientation. It is not medical, legal, tax or insurance advice. Plans, prices and rules change. Confirm details with the insurer, a licensed broker, the SSR or the CSS before you buy or cancel any cover.

Sources

• <a href="https://www.superseguros.gob.pa/sujetos-regulados/companias-de-seguros/">SSR: licensed insurance companies</a>, list and licensed lines, checked 2 November 2026
• <a href="https://www.superseguros.gob.pa/proteccion-al-consumidor-de-seguros/">SSR: consumer protection, complaints process and yearly health increase tables</a>
• <a href="https://superseguros.gob.pa/wp-content/uploads/Incremento-2026-v1.pdf">SSR: health rate increases approved in 2026</a>
• <a href="https://superseguros.gob.pa/wp-content/uploads/Incremento-2025-3.pdf">SSR: health rate increases approved in 2025</a>
• <a href="https://superseguros.gob.pa/wp-content/uploads/DPC-LC-09-2026.pdf">SSR: list of insurers' complaints officers</a>
• <a href="https://www.superseguros.gob.pa/proteccion-al-consumidor-de-seguros/deberes-basicos-del-contratante-y-asegurados/">SSR: basic rights of policyholders and insured persons</a>
• <a href="https://www.superseguros.gob.pa/proteccion-al-consumidor-de-seguros/requisitos-para-presentar-una-queja/">SSR: requirements to file a complaint</a>
• <a href="https://supervalores.gob.pa/wp-content/uploads/2021/03/Ley_12_de_2012.pdf">Law 12 of 3 April 2012 on insurance (Gaceta Oficial 27007-A)</a>, articles 64, 146, 150, 153, 155, 156, 160, 161, 163, 249 and 251
• <a href="https://www.css.gob.pa/tramites/tramites-para-asegurados/afiliacion-al-asegurado/">CSS: affiliation of employees</a>
• <a href="https://www.css.gob.pa/afiliacion-de-asegurados-voluntarios/">CSS: voluntary members</a>
• <a href="https://prensa.css.gob.pa/2025/08/19/css-notifica-e-informa-a-los-afiliados-al-regimen-de-seguro-voluntario/">CSS: voluntary insurance contribution rates from July 2025</a>
• <a href="https://tramites.css.gob.pa/">CSS online services: voluntary insurance FAQ</a>
• <a href="https://www.minsa.gob.pa/acerca-de">MINSA: about the ministry</a>
• <a href="https://www.salud.assanet.com/">ASSA: health insurance plans</a>
• <a href="https://www.assanet.com/Folletos/ASSA_Medic_Care.pdf">ASSA Medic Care brochure with monthly rates from 1 February 2024</a>
• <a href="https://www.assanet.com/condiciones-generales/salud-01.pdf">ASSA Medic Care general conditions</a>
• <a href="https://www.assanet.com/Folletos/Folleto-ASSA-Salud-Integral.pdf">ASSA Salud Integral benefits brochure</a>
• <a href="https://www.mapfre.com.pa/seguros-salud/">Mapfre Panamá: health insurance plans</a>
• <a href="https://www.mapfre.com.pa/media/SOLUCION-BASIC_SALUD.pdf">Mapfre Solución Basic plan sheet, version 1 October 2025</a>
• <a href="https://www.mapfre.com.pa/media/MP-SAIN-202501-CONDICIONES-GENERALES-SALUD-1.pdf">Mapfre health general conditions</a>
• <a href="https://www.mapfre.com.pa/media/condiciones-particulares-solucion-classic.pdf">Mapfre Solución Classic particular conditions</a>
• <a href="https://www.acodeco.gob.pa/wp-content/uploads/2026/10/Ley6Jubilados_texto_unico.pdf">Law 6 of 1987 on retirees and older adults, consolidated text (Gaceta Oficial 26314-A, 2009)</a>
• <a href="https://panexpats.com/en/news/669861cf-54ec-44e4-afd4-1f9622617e63/ley-562-descuentos-jubilados-gaceta-nov-2026">New retiree discounts start in May 2027</a>
• <a href="https://www.gacetaoficial.gob.pa/storage/gacetas/2026/11/30647/106224.pdf">Law 562 of 2 November 2026, Gaceta Oficial Digital No. 30647</a>
• <a href="https://panexpats.com/en/guides/healthcare/healthcare-guide-panama">PanExpats overview: Healthcare in Panama: Hospitals, Insurance and Costs</a>