Health Insurance and the Social Security Fund (CSS) for Foreigners in Panama

Who is covered by the CSS?

• Employees in Panama, Panamanian or foreign: the employer must register them and pay contributions for them.
• Their dependents, such as the spouse and children, under the conditions set by law.
• Self-employed workers who pay contributions, in the cases and under the conditions set by law.
• The CSS's own retirees and pensioners.

Having residency does not give you access to the CSS: what counts is paying contributions. That is why people who live in Panama on a foreign pension, on their investments or on remote work for employers abroad are generally not insured by the CSS.

What options does a foreigner who doesn't pay contributions have?

• Panamanian private health insurance: policies from local insurers, supervised by Panama's Superintendency of Insurance and Reinsurance.
• International insurance: useful if you spend time abroad or want coverage in several countries. Check that it covers Panama and the hospitals you are interested in.
• Ministry of Health public facilities: they also treat uninsured patients, who pay the established rates.

What should you check before buying a policy?

• Exclusions for pre-existing conditions and waiting periods.
• The maximum age to buy a policy and how the premium rises with age.
• Which hospitals and clinics are in the network and whether you can choose your doctor.
• Annual and lifetime limits, deductibles and co-payments.
• Whether it covers transfers from areas far from the capital, if you plan to live outside it (see where to live in Panama).

Does residency require health insurance?

It depends on the option. The remote worker visa requires health insurance with coverage in Panama for the whole stay; for other options it is not always a requirement, but it is highly recommended. Some residency options, such as the Pensionado Visa, also require a health certificate issued in Panama, which does not replace insurance.

What changes if you hire workers?

As an employer you must register with the CSS, register your workers, including foreigners, and pay employee and employer contributions every month (see hiring employees in Panama). It is one of the first steps after forming the company and getting the business license.