Best Place to Retire in Panama

Boquete Hospitals and Health Care

I often get into conversation with people about Health care in Panama. Most people are very fearful of living and sometimes even travelling out of their home country for fear of “3rd World Health Care”. What many don’t realize is that everyone needs health care and in many parts of the world it is not only much cheaper but often easier to gain access to.

I was going to do a complete review of what happens when you get sick in Panama - hospitals, emergency care, health insurance, etc. but then I was reading Richard Detriches Blog, a fellow ex-pay who lives on and off in Panama, and I discovered Richard had done a great story on all of those things. What is cool is that he focused on health care services in Chiriqui, Panama so you can get a good idea of what it is like to get care when you live in Boquete or somewhere between Boquete and David, the Panamanian provincial capital.

Here’s Richard’s explanation of health care in and around Boquete Panama -

Hospitals: David, Panama

Chiriqui Hospital in David Panama

In David, the third largest city in Panama, 45 minute drive from Boquete, there are four large hospitals. The Maternal & Child Hospital is a National Hospital focusing primarily on material and pediatric care. It is only two years old and was a gift from the people of Taiwan, with whom Panama has diplomatic relations. Almost next door is the Social Security Hospital which serves people who are working in Panama and paying into the Social Security system. Just down the Pan American Highway is Hospital Mae Lewis, a private hospital that is used by locals and gringos. And a few blocks off the Pan American Highway is Hospital Chiriqui, a private hospital that is generally preferred by expats because of their insurance program (more on that later). Hospital Chiriqui. Additionally, scattered around David, there are almost a half dozen tiny private hospitals owned and run by a consortium of doctors. In some ways it isnt very efficient, yet the hospital costs are low. A private room runs about $60 a day! Of the private hospitals, Hospital Chiriqui has the most bells and whistles including a state-of-the-art MRI machine, one of two in Panama.

Unlike in the US, in Chiriqui any doctor can practice in any hospital and you are not limited to only certain hospitals where your doctor happens to be on staff.

Emergency Care in Panama

Here is where things can get a little dicey.

If you happen to be one of the very few people to get bitten by one of our famously poison snakes, like the fer de lance which is fairly common in Chiriqui . . . and let me quickly add that your chances of getting bitten by a poisonous snake are about the same as your chances of getting struck by lightening or winning the lottery! . . . if you are bitten by a snake anywhere in Panama you are generally about 45 minutes from a Social Security hospital which is where the anti-venom is kept. So you have plenty of time to get to the hospital where you will find that rather than immediately giving you anti-venom there is a long waiting/observation period while they test your blood and wait to figure out what kind of snake bit you and what type of anti-venom you need. Almost everyone, except for Indians living in very remote areas, recovers. So although the fer de lance and bushmaster can be deadly, your chances of dying if you get assistance are very slim.

OK, we got that out of the way!

When we first came to Panama my wife asked our Boquete doctor, So if Im having a heart attack, what do I do?

His response: First you call me. Ill come to your house and call an ambulance. Well stabilize you in David, and if necessary, once you are stabilized, we will fly you to the Panama City where the hospitals and doctors who specialize in invasive procedures are located.

Good enough . . . but when we say ambulance do NOT think of ambulance service in the US! There have been times in Boquete when we had four different ambulances . . . and none were working! And an ambulance here is primarily a means of transportation. Dont think a team of trained EMTs on call . . . or an ambulance with any sort of equipment on board. Over the years weve been in Boquete the expat community has worked hard and raised money to improve ambulance service, but it still is nothing like what we were used to in the States.

One Couples Panama Health Care Experiences

Chiriqui Hospital Panama

Chiriqui Hospital Panama

One afternoon my wife started having some kind of episode. She was dizzy, had no feeling in her arms, was weak, and couldnt stand up. It looked like some kind of allergic reaction and I feared she was going into anaphylactic shock. (We have experience with this: I am highly allergic to shellfish of any kind in any amount, and my daughter is highly allergic to chocolate.) Without 911 or any similar kind of emergency help, I called our friend Brad, and together we carried Nikki to my car, and I went to the doctors office (the same guy who treated her when she was thrown off the horse . . . the story I told yesterday). It turned out the good doctor was on vacation and the gal who was filling in not only didnt speak any English, but wasnt that familiar with his office. Eventually she found the oxygen mask, started an intravenous drip, got Nikki stabilized and agreed we needed to get to the hospital in David. She called the ambulance . . . and the fun began.

The doctor called the ambulance, then said to me, They dont have any gas. They want to know if you can pay for the gas? Yes!!!

So the ambulance and attendants arrived . . .

First problem: the doctors makeshift treatment room and the gurney that wouldnt fit in.

Second problem: the ambulance crew hadnt the slightest idea how to move a patient from a bed onto a gurney. Somehow we managed.

Third problem: Nikki was too big for the ambulance. Panamanians are shorter. So they couldnt close the back doors of the ambulance all the way. She wouldnt fit! So the creative solution was for the ambulance attendant riding in the back to wedge himself between the side of the ambulance and press his feet against the gurney to keep Nikki from sliding out the back doors, which were flapping in the wind.

Fourth problem: Nikki had an IV drip going and there was no place to hang the drip in the ambulance. The attendant in back was busy trying to keep the gurney from flying out the back, so Nikki had to hold her own IV bag.

OK, we stopped and got $20 worth of gas. Then we began racing down the mountain to David with lights and sirens going.,

Fifth problem: Nobody in Panama is going to move for an ambulance! Only the expats will pull over out of force of habit. So Im in front, the driver is laying on the horn so people eventually will move out of the way.

Sixth problem: We start to get one of our famous, afternoon rainy season cloudbursts when the water is coming down in torrents. In front the windshield wipers are barely working and in back the doors are flapping in the wind and the water is coming in soaking Nikki and the attendant who is bravely still holding the gurney in place with his feet.

The reality: Supposedly laughter is the best medicine and Nikki, although the center of the drama, couldnt help but find the humor in the situation.

Fortunately we arrived at Chiriqui Hospital and into the tiny emergency ward. It took a while, but Nikki was stabilized and a team of internists eventually discovered that she had developed an allergy to aspirin. She spent two nights in the hospital, before coming home. The ambulance ride:(for those of you who remember the original Disneyland . . . definitely an E-ticket ride!) $20 for gas, and another $5 (in gratitude) for beer for the guys. Hospital: emergency room, two nights, and physicians $225.

Yet another story . . . my wife keeps things interesting!

Nikki was experiencing tingling in her arms, chest pain, yada yada . . . with her history . . . Come on, Nikki, dont be a hero! Lets get it checked now. If its nothing, fine . . . if its not, golden hour and all that stuff. So we go to Boquete to the new clinic for such emergencies that Hospital Mae Lewis has opened. The only problem is theres only a receptionist staffing the clinic. No doctor . . . not even a nurse . . . receptionist and janitor. The receptionist informed us that the doctor was going to be coming in an hour and that we could sit and wait. OK, so this is to be an Emergency Clinic . . . right. And if it is a heart attack, were going to sit here and twiddle our thumbs for an hour and hope that the doctor actually does show up as scheduled . . . which, in itself, would be somewhat of a miracle anywhere, let alone in Panama. And Im about to have a Richard-goes-ballistic attack . . .

I remembered that a friend I had met because he had read this blog, lived in an apartment upstairs. He is a retired neurosurgeon who still consults via video cam in complicated surgeries around the world. Although he wasnt a cardiologist, I knew he had his own personal encounter with a massive heart attack and open heart surgery, so I went upstairs and asked him if he could just come down and take a look at Nikki. Gracious friend that he was he put on his slippers, found his stethoscope and came down and took a look. His verdict, I cant say what is going on, but I can say with 99.9% certainty that she is not having a heart attack.

So . . . forget paramedics and 911.

As oldsalt1942? commented about yesterdays post, You get better or you die, and thats the reality of health care in the vast majority of the world. You get better or you die. Period. And lets face it, you cant take life too seriously because none of us are getting out of here alive.

Health Insurance in Panama

Folks handle insurance in different ways. People who worked for the Canal or the US military in Panama have their own insurance. Some people worked for companies who still provide their retirees with the insurance they were promised when they retired. Some have their own policies from the States or some international insurance policy. Like most insurance when you are trying to get insurance after retirement you find that the insurance companies dont cover preexisting conditions, which is exactly what you are worried about. And by the time most people reach retirement age they have preexisting conditions.

When you turn 65 of course and are collecting US Social Security you have Medicare. However, Medicare only covers treatment in the US. So unless you want to return to the US when you need medical care, which some folks elect to do, you are not covered. When I looked at the cost of Part B for me, and what all was not covered by Part B, I decided that for me it was cheaper to just pay the full amount for the procedure in Panama. So we, basically, self-insure . . . with a couple of exceptions.

Panama Travel Health Insurance

Panama Travel Health Insurance

Since we travel a lot, we purchase annual travel policies from a company in Scandinavia that cover us when we are away from Panama for emergency medical care except in the US. When you include the US the cost is prohibitive, and at least when I am in the US, I could use Medicare. My wife is too young for Medicare! Since we are on ships a lot, it is important for us to have insurance that covers medical evacuation. I think anyone is crazy who takes a cruise without having travel insurance that includes coverage for evacuation. The cruise line wants you off the vessel and into a hospital as soon as possible, firstly for your own medical welfare, and secondly to avoid legal responsibility. A medical evacuation from a ship by helicopter can easily run $10-15,000! Get insurance!

Hospital Chiriqui does have an insurance scheme called Medical Services Chiriqui, or MSChiriqui which we use. It is not really insurance but more of a discount plan. A doctor visit that usually would cost $40 with a MSChiriqui coupon costs us $20. There are discounts on almost all hospital services and treatment, somewhat akin to a major medical plan in the US. In our case when my wife required an angioplasty and stents, because the procedure is not available at Hospital Chiriqui, we went to Hospital Paitilla in Panama City and the MSChiriqui plan covered half of the cost. After you have belonged to the plan for 2 years it does cover pre-existing conditions. The plan now costs us about $1200 per year for both of us.

Filed Under Americans in Panama, Best Places to Live, Boquete Panama, Health News, Panama, Panama Government Incentives, Panama Health Care | Leave a Comment

Beyond Boquete Panama?

As we now know the cool climate, fresh mountain air, and lush valleys you find in Boquete are no longer Panamas secret. Ive been telling you about this idyllic valley for years. More recently, The New York Times, The Chicago Tribune, and others have also alerted their readers to all that Panama–and particularly the Chiriqui province where Boquete is located–has to offer.

As more and more people catch on to what Boquete proper has to offer, you need to look elsewhere in the region for the best deals.

That said, you can still find good deals on older, established farms and tiny pockets of property near Boquete, but sellers can have unrealistic ideas of what prices should be. Remember, in markets like this one, youve no reliable way to do comps. So owners dont have any real idea of what their land is worth. They take their chances when a gringo buyer presents himself.

Some believe the market has gone beyond itself in Boquete. I’m not so sure but still I think it’s important to stay informed and why Im looking beyond Boquete. I’d like to introduce you to another town in Panamas inland Chiriqui region offering the same pleasant, spring-like climate of Boquete it’s called –Volcn.

Volcn doesnt have all the amenities and infrastructure of Boquetebut neither does it have the developed (some might say inflated) pricing. Youll spend half as much to own here as you would in Boqueteand youre buying the same spring-like climate year-round, the same fresh mountain air, and the same beautiful scenery.

The small mountain town of Volcn doesnt boast a big expatriate community, grand housing developments, golf courses, or a thriving social scene, but, at 5,000 feet elevation, it does offer a cool climate (something that can be a welcome escape from hot, humid Panama City) and great outdoor activities. It has a comfortable and refreshing small-town feel. This is an area Ill be paying close attention to in coming monthsand that I think is worth a look from you, too, if Panamas interior is of interest.

I explored this area recently and heres what I found:

* An old, rustic blue house on a 1/2-acre lot just outside town–on the market for only $10,000. Its in need of repairs and restoration, but its just off the main road and a two-minute drive to town.

* A 2 1/2-acre lot along the roadside a bit closer to town. This one isnt dirt cheap (its priced at $120,000), but it could be the perfect site for a restaurant or small cantina.

* Just outside town in an area called Paso Ancho, with a view of Volcn Bar, I saw 15 acres for sale for only $200,000. With that much land, you could create your own private havenor invest in your own small development.

* Right in the town of Volcn, I saw 1 1/4 acres, on which is sitting an old, bright green, three-bedroom, two-bathroom house in desperate need of a paint job. But its priced at only $50,000. Youd pay at more than twice that in Boquete right now.

Im going to be watching this little town and its emerging market closely. Im sure that, in the coming months, Ill find even more and better deals.

Filed Under Americans in Panama, Best Places to Live, Boquete Panama, Panama Government Incentives, Panama Real Estate, Volcan Panama | Leave a Comment

Top Places to Live

Why is Panama considered one of the Top Places to Live?

If you are looking for a great place to retire, vacation or invest you may want to consider Panama. This small and often overlooked country has something to offer people from all over the world. Over the past five years people from the United States and Canada have been discovering Panama to be a great place to live and many consider it the best place to retire.

The official language of Panama is Spanish with English being the official second language. Many native people of Panama are bilingual and with plenty of shop owners, taxi drivers, police and government officials speaking English. If you are not comfortable rediscovering your high school Spanish or playing charades with the locals then you may want plan on spending more time in Panama City. However, adventuring out into the interior is nothing to shy away from. Just make sure you carry a good Spanish-English dictionary and a playful heart. The people of Panama are very friendly and gracious. They will go out of their way to understand and to help you. If you are planning to move to Panama, your best bet is to learn at least a little Spanish so you will be more comfortable in your environment and better able to blend in with the community.

Panama uses the US currency which makes it very easy to shop and get around in Panama. No hassles with exchange rates and no worries over the ever changing value of the dollar. The one thing you will notice right away is that everything is cheaper. It’s often unnecessary to break a $20 bill for a nice dinner and thats for a party of two. Food is cheaper and so is travel and accommodations. If you decide to move to Panama you will discover Panama Real Estate for a fraction of what it would cost in other places. You will find beautiful Panama City condos, ocean-side properties, cool mountain retreats and much more.

A booming Panama City is another reason why Panama is considered one of the top places to live. Dont mistakenly think this country is underdeveloped or underprivileged just because it is so cheap to live there. The capital city of Panama has been a major financial center for two decades and it is continuing to grow each day by becoming a popular vacation and retirement spot. New shopping centers, restaurants, night clubs and other attractions are being built in this beautiful area, giving you plenty to see and do.

The sense of community in Panama is strong and vibrant. The people are very friendly and peaceful. Community members work together to achieve common goals and to help their fellow neighbors. Neighborhoods are safe and residents look out for one another. Just another reason why Panama is one of the Top Places to Live. For more Panama information visit LearnAboutPanama.

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Boquete Panama

Boquete is a small town tucked into the green mountain highlands of Panama, in western-most Chiriqu Province, about 60km. from the border with Costa Rica. Because of its altitude, some 1,200 metres above sea level, its climate is refreshingly cooler than that of the lowlands. Its scenic location, temperature, and natural environment make it extremely popular with Panamanians, and with tourists from all over the world.

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Best Places to Live in the World

It’s that time of year for International Living to release the 2010 Quality of Life Index highlighting the Top 10 Best Places to Live in the World.

Boquete did not make this index but it has been a favorite many times on the International Living Best Places to Retire list.

Check out the blog for more details on the 2010 Best Places to Live in the World!

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