Insurance in Panama

Health Care in Panama

• Panama offers great health care with First World Hospitals and Doctors.
• Health care providers you know and trust have branches in Panama, such as Blue Cross Blue Shield, IHI, and World Wide Medical.
• Health Insurance premiums can be significantly lower since Panama is not a litigious country.
• It is extremely important to get health insurance in Panama since hospitals will require by law proof of insurance (your card) or a credit card before allowing you to be admitted into the hospital, even for persons in critical conditions.

Your health insurance policy can cover you for hospitalization and/or medical expenses. You can also obtain Local or International Coverage.

Hospitalization

• Maternity
• Room and food
• Intensive care
• Special hospital services
• Emergencies
• Medical Expenses
• octor’s fees
• Ambulatory consultation
• Medicine
• Lab exams and X Rays

Local Coverage

• Includes Hospitalization and Medical Expenses.
• With Co-Payment: the insured person pays a fixed amount for each consultation and the rest the insurance company pays directly to the doctor.
• Medical Network: list of doctors in most hospitals in the country.
• Doctors/Hospitals outside the network are covered up to a percentage negotiated with the network.
• Coverage without maximum age.
• Premium depends on age range.

Internacional Coverage

• Can choose between Hospitalization and/or Medical Expenses.
• Coverage in Panama and in every country in the World.
• Coverage without maximum age.
• Premium depends on age range.
• Higher insured sum (1- 2 million lifetime benefit)
• Deductibles are done by policy or calendar year, they are not by event.
• Medical and/or Lab Requirements

Depends on the company – some have no requirements.

If they do:
· For Panamanians over 40 years of age.
· For foreigners of all ages.
· For children – pediatric report required.

To get more information on a Health Insurance Policy that suits your needs or to get a quote, contact our customer service department at forlacol@gmail.com or by phone (507) 6676 5151.

WWSelect is the best WWM offers
World Wide Coverage up to $2,000,000 per year with 3 different deductible options:
$1,000, $2,500 and $5,000. The deductibles are done by policy year, not by event.
90% coverage in your country of residence (Panama) without deductible

Select Hospitals ~ In our 6 Select Hospitals your deductible will be reduced in half and WWM will cover 100% of expensesHospitals in your Country of Residence (Panama) ~ No Deductible and WWM covers 90% of expenses

World Wide Coverage with a lifetime benefit of $2,000,000 with 3 different deductible options: $1,000, $2,500 and $5,000. The deductibles are done by policy year, not by event.

90% coverage in your country of residence (Panama) without deductible

Maternity
Coverage by event of $2,000 in Panama and $5,000 elsewhere.

For maternity to be covered there must be a 10 month waiting period. If pregnancy occurs 2 months after buying the insurance and as long as the labor happens 10 months after you are insured then you are covered.

Air Ambulance ~ Up to $25,000 per case

Organ Transplant ~ Up to $250,000

Congenital Problems ~ Only if maternity was covered by the policy ~ Up to $25,000

Dialysis ~ $25,000 per year, $75,000 lifetime benefit

Physical Therapy ~ Up to $1,000 each year

Ambulatory Expenses ~ Such as laboratory exams, consultations, X rays, or medicine are covered world wide except for Panama

Hospital Room ~ Semi-private outside of Panama, private in Panama

Traveler’s Assistance/Insurance ~ included

4 Service Alternatives

Participating Hospitals ~ Over 4,000 Hospitals ~ Deductible must be covered then WWM covers 80% of expenses up to $25,000 after which WWM covers 100% of expenses

Non Participating Hospitals ~ Deductible must be covered then WWM covers 80% of expenses up to $25,000 after which WWM covers 100% of expenses

Select Hospitals ~ In our 6 Select Hospitals your deductible will be reduced in half and WWM will cover 100% of expenses

Hospitals in your Country of Residence (Panama) ~ No Deductible and WWM covers 90% of expenses

Includes over 4,000 participant hospitals, the 6 select hospitals, and the hospitals in your country of residency (Panama).

World Wide Coverage with a lifetime benefit of $2,000,000 (at age 80 this is reduced to $250,000) with 3 different deductible options: $1,000, $2,500 and $5,000. The deductibles are done by policy year, not by event.

This plan does not include maternity benefits and has a $100 deductible for all hospitals in Panama.

Air Ambulance ~ Up to $25,000 per case in participating hospitals

Organ Transplant ~ Up to $250,000

Dialysis ~ $25,000 per year, $75,000 lifetime benefit

Physical Therapy ~ Up to $1,000 each year

Ambulatory Expenses ~ Such as laboratory exams, consultations, X rays, or medicine are covered world wide except for Panama

Hospital Room ~ Semi-private outside of Panama, private in Panama

Traveler’s Assistance/Insurance ~ included
4 Service Alternatives

Participating Hospitals ~ Over 4,000 Hospitals ~ Deductible must be covered then WWM covers 80% of expenses up to $25,000 after which WWM covers 100% of expenses

Non Participating Hospitals ~ Does Not Apply

Select Hospitals ~ In our 6 Select Hospitals your deductible will be reduced in half and WWM will cover 100% of expenses

Hospitals in your Country of Residence (Panama) ~ $100 Deductible and WWM covers 80% of expenses

To be eligible a person must fit the following requirements:

1. Be under 70 years of age
2. Do not live in the United States, Puerto Rico, or Canada
3. You must be in the process or have a visa to be eligible for WWM Insurance
4. Selection Requirements

Our standards are based on the Selection Manual of our reinsurance companies.

Evaluation
Our international health plan does not require medical exams. Our subscription is based on the answers given by the client and the client must understand this is accepted on a good faith basis.

WWM reserves the right to ask for additional information

It is of extreme importance that the answers you provide when filling the application are truthful and explicit

Subscription Methods

• Acceptation with normal coverage
• Acceptation with exclusion for a determined period
• Acceptation with permanent exclusion
• Acceptation with extra premium
• Coverage refusal

Select Hospitals

Inside our network we have 6 participating Hospitals which we call select. The advantage of using these hospitals is that your deductible will be reduced in half (except for Punta Pacifica –no deductible) and then all the medical expenses are covered at 100%.

Our centers are among the best world wide. They include:

Baltimore, Maryland

 
Cleveland, Ohio

Panama

St. Louis, Missouri

 
Miami, Florida

     Houston, Texas

I’m 65. Am I still eligible?

The client can subscribe to our plans if younger than 70 years of age. The completion of a Subscription Form is required. There is no medical examination.

Up to what age am I covered? Our plans offer lifetime coverage. 

How can I add my newborn to the plan? You have ten days from the day your child is born to submit a completed Subscription Form along with its corresponding payment. This form will be evaluated by our Underwriting Department. 

Can I cover my children? You can cover your dependent children up to age 25 as long as they are single and live with you.  

What is my coverage in my country of residence? In your country of residence, we cover hospitalization and ambulatory surgeries. Please contact us for more information.

When and how can I change the coverage under my plan? Changes to your plan may be requested at renewal time. You will have to send a completed Subscription Form, along with the corresponding payment, and your request will be evaluated by our Underwriting Department. 

What happens if I have a plan through another company which provides similar coverage and want to switch to yours? When will I be covered? If you provide us with certification that your coverage with the other carrier is in effect at the time you subscribe with us, we will waive the customary four-month waiting period.

I will be living in the United States temporarily while going to school. Will I still be covered? Yes. You are covered as long as you are a student and reside in the United States.

How can I obtain a list of the hospitals in the network?

Suppliers:
Hospitals in the United States
Hospitals Outside the United States
Hospitals in Latin America

I have a pre-existing medical condition. Can I request coverage through your company? You will need to complete a Subscription Form, attaching medical reports related to the specific condition. Our underwriters will analyze your case.

How does the air ambulance benefit work? The insured will be transported to the nearest medical institution with the necessary equipment to treat the patient. The insured is eligible for the air ambulance benefit if the treating physician certifies that he requires emergency medical evacuation to receive the required treatment, and that such treatment is not available in the area where the insured is. Also, that the condition of the insured will require a period of hospitalization, and that transportation via a commercial flight is not possible or that the insured’s disability requires special services found only onboard an air ambulance.

Do you have 24 hour service? For assistance within the United States, call 1-877-688-8821. Outside the United States, call (305) 821-8430 (collect calls accepted) Representatives are standing-by to guide you through the claim process, pre-certification, assistance to locate providers, other processes to follow, etc.

Coverage: the whole country of Panama. This plan works with co-payment and though a network of providers. In this plan the insured person assumes an amount or a percentage of the medical attention received.
We want you to understand your health insurance policy, so you can take full advantage of it.

Policy Info:

General Info:

Maximum Lifetime per Person: $300,000

Stop Loss: is the maximum amount you will ever have to co-pay each policy year: $4,000. After this the insurance company will pay 100%.

Deductible: $200 for prescribed medicine. This deductible covers all the medicines you are prescribed in your policy year.

Hospital Expenses:

Require Pre-Authorization: If a procedure is planned for you have to let the insurance company know before being admitted into the hospital.

Includes for Hospital Expenses:

• Days 1-4: co-payment of $150.00 daily per event.
• Days 5-10: your policy covers 100%.
• Days 11+: your policy covers 80%.
• Daily Room and Board (Private Room) ~ 100%
• Intensive Care Unit ~ 100%
• Hospital Miscellaneous Expenses ~ 100%
• Medical Fees for Surgery and Anesthesia ~ 100%
• Medical Fees for Hospital Visits ~ 100%

Ambulatory Expenses:

Outpatient Examinations ~ Specialist ~ Co-payment of $18.00
Outpatient Examinations ~ General Doctor ~ Co-payment of $12.00
X- Rays and Laboratory ~ Co-payment of 25%
Special Examination (Pre-authorized) ~ Co-payment of 30%
Hem dialysis (Pre-authorized) ~ Co-payment of 30%
Chemotherapy or Radiotherapy (Pre-authorized) ~ Co-payment of 30%
Chiropractic (Pre-authorized) ~ Co-payment of $15.00 ~ Max 5 sessions a year
Acupuncture (Pre-authorized) ~ Co-payment of $15.00 ~ Max 5 sessions a year, 20 sessions per life
Physical Therapy and Rehabilitation ~ Co-payment of $5.00 ~ Max 20 sessions a year, more than this has to be pre-authorized.

Emergency Room:

Per Accident: your policy covers 100%

Detailed Illness: Co-payment of $50.00

What is a Detailed Illness: Attentions to acute cases of: Nephritic Colic, Hepatic Colic, Episodes of chest angina, infarct of the myocardium or coronary insufficiency, pulmonary embolism, acute bronchial asthma attack, loss of knowledge or obnubilation and/or sudden, acute allergic reactions or anaphylactic disorientation, hemorrhages of all type, including gynecological and obstetrics, vomits and severe diarrheas with or without dehydration, acute abdominal pain, convulsions, state of “shock” and the like, acute urine retention, high fever in infants.

Ambulatory Surgery:

• In Hospital ~ Co-payment of $200 per event
• In Doctor’s Office ~ Co-payment of 30%
• Medical Fees (Doctor Provider) ~ Your policy covers 100%

Maternity Benefits:

Applied to Single and Married Mothers

Period before benefit applies: covered if the pregnancy occurs from the first day of the 13th month of the period of the policy. In other words, you have to have the policy for 4 months (using a 9 month pregnancy) before getting pregnant for the policy to cover the birth.

Before the Birth:

Maximum per event ~ $3,000.00
Prenatal Consultation ~ Co-payment of $18.00 ~ Max 8 visits
Prenatal Ultrasounds ~ Co-payment of 25% ~ Max 3 times

After the Birth:
New Born Child: the baby will be included under the mothers policy for the first 9 days of life, after the 10th day he/she must be registered as a dependant ~ Your policy covers 100% of costs up to $5,000.00

Premature Child: the baby is born before the 37 week of pregnancy ~ Your policy covers 100% of the costs up to $10,000.00

Neonatal Congenital, Hereditary, or Acquired Illnesses: The policy covers illnesses acquired by inheritance or at the time of birth as long as the mother is covered by the policy ~ Your policy covers 100% of the costs up to $30,000.00

Preventive Medicine within the Network:

Healthy Child Control:

For children up to 6 years old
Co-payment of 50%

Control consultation:

0 – 12 months ~ 8 visits per year
13 – 24 months ~ 4 visits per year
3 – 6 years ~ 2 visits per year

Compulsory vaccines regulated by the Ministry of Health during Control Visits:

BCG (Tuberculosis) ~ $10.00
DPT (Difteria, Tosferina, Tétano) ~ $10.00
MMR o SPR (Sarampión, Rubéola, Paperas) ~$25.00
POLIO (Poliomielitis) ~ $10.00
Hepatitis A ~ $30.00
Hepatitis B ~ $25.00
Hibtiter (Meningitis) ~ $30.00
Varicela (Chicken Pox) ~ $75.00
Pentavalente (Difteria, Tétanos, Tosferina, Meningitis por Haemophilus Tipo B y Hepatitis B)

Women:

Co-payment of 50%
Annual Control and Pap Smear Test 
Annual Mammography after the age of 40

Men:

Co-payment of 50%
PSA test after the age of 40

Ambulance Benefit:

Land Transportation: Your policy covers 100% ~ Max $100.00
Air Transportation: Your policy covers 100% ~ Max $1,000.00

Private Nurse:
Pre-authorization required ~ Covers 100%, limit 30 sessions ~ Max 8 hour sessions

AIDS:

Calendar Year: Your policy covers 100% ~ Max $5,000.00
Lifetime: Your policy covers 100% ~ Max $25,000.00

Out of Network Services in Panama:

If you decide to use a doctor or hospital who is not in the Blue Cross, Blue Shield Network ~ Reimbursement will be 60% of the cost agreed with medical providers in Panama

EMERGENCIES OUTSIDE OF PANAMA:

Accident or Illness ~ including hospitalization expenses and medical fees ~ Your policy will reimburse 60% of the cost agreed with medical providers in Panama.

Laboratories that you can go to get your exams done:

•  Laboratorio Raly
• Laboratorio Clínico Fernández 
• Laboratorio De Sedas

It necessary that the applicants complete the following requirements:

These requirements are written in Spanish as well so you can print and take this page to the lab and tell them which ones you need.

Panamanians from 40 to 45 years old (Female and Male)

• Fee for Exam $48.10
• Hemograma Completo ~ Complete Hemogram
• Glicemia ~ Glicemia
• Urinálisis ~ Urianalysis
• Perfil Lipídico ~ Lipid Profile
• PSA (Para los Hombres) ~ Prostate Exam

 Foreigners 18 to 45 years old (Female and Male)

All of the examinations above including HIV

BOTICA EL JAVILLO: In any of their locations ~ OBTAIN a 20% discount GUARANTEED.

Blue Cross and Blue Shield of Panama offers as an additional benefit the exclusive service of “Home Delivery”, without any additional cost. This benefit has been designed to help you save time and money in the purchase of all your medicine.

The advantages of this service are:

• You can order by the phone
• You will receive in your house, office, or any location you prefer, your order in less than 24 hours.
• $1.00 charge for delivery, no matter the size of your order.
• Coverage Area: in the North until Las Cumbres, in the South until Ave. Balboa, in the East until Tocumen, and in the west until the Americas Bridge.
• Applies for all medicines with or without prescription, covered or not covered by your policy.
• Options of payment: Visa, MasterCard, American Express, Clave, Check or Cash.

All you have to do is call 800-0026 or 302-3225.

Order placement Schedule:

Monday - Friday: 9:00 a.m. - 9:00 p.m.
Saturday: 9:00 a.m. - 1:00 p.m.

Delivery Schedule:
Orders placed from Monday through Saturday will be delivered:
Before 7:30 p.m. ~ the same day before 9:00 p.m.
After 7:30 p.m. ~ before noon of the next day

You can also order on the phone and go directly to any of their following locations:
Río Abajo, next to the Super 99 ~ Telephone: 224-1206
Vía España, on the ground floor of the San Fernando Hospital under the Pediatric Wing ~ Telephone: 229-6745
Plaza 5 de Mayo, on the ground floor of Hotel Internacional ~ Telephone: 262-5768
Paitilla Mall Local ~ Telephone: 215-2581
Colon ~ Hospital 4 Altos, Local No.12 ~ Telephone: 433-7526
Urbanización El Crisol, Plaza Dragón Local No. 5