Monday, December 17, 2018

Country Guide – Panama Everyday Life

The Panama guides are divided into three parts, namely:

At A Glance will give you a basic understanding of this unique Central American country by highlighting its most important features.

Visas & Residency will focus on the most important requirements to make Panama your home.

♦ Everyday Life covers the topics of safety, healthcare, ownership and cost of living. The purpose is to concisely discuss the four most important aspects, as ranked by prospective expats, to give you an overall picture of everyday life. 


When asked about their reasons for considering immigration, or at least relocation, expats normally include personal safety under their top five reasons.

Personal security is at the essence of our well-being, and includes the risks of being physically assaulted or falling victim to other types of crime. Crime is not just about loss of property, more importantly, it can lead to loss of life as well as physical pain, post-traumatic stress and anxiety. Even a perceived threat can negatively affect our well-being through a feeling of vulnerability.

Personal safety in Panama is highly subjective and a hotly debated topic. Unfortunately, there is no clear or quantitative answer. The discussion below will try to shed light from different angles, and hopefully it will enable you to form an opinion or guide you towards more research of your own.

I have done extensive work-related travelling and was involved in establishing numerous international offices. One thing I have learnt is the value of local knowledge, so much so that the recruitment process was focussed on local talent (read knowledge) and expats were only considered in critical positions. In short, ask the locals.

The first thing I did after arriving in Panama City was to talk to the taxi drivers, about crime. I spoke to young ones and old ones, on short trips and long ones. And I spoke to as many locals as possible, wherever the situation allowed. None took offense about my questions and all gave me very valuable information.

The single most important take-away? Don’t leave your common sense at home!

Apart from mentioning a few specific areas or neighbourhoods to avoid, the general advice was as follows:

  • Try to blend in, tourists and expats are targets for opportunistic criminals;
  • Don’t flash, neither cash nor valuables;
  • Be careful who you befriend, and take your time about it;
  • Darkness is danger, especially visiting ATMs and walking in quiet/dark places;
  • For nightlife, ask about an area or venue before you go.

While travelling around Panama I noticed burglar bars of all shapes and sizes, on homes and businesses alike. When asked about it, locals simply shrugged and said “It’s just how it is, it’s part of our life”. Not many have experienced crime, but most take the precautions.

An older man that I spoke to offered another perspective. He said that at least part of what is visible today, is a hangover of the Manuel Noriega era, during which time the convicted drug trafficker used Panama as his personal criminal enterprise. Although arguable, it is something to ponder.

The tricky part about local opinion is that you will not find it in blog posts or on expat forums. You find it in Panama.

A google search on the topic will deliver thousands of opinions. Many of these are lumped into groups or forums. A group that you can start with is “Expats in Panama”. Facebook groups have search functions and by searching for “crime” in this group, you will get the unedited version.

Note: from a person’s reaction or answer, try to establish whether he or she actually lives in Panama, or whether it’s an overzealous wise-crack who has a friend that knows where Panama is.

If you want to know more about crime in a specific area, search for Neighbourhood Watch groups or other groups in that area with a focus on crime.

From what I have read, the consensus opinion of expats is that Panama is safe, provided that you do your part to keep yourself safe, and use your common sense to stay aware of your environment.

Having said that, peoples’ opinions can sometimes be somewhere between pedantic and fickle. So let’s consider four other opinion pieces namely:

  • OECD Better Life Index
  • Social Progress Index
  • Global Peace Index
  • An article produced by InSight Crime

The OECD Better Life Index is designed to let you visualise and compare some of the key factors – like education, housing, safety, and so on – that contribute to well-being in OECD countries.

Panama is not a member of the OECD, so why do I even mention this survey? Because it demonstrates a few points:

  • The importance of safety in an overall assessment of a country;
  • How personal safety contributes towards our well-being;
  • Most importantly, our opinion is heavily influenced by where we come from.

To demonstrate my last point, below are the summaries on safety for Canada and South Africa, respectively:

In Canada, about 82% of people say that they feel safe walking alone at night, more than the OECD average of 68%.

The homicide rate (the number of murders per 100 000 inhabitants) is a more reliable measure of a country’s safety level because, unlike other crimes, murders are usually always reported to the police. According to the latest OECD data, Canada’s homicide rate is 1.5, lower than the OECD average of 4.1.

In South Africa, 40% of people say that they feel safe walking alone at night, much less than the OECD average of 68%.

The homicide rate (the number of murders per 100 000 inhabitants) is a more reliable measure of a country’s safety level because, unlike other crimes, murders are usually always reported to the police. According to the latest OECD data, South Africa’s homicide rate is 9.6, much higher than the OECD average of 4.1

So asking a Canadian expat and a South African expat whether Panama is safe, will probably produce very different answers, based on their different frames of reference.

This is one of my favourite reports as it not only gives an overall ranking, it ranks 12 individual sections within the index. The 2017 Social Progress Index includes data from 128 countries on 50 indicators.

Panama achieves an overall rank of 40/128 and on Personal Safety the ranking is 49/128.

The Global Peace Index is compiled by the global think tank, the Institute for Economics & Peace (IEP). It measures a wide range of indicators, 22 in all, the most relevant to this discussion include the following:

  • Level of organised conflict (internal);
  • Level of perceived criminality in society;
  • Number of refugees and displaced persons as percentage of population;
  • Homicide rate;
  • Level of violent crime;
  • Number of internal security officers and police per 100,000 people.

The 2017 Global Peace Index ranks Panama at 49 out of 163 countries. The interactive map is user friendly and has the functionality to search any one of the 22 individual indicators.

InSight Crime is a foundation that studies the principal threat to national and citizen security in Latin America.

In an article “Mapped: Where Panama’s Gangs are Strongest, Homicides are Highest”, the author illustrates the link between gang activity and the local homicide rate.

As an expat I can certainly avoid gang activities and, to a meaningful degree, avoid areas where gangs are most active.

Another angle on this is the non-gang related homicide rate. Which could well be called the non-drug related homicide rate. Removing gang and/or drug related homicides from the total, significantly reduces the “everyday” homicide rate; the rate that I as an expat are concerned with.

Like any other country, Panama has crime, committed by a range of criminals from sociable scamsters, to opportunistic pickpockets and hardened gangsters. Some statistics and reports suggest that the long term trend is positive (improving), but that does not mean anybody should lessen their awareness.

Safety as an expat is a function of 3 things:

  • Being informed;
  • By doing your part to safeguard yourself;
  • Of how well you interact with locals.

It’s also helpful to maintain a balanced perspective. When someone reports a purse snatching, don’t decry the entire country as “crime ridden”, rather use the incident as a reminder to sharpen your vigilance and warn friends, thereby contributing towards community-wide awareness.

When it comes to our health, we are quite happy to do whatever is necessary to remain healthy – we will even eat broccoli! Same thing with safety.


This section investigates the level of healthcare available in Panama, not the cost thereof. The cost of healthcare and medical insurance are covered under Cost of Living.

Finding quantitative measures to define the quality of healthcare in Panama proved more difficult than I imagined. Some of the more comprehensive studies and comparisons (for example from the World Health Organisation) are simply too old for our use. The information following below should however enable you to form an opinion:

There are a few indicators we can use to get a rough idea about the healthcare system in Panama. Below are three key indicators with comparisons to the USA and Colombia (Information courtesy CIA World Factbook):

Density of physicians (total number per 1,000 people)(an indicator of availability)

USA – 2.4                                 Panama – 1.5                        Colombia – 1.4

Density of hospital beds (total number per 1,000 people)(an indicator of infrastructure)

USA – 3.0                                 Panama – 2.4                        Colombia – 1.4

Life expectancy (at birth)(an indicator of overall quality of healthcare, albeit marginal)

USA – 79.5                               Panama – 78.3                      Colombia – 75.2

Panama has 6 universities offering medical programs, one of which with graduate entry only.

Only Panama citizens can practice as physicians. (View the complete list of reserved jobs)

Panama is a small country and wherever you choose to live, you would be less than two hours away from good medical facilities. For example, Colón Island in the Bocas del Toro archipelago, is just one hour flight time away from Panama City.

Major hospitals in Panama City:

Clinica Hospital San Fernando. Located on the busy arterial Via España, the hospital has created a facility to assist expats who cannot speak Spanish.

Hospital Punta Pacifica. The newest of the major hospitals and the only hospital in Latin America and the Caribbean to be affiliated with the world-class Johns Hopkins International. Located on Boulevard Pacifica.

♦ Centro Medico Paitilla. Boasting the best oncology unit in Panama, the hospital is located just off Avenue Balboa.

♦ Hospital Nacional. In operation since 1973; today it is well affiliated with US medical facilities as well as a US management company. Located on Avenida Justo Arosemena, across the Santo Tomás metro station.

Major hospital outside Panama City:

♦ Situated in the city of David, Hospital Chiriqui opened its doors in 1988, and has established a well-respected reputation for quality healthcare services.

There are many smaller or specialised hospitals and clinics in Panama City. Other noteworthy (expat noteworthy that is) cities and towns with small hospitals, satellite facilities and/or clinics include Coronado, Chitre, Las Tablas, Pedasí, Santiago, Boquete and Bocas.

Medical procedures

Medical procedures available in Panama are not limited to general ails and illnesses, or reconstructive surgery. The country has firmly established itself as a medical tourist destination, with specific reference to cosmetic surgery and related treatments, including plastic-, orthopaedic- and obesity surgery.


As far as pharmacies go, there are no issues with availability; hospitals and many supermarkets have pharmacies. The two largest pharmacy groups are Arrocha and Metro, while the Rey supermarket group have pharmacies as well as 24-hour service.


The availability of medicine, including prescription drugs, is relatively good. Many drugs that would only be available on prescription in other countries, are available over the counter in Panama. Keep in mind that you might not find the exact brand name or registered name of the medicine you are looking for, so if it’s an issue for you, try to find its generic substitute before coming to Panama.


The only real limitation faced by some expats would be language. If you don’t speak Spanish, you might want to consider the service of a translator. Having said that, many doctors have trained in the US and many do speak English.

Although the government provides basic health services to citizens and permanent residents, at public hospitals and clinics, expats generally prefer to buy private health insurance. And it is readily available. Health insurance can be divided into 2 categories, namely local insurance and international insurance.

Local health insurance

Companies offering local insurance include Blue Cross/Blue Shield, PALIG, ASSA, and ANCON. The maximum age at application varies between 60 and 64 years. All local insurance policies require a medical exam which will cost between $150 and $200. All plans have a deductible amount; some are fixed while others allow you to choose an amount up-front. All plans have a Stop-Loss (out of pocket maximum) clause.

International health insurance

Companies offering international insurance include WWMA, PALIG, Blue Cross/Blue Shield and BUPA. The maximum age at application generally varies between 64 and 74 years. Only a few companies require a full medical exam while all require at least a PSA test for male applicants over the age of 50, which will cost about $25. All plans have deductible amount options while only Blue Cross/Blue Shield offer a co-insurance option. All plans have a Stop-Loss (out of pocket maximum) clause.

Expat opinions and answers can be found on various Facebook groups and expat forums, which are the best sources of the unedited version. Here is your shortcut to “Expats in Panama” after I entered “Healhcare” in the search function.

From what I have read, the consensus opinion is that both the availability and quality of healthcare in Panama is good.

If any blog, broker or person sells Panama’s healthcare as world-class, it might be stretching the truth just a bit. I think there are many pockets of excellence, with some sectors of the health tourist market as examples. The four major hospitals can certainly boast very good care services, some even exceptional, but to tag the national healthcare system as “world-class” might be a little way off.


Ownership questions normally revolve around the limitations and risks in owning a business, real estate and a vehicle. The discussion to follow is not a detailed how-to manual, it is an overview to get a perspective of limitations and risks. It is a summary of salient features to enable further research, if the overall scenario satisfies your criteria.

Anybody can own a business in Panama, either by way of a start-up or buying an existing business.

Before we discuss the typical forms of business ownership in Panama, a few notes on the limitations:

  • Owning a business in any form does not automatically give an expat a work permit;
  • The following jobs are preserved for Panamanian citizens:

•Dentist •Dental Assistant •Lawyer •Veterinarian •Chiropractor •Medical Doctor •Nurse •Medical Assistant •Medical Radiologist •Medical Laboratory Technician •Pharmacist •Nutritionist •Sociologist •Psychologist •Physiotherapist •Speech Therapist •Social Worker •Accountant •Hairdresser •Cosmetologist •Chemist •Engineer •Architect •Journalist •Economist •Public Relations jobs •Agricultural Sciences jobs

  • Only Panamanian citizens can operate a retail business;
  • Operating as a real estate or insurance broker can only be done after 10 years of legal residence in Panama;
  • A corporation requires a minimum of 3 Officers/Directors, but this can be legal entities, or local nominee Directors.

A business in Panama can be owned in 3 forms, namely sole ownership, a partnership or by means of a corporation.

Sole ownership

Typical of smaller or family lifestyle businesses, this form of ownership gives the person or family outright ownership of all the business assets.


Panama’s laws make provision for 3 types of partnership, mostly notably the Civil Partnership (Sociedad Civil), generally used for professional practices. Partnerships are an uncommon form of business ownership amongst expats.


The registration of a Panama corporation is quick and simple, with no limitations as to residency or citizenship requirements. It is a versatile business format that can be used to open an offshore bank account, conduct international trade or hold investments and assets of any kind.

A Panama corporation can offer very good corporate privacy, banking secrecy and overall asset protection – ask your immigration lawyer about a corporation with bearer shares. Panama is seen as a tax haven because corporations don’t pay tax on offshore profits (trade or investment, interest or capital gains).

Panama has progressive property laws and apart from protection provided by the constitution, the government has enacted several laws to protect private property rights. Foreigners, residents and citizens enjoy equal protection. In two other words, no restrictions.

The property can be registered in your personal name or it can be acquired by a legal entity such as a corporation or private interest trust. A very important aspect of Panama property that need to be understood upfront, is that there are two “types” of property, namely Titled and Rights of Possession.

Titled property

Most properties are “Titled” which is a title deed, the ownership of which is registered in the government’s Public Registry. The process of buying and selling titled real estate in Panama is similar in concept to that of the USA. The actual process would follow these steps:

  • Promise to Purchase Agreement (formal contract to allow due diligence process);
  • Title Search (due diligence to confirm ownership, encumbrances, etc);
  • Buy-Sell Agreement (final agreement upon positive title search);
  • Transfer of Title (recording the sale if the Public Registry).

A mortgage can be secured by registering a lien over the property. Titled property is subject to property taxes.

Rights of Possession (ROP) property

A ROP is simply a document that certifies the right of possession of a government property. The difficulty in dealing with ROP property stems from the fact that ROP certifications can be issued by multiple authorities and these certifications are not recorded in the Public Registry or any central data base.

The process to buy a ROP property is very similar to that of titled properties, but with much more emphasis on the due diligence to ensure there are no conflicts of interest:

  • Promise to Purchase Agreement (formal contract to allow due diligence process);
  • Certification Search (very detailed due diligence process);
  • Buy-Sell Agreement (final agreement upon positive due diligence outcome);
  • Conveying of ROP Certification (transfer of ownership).

Note: Two expats that I have spoken to, and who have bought ROP real estate without any problems, have mentioned that they use two different lawyers for the due diligence process. The cost involved could potentially be prohibitive, but it will certainly contribute towards risk mitigation in dealing with ROP properties.

A mortgage cannot be secured since the property belongs to the government. ROP property itself is not subject to property taxes but the improvements thereon may be. It is possible to convert ROP property into titled property.

Title insurance

A title search is not always 100% accurate. There can be “hidden defects” which will not show up even with a most thorough title search.  Hidden defects can include forgeries, fraud, defective deeds, an undisclosed spouse and clerical record errors.

Title insurance protects real estate owners against future loss if the state of the title changes from the date the insurance policy was purchased. There are no Panamanian title insurance companies. However, there are licensed agents in Panama of several international insurance companies who offer property title insurance policies and title guarantees in Panama.

There are no limitations as far as car ownership goes, so even a tourist can buy and insure a car.

Travelhippi, Retire Early, Retire in PanamaThe ownership of the vehicle must not be confused with the appropriate driver’s licence. International driver’s licences are good for the first 90 days of your stay. For those that apply for residency: as soon as your temporary residency card is issued, your international driver’s licence can no longer be used, you need a Panama driver’s licence. Just to make it more interesting – if you do get a Panama licence, it will be temporary, expiring on the same date as your temporary residency! So, after you receive your permanent residency card, it’s off to the authorities for your permanent licence, which fortunately, is a much easier process than the initial application.

Cost of living

It is fairly difficult to pinpoint the cost of living in any country, and Panama is no different. This is because the cost of living within a country can vary tremendously from one location to the next, and also because the audience for the discussion ranges from young adventurers to retired couples.

It is however possible to compare the cost of living amongst countries and to present indexes, country rankings and indicative price ranges of certain items. By considering both global perspectives and local figures, you should be able to form an idea of the cost of living. It should also serve as a guide to make further investigation easier.

The Numbeo website is not only very comprehensive, it is user friendly and a pleasure to explore. It contains the Cost of Living Index by Country 2017 (Mid-Year) in which Panama is ranked at 47 out of 115 countries, compared to 51/123 a year ago, and 51/125 the year before that.

Expatistan is a no-frills website, used by both expats and HR managers. Its Cost of Living Ranking by Country ranks Panama at 39 out of the 107 countries in its index.

The Expat Insider Survey started in 2014 and offers an interesting perspective about expat financial well-being. It produces two indexes, namely Personal Finance and Cost of Living. The 2017 Survey ranks Panama at 39 out of 65 countries featured.

With this particular survey, I would strongly suggest that all the information on the website, or at least the page we have linked to, be read carefully. It would be imprudent to consider the Cost of Living index in isolation.

Panama Budget Calculator

Amongst the many factors within a single country that influence the cost of living, your consumption behavior will contribute significantly. Your personal cost of living is influenced by your chosen standard of living, overall lifestyle and buying habits.

To help you construct a budget for living in Panama, we have researched the typical cost of 10 different categories. Where applicable, we have also included the price ranges of 4 different locations. The table below each heading will give you a quick reference, and the slider above the table can be used to quickly do your Panama budget. As each of the 10 sliders are adjusted, the total budget will respond accordingly:

My Panama budget :


1. Rent


PlaceLower end ($)Higher end ($)
Panama City7502500

There are a large number of variables that influence rent, including size, location, location within that location, furnished or not, type of construction, age of construction, quality of finishes, and many more.

In tourist hotspots such as Bocas, the rent is hugely influenced by the tourist season, in terms of both price and the term available.

Here is an advertisement that recently appeared: “House for rent! 2bedroom/3bathroom house located in Hato Pintado in Panama City. Great location near Metro, Pharmacy, Grocery, and Hospital. Has been renovated with new kitchen, and bathrooms. Private gated driveway, and beautiful yard. $1,300 pm.”  Given everything I have researched in terms of rent, I think this is a very well-priced option.

Another advertisement; this one is for an apartment in David: “Rent apartment with space for living room, kitchen, bathroom, a large room, laundry under roof and a parking lot. Located on the way to the airport after Radio Chiriqui. $250 pm.”

Lease agreements would normally require rent paid in advance, on top of a security deposit equal to at least one month’s rent.

Important: Make sure that your rental agreement is registered with the Ministerio de Vivienda (MIVI for short) and that they hold the deposit, otherwise you might have trouble getting your deposit back, in full and/or in good time.

2. Utilities


PlaceLower end ($)Higher end ($)
Panama City150400
*Based on two people at or near retirement age

Although the price of propane is fairly universal across the country, the price of electricity varies greatly, depending on your location. Smaller rental units, without an air conditioner, will sometimes advertise a rent including electricity. But the quoted rent of larger units, especially when one or more air conditioners are available, mostly exclude electricity.

Stating the obvious, but keep the tropical climate in mind – the use of air conditioners have a significant impact on your utility bill.

3. Health insurance, Healthcare


PlaceLower end ($)Higher end ($)
All cities150550
*Based on two adults aged between 50 and 55

The cost of health insurance is mostly influenced by the ages of the applicant and dependant; the health insurance companies quote premiums in 5-year age brackets. Thereafter, the premium is influenced by the choices in terms of:

  • Health insurance company;
  • Local or international insurance;
  • Level of deductible;
  • Level of co-insurance;
  • Frequency of premium payment.

Tip: see Healthcare for more detail.

Apart from health insurance, you could budget for a routine doctor’s visit of around $30 per person, per month. If chronic medication is required (for example high blood pressure medicine), add another $50 per individual, per month.

4. Connectivity, Mobile service


PlaceLower end ($)Higher end ($)
All cities50150
*Based on two people at or near retirement age, not requiring good connectivity for a mobile business

A pre-paid package deal of $15 with DigiCell, gives the user 2GB data, 10GB social media ‘data’, 150 minutes talk time and 50 SMSs, all valid for 30 days.

Very good connectivity can be arranged for $100 pm, but it’s possible to get by on as little as $40 pm.

5. Insurance (house content, cars)


PlaceLower end ($)Higher end ($)
All cities50200
*Based on two people at or near retirement age

The three variables that will have the biggest effect on the monthly premium are the vehicle’s type, age and location.

6. Transport (public and/or own)


PlaceLower end ($)Higher end ($)
All cities50250
*Based on two people at or near retirement age

This obviously depends on whether you are living in Panama City and commuting to work every day, or living in Bocas and riding your bicycle to the shop!

The price of gasoline (that is fuel or petrol for non-Americans) is $0-81/ℓ in Panama, so you can do a quick estimate if you intend to use your own vehicle(s).

A rechargeable travel pass, for both the Metro and Metro Bus, will get you a one-way ride for $0-25, so with a recharge of $10 you can cover a lot of miles.

An average taxi ride in Panama City is $5 to $10; from Tocumen International Airport to the city center about $30. Both Uber and Lyft are available.

7. Groceries, Household cleaning


Place & ProductLower end ($)Higher end ($)
Panama City, buying international brands350800
Smaller towns, buying local products300750
*Based on two people at or near retirement age

Two major factors are at play here. The first is Panama City versus the smaller cities or towns further away, with Panama City as a general rule being more expensive. Having said that, some smaller towns (Boquete for example) are experiencing an inflow of expats (driving prices up) while Panama City offers a large variety of stores and supermarket options, which tend to keep prices competitive.

A typical small-town exception is Bocas, where groceries are more expensive than Panama City, since everything needs to be transported over long distances, including a sea passage.

The second factor at play is international brands versus local products. If you are bent on buying everything that you used to buy in the US or Canada, expect to adjust your budget upward, by a lot. Getting used to local brands, and adjusting to local buying habits, can keep your grocery bill manageable.

Tip: Although Panama is officially using the metric system, many prices are shown for pounds or gallons. Some items will show both. So be sure to check.

8. Education


Type of schoolLower end ($)Higher end ($)
Panama City, good international school4001500
Smaller towns, good local schools150300
*Based on one child

Private international schools can cost anywhere between $400 and $1500 per month, per child.

Good schools outside Panama City can cost about $150 pm per child, but depending on your desired level of tuition, you might have to invest in extra tuition or private classes in some subjects.

9. Clothing & Footwear


PlaceLower end ($)Higher end ($)
All cities50300
*Based on two people at or near retirement age

Based on average prices available in the larger malls in Panama City, the following items might give you an idea:

  • Women’s full-body bathing suit $30
  • Women’s shorts $25
  • Women’s light summer dress $45
  • Women’s casual sandals $25
  • Women’s/Men’s branded jeans $65
  • Men’s shorts $20
  • Men’s flip-flops $20
  • Men’s running shoes $85
  • Large straw sun hat $35

10. Sport, Recreation, Entertainment


Type of activityLower end ($)Higher end ($)
Golf – monthly membership250350
Golf – play a round50120

Golf club membership in the popular expat area of Coronado is in the region of $15,000, or if you buy a membership, the transfer cost is about $5,000.

Like anything else, the money spent on dining out is determined by personal preference. A couple can certainly enjoy a light meal for $30 or spend a small fortune on pre-dinner cocktails in one of the city’s rooftop restaurants.

Gym membership in Panama City can range between $50 and $75 per month.

Back to budget total

Conclusion: For a long time, Panama was punted as a cheap destination, a retirement haven where low prices will enable the average couple to retire comfortably. Relatively speaking, it might still be the case, but to a lesser degree. In terms of cost of living, Panama is now on par with some US cities, and only slightly cheaper than the US overall.

We will update the Panama Relocation Guide every quarter, so make sure to subscribe to our newsletter and we will keep you posted.

Make sure to get the free e-book “50+ Things To Consider Before Immigration”.

This will help you to make an informed decision, by prompting the thinking and planning process around immigration.

Travel Hippi, retire early, retire abroad

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