When we moved to Nicaragua, my dad’s first request was that I not get pregnant while living abroad (a physician, I assumed this was his recommendation based on health – I only learned much later, with my first child, mind you, that this was actually a grandfather plea).  In any case, I’ve since had two kids here and all has gone exceedingly well.  But I digress.  His second request, let’s be honest here – his second demand – was that we have some form of health insurance.

“I was talking to a friend whose brother worked over seas for a few years and the phrase was (a bit out of date), “For minor illnesses you take two aspirin, for major illnesses you take Pan Am.”  -Dad (September 2007)

And so we began our research by looking into catastrophic insurance, which would essentially help only if we needed medical evacuation.  Justin, in his usual charming way, reached out to an expat we’d met during our visit to Nicaragua the previous year:

“I’m writing you to ask about health insurance.  We are fine with going to Nica doctors for bumps & bruises, etc, but I’d like to have coverage for anything catastrophic.  Like cancer, monkey attacks, or (gasp) if I knock my wife up.” (November 2007)

Run a search on “medevac insurance” and you will be inundated and overwhelmed by options.  We eventually paid through the nose for a catastrophic insurance policy via IMG (International Medical Group).  And as a fellow expat once shared,

“This is how I look at it (and it might be a little harsh but..), chances are if you get in a catastrophic accident here in Nicaragua, the probability that you get to a hospital in time, they get organized and get that helicopter that you need to fly you out of Nicaragua is probably not going to happen. But, good news is, that the Vivian Pellas hospital in Nicaragua is world class, and has a host of international doctors there.”

Thankfully, we never needed to be airlifted out of Nica, but it did appease my risk-averse dad who had a friend who did, indeed, need to be med-evacuated out of Costa Rica (20 years ago) after a heinous rappelling fall.  I will say that international health insurance policies appear to have come a long way in just the six years since we moved, including basic travel insurance and not just catastrophic options.  So I do recommend looking into all options before discounting them altogether.

After a year, we let our policy lapse, but fortunately, our health did not.  Then, we began the baby talk and decided that even if we didn’t worry so much about our own health, it was time to take the responsible road and insure our children’s health.

We ended up purchasing a policy via Seguros America.  With an office in Managua, they were easy to find, helpful in choosing the appropriate policy for our needs, and very affordable.  Seguros America offers tiered coverage, including a silver or gold plan with varying deductibles.  You can purchase a policy that covers you in only Nicaragua, in all of Central America, or worldwide.  Obviously, those plans with lower deductibles and greater geographic coverage are more costly, but they are still quite reasonable.

For under $1,000 per year for the entire family, our policy provides us with regional coverage, up to $25,000 per person per year.  The plan provided up to $2,000 in maternity care (prenatal and labor and delivery).  You have up to two weeks after the birth of a child to add him/her to your policy and receive coverage for newborn costs.  Ambulatory visits are unlimited and will be reimbursed up to $20 per visit.  Specialized medicine visits are also unlimited and covered up to $30 per visit.  There are plenty of more detailed items that are covered, based on your chosen deductible and package, including ER visits, surgeries, physical therapy, etc.  It’s best to consult with an insurance agent to review these details prior to purchasing a package.

To obtain coverage, you must first meet with a rep from the SA office and then submit to a physical exam. We still pay out of pocket for all medical expenses and then submit receipts, along with a basic reimbursement form signed by our doctors, to the headquarters in Managua.  We typically receive reimbursement checks within two weeks.  All of our healthcare has taken place at Hospital Metropolitano, Vivian Pellas and have had no problems seeking reimbursement.

Another option, which I understand functions similarly to Seguros America, is the insurance plan offered by Vivan Pellas.  They have an office on the first floor of the hospital.

To date, we have been exceedingly happy with our coverage.  Though it does not cover us when we travel outside of Central America, we have found great travel insurance plans via Seven Corners.  They provide you with a quick and easy online quote after completing a basic questionnaire. Look into travel insurance provided by your credit cards, as well.

For further reading on health insurance in Nicaragua, visit The US Department of State website:

“You can’t assume your insurance will go with you when you travel. It’s very important to find out BEFORE you leave whether or not your medical insurance will cover you overseas. You need to ask your insurance company two questions:

• Does my policy apply when I’m out of the United States?
• Will it cover emergencies like a trip to a foreign hospital or a medical evacuation?

In many places, doctors and hospitals still expect payment in cash at the time of service. Your regular U.S. health insurance may not cover doctor and hospital visits in other countries. If your policy doesn’t go with you when you travel, it’s a very good idea to take out an additional policy for your trip. For more information, please see ourmedical insurance overseas page.

Be wary of private companies that claim to provide Medicare coverage outside of the United States. Generally, Medicare does not extend to beneficiaries overseas; we recommend you purchase additional medical insurance to ensure complete coverage. Please see the pamphlet Medicare Coverage Outside the United States for more information.”