This guide will provide you with an understanding of Paraguay’s healthcare system and health insurance: how it works, its costs, and how to access it.
It might well be that during your life in Paraguay you will require nothing more than routine treatments and that Paraguay will be kind to your health. The knowledge of what to do and where to go if anything serious were to occur is comforting and ensures that access to healthcare is not something to be worried about.
Does Paraguay have good healthcare?
Paraguay is a developing country and expectations of its healthcare system must be adjusted accordingly.
In all but the very most modern of private hospitals, the equipment is somewhat aged and technologically inferior to that which may commonly be found in hospitals in Europe or North America. However, the staff may have had years of experience getting the very best out of what they have to hand.
During 2020 there was a large-scale programme across the country to update and expand hospitals and health centres. These works were prompted by the Covid crisis and once that has passed the improved facilities will remain.
Another indicator of the availability of healthcare is the number of physicians. In the USA this is 2.56 per 1000. Here in Paraguay, it is just 1.23 per 1000. Furthermore, these are disproportionately concentrated in Asunción and surrounding districts.
The further you travel away from Asunción the thinner the health coverage becomes.
Then there is the question of public or private.
Public healthcare is available to all and there is a hospital in every town. All towns have a private clinic but private hospitals are only to be found in the largest towns.
A public hospital is not necessarily inferior in terms of hygiene and quality of care to a private one. However, the building will look more old fashioned and the facilities more dated. With public hospitals being there for everyone they are very often full of patients waiting their turn to be seen.
This alone may encourage you to use private clinics which do not have people queueing for hours in order to consult a doctor.
What is healthcare like in Paraguay?
Public healthcare in Paraguay is integrated vertically from doctors in the most remote areas through to national hospitals in Asunción.
At its farthest extreme it is represented by doctors travelling many miles between small settlements to visit widely scattered patients. Unless you travel to the very remotest areas you may never have reason to encounter one.
Above this level, all medical practitioners practice from fixed locations. The smallest of them are the neighbourhood health centres. Next, there are local town hospitals and then regional district hospitals. Then finally a number of national hospitals are located in Asunción.
In practice, you will find that for an expat there is little reason to access anything below a regional hospital. Every town has a number of small private health centres which are better equipped than their neighbouring public hospitals.
These small private clinics tend to be pay-as-you-go establishments rather than ones requiring insurance to be taken out and so are ideally suited to be used for occasional medical requirements.
Public healthcare as a whole is funded by the central government. The funds are often thin and spread unevenly across the country. Additionally, as everything has to be passed through each level of the system there is a tendency for some of the funds to go missing before reaching their desired destination.
However, during 2020 central healthcare spending has been increased and many publicly run facilities have seen major expansions and modernisations at all levels.
In contrast to this private healthcare is funded solely by the revenue from their members and patients. This is sufficient to enable the private sector access to more modern and specialised equipment.
Large private clinics and hospitals which are scattered across Asunción often offer insurance packages as membership of the institution. This is not generally the case outside Asunción.
Outside Asunción the best option for insurance is an international health policy, making sure that covers the costs of treatments in Paraguay and will not seek to evacuate patients requiring more complicated or expensive procedures.
Is healthcare free in Paraguay?
In Paraguay, both nationals and foreign residents have the right to access public healthcare at the same level at any time.
In the public system, there is no charge for a consultation with a doctor.
Beyond the consultation, though even in the public sector little is free. Prescriptions and the use of a hospital’s facilities all require payment just as they would in a private hospital.
From an expats point of view, however, this may be another reason for using private rather than public health facilities.
Public health facilities are busy, crowded places. It is not uncommon for new arrivals to be issued with numbered tickets and for those arriving more than a couple of hours after the hospital has opened having little chance of being seen that day.
Using the public system requires a lot of patient waiting.
Overall, the public health service does function and does provide the services and healthcare required of it. However, as someone who can afford to pay for their medical consultations, you would be best advised on most occasions to select a private institution.
Private healthcare insurance and costs
Living in Paraguay does not require health insurance. Neither is it necessary in order to obtain residency.
As part of the residency process, a health check is required. This is done at a hospital in Central Asunción simply by turning up and requesting one.
You may feel that having all medical possibilities covered by an insurance plan is a sensible precaution to take. International healthcare insurance could be the best option. You will, however, need to check the wording of any policy to ensure that Paraguay is included as somewhere where all medical costs would be covered.
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Make sure you know what action will be taken in the cases of serious or emergency conditions. Hospitals offering a high level of care can be found in Paraguay, so being evacuated abroad to receive medical care would not be the most sensible course of action.
With those caveats, the benefit of an international policy is its flexibility. Within Paraguay, with private facilities being autonomous from each other a local policy would be in reality membership of a particular hospital.
Plus, healthcare is expensive in Paraguay. An international policy could quite probably be both cheaper and better value for money.
Local private health insurance
For a healthcare policy taken up in Paraguay with a good hospital, you should expect to be paying in the region of $75 per month. That figure would rise considerably for access to one of the top private hospitals in Asunción.
As healthcare costs are so high most private healthcare is pay-as-you-go. Almost all private clinics and hospitals accept paying customers. In fact, nearly 90% of private healthcare is paid for that way.
Doing so allows private care to be accessed when it is required.
Examples of treatments that are better off dealt with in this manner are dentistry and routine health checks.
How to find a GP in Paraguay
In Paraguay, the idea of having a GP whom you can refer to as your GP is not a standard practice.
Instead in the private sector, it is preferable to always use the same institution and through that build up a relationship with the medical practitioners there. A smaller clinic may just have a couple of doctors so there it will be almost by default the same doctor you get to see on each visit.
Even in a larger private hospital once you find a doctor with whom you are comfortable it is quite acceptable to request to see them on subsequent visits. Doing so is standard practice in private healthcare facilities.
In a public hospital, you will have to see whatever doctor happens to be there on the day.
Hospitals in Paraguay
Public hospitals in Paraguay are lagging far behind similar ones in Europe or North America.
This situation has been altered somewhat during 2020. Throughout the year there has been a large scale programme of renovations, expansions and modernizations of public hospitals and health centres.
However, the best hospitals in Paraguay are all private ones.
These are better funded, not having to rely on the whims of the Health Ministry and are able to spend their funds where it would be best suited to their needs and requirements.
Again even in all but the top private hospitals, the equipment will be rather dated by Western standards, but it will be newer than that found in a public hospital.
Even in the smallest of towns, a private clinic will be the best equipped medical facility in town and home to many of the best staff members.
In Asunción, there are a number of very good private hospitals. Two of the very best are Centro Medico Bautista and Sanaterio Americano. They both almost always receive very positive reviews from patients.
Outside Asunción, large private hospitals are more thinly spread. Every town has a private facility of some sort operating as well as or better than any of the public healthcare facilities around.
One that does deserve a mention is the Hospital Mennonita which is located 81 km outside Asunción near the town of Itacurubi.
It has a very good reputation and provides a high quality of care. It on the whole operates more like a clinic than a hospital, providing treatments rather than beds.
Its reputation is such that people often travel many miles to receive treatment there. It is not uncommon for queues to build up long before the doors are opened each morning at 6 am.
If you are living in the interior and within a sensible driving time of it the Hospital Mennonita is well worth considering.
Prescriptions and pharmacies in Paraguay
In Paraguay, you are never far from a pharmacy. Every town and village in Paraguay has multiple pharmacies, often several along the same stretch of street.
These range from small and basic to large independents and through to national chains.
All but the smallest pharmacy is well stocked with prescription drugs. A small number of more expensive or specialised drugs will only be held in a few authorized pharmacies, but any doctor prescribing one will know exactly where you can find it.
All items are purchased from the pharmacy at cost price. There is no system of price differences if a drug is prescribed or not.
This can be an issue as doctors do have a tendency to write prescriptions for expensive brand-name drugs rather than cheaper generic equivalents.
Drugs are expensive in Paraguay. Even the most basic of items may well cost more in real terms than elsewhere.
Like everywhere else Paraguay also has its list of what can and cannot be simply purchased over the pharmacy counter. The quickest way to discover where or not something requires a doctor’s prescription is to ask in a pharmacy. They will know exactly what they are permitted to issue in that manner.
Healthcare in Paraguay – summary
You can find good quality healthcare in Paraguay, but at a cost.
The public system is as accessible to an expat as everyone else, but in reality, private healthcare will be the best option in the great majority of cases.
How that is paid for depends upon circumstance and preferences but however, it is done once you find a doctor in whom you have confidence and with whom you can build a rapport, stick with them.
As the best medicine is preventative medicine it is strongly advised that you plan your healthcare in advance. Last-minute arrangements during an emergency may not have you directed towards the best practitioners.
Plan your healthcare in advance; if anything were to happen, you would receive the best healthcare the country can provide.