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Healthcare Guide for Digital Nomads and Remote Workers in Nicaragua | Digital Nomad Exchange
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Parque Central Square in Leon, Nicaragua

Healthcare & Health Insurance in Nicaragua

By Joshua Wood, LPC

Summary: Digital Nomads in Nicaragua share their experiences with health insurance, healthcare in Nicaragua, local hospitals and specialists, quality of medical care and more.

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What are healthcare services like in Nicaragua?

When we asked expats and global nomads about the quality of medical care in Nicaragua, they replied:

"Healthcare services in Nicaragua are provided by both public and private institutions. The public healthcare system is funded by the government and is available to all citizens and legal residents. The quality of public healthcare varies depending on the region, but generally it is considered to be of lower quality than private healthcare. Foreign residents do have access to the public healthcare system, but they may need to pay out-of-pocket for some services. Expats in Nicaragua often use the public healthcare system for basic medical care, but they may opt for private healthcare for more specialized services," said one digital nomad in Nicaragua.

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What is the quality of medical care in Nicaragua like?

When we asked expats and global nomads about the quality of medical care in Nicaragua, they replied:

"My wife and I are near age 70 - expat health insurance has become too costly. We have Medicare coverage in the USA, so plan to return there in case of required hospitalization (non-emergency). We joined a "health plan" that offers discounts at one of the best hospitals in the country," said a member in Tola.

"Medical services in Nicaragua vary greatly depending on the region. In rural areas, access to medical care is limited and often of poor quality. In urban areas, there are more options for medical care, but the quality of care is still not up to the standards of many other countries. The public health system is underfunded and understaffed, and many people rely on private clinics and hospitals for medical care. The government has made efforts to improve access to healthcare, but there is still a long way to go," explained one person living in Nicaragua.

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Are healthcare and health insurance expensive in Nicaragua?

"Healthcare and health insurance in Nicaragua can be expensive for some people. The cost of healthcare services and health insurance can vary depending on the type of services needed and the type of insurance plan chosen. Generally, the cost of healthcare services is higher than in other countries, and health insurance plans can be expensive for those who do not qualify for government subsidies. Additionally, the quality of healthcare services in Nicaragua can be lower than in other countries, making it difficult to access quality care," said one digital nomad in Nicaragua.

"I've used both the public system, and "private doctors", and been satisfied with both. Almost all Nicaraguan doctors work for the government in the morning, and then hold private office hours in the afternoon. A private doctor's visit is inexpensive, $20 - $30. If you want to queue up at the clinic, it's free. It may take you a while to be seen, depending... Private labs do blood work inexpensively. Most medications are available without prescription, and are reasonably priced. I maintain a "footprint" in the US, I''m registered to vote here, and have an address where I receive mail. This enables me to have a no premium Medicare Advantage plan. I've been very happy with it. I also have relationships with both a primary care provider and various specialists. I feel it's important to establish these relationships before you leave the US. I'm only a 5 hour flight from Managua. I recently had some heart work done that was billed to the plan for $160K. An angioplasty and a couple of stents plus the diagnostic work that led to the operation. My nut was only $600, for a co-pay for a night in the hospital and specialist co-pays, and a co-pay on one of the diagnostic tests. My prescriptions are shipped to my mailbox and I pay nothing, or very little, for a 90 day supply of the medications I need. Although this work would have been available and probably cost significantly less in Nicaragua, maybe $20K, it's still a lot of money. The diagnostic tests (stress EKG and Echo Cardiogram) that led to the decision to go into my heart WOULD be harder to come by in Nicaragua. All of this has to be arranged before you leave. But, it's not complicated, and is 99% on-line, or by phone. This has been my solution to my medical needs, and it has worked very well. Yours might be different. ," commented a person living in Nicaragua.

What are emergency services like in Nicaragua?

When we asked about emergency services, members in Nicaragua wrote:

"Emergency services in Nicaragua are limited and vary in quality. In the event of an emergency, the best way to call for an ambulance is to dial 118, which is the national emergency number. Ambulances are often slow to arrive and may not be equipped with the necessary medical supplies. It is recommended to call a private ambulance service if possible," explained one digital nomad living in Nicaragua.

"Consider using Hospital Vivian Pellas in Managua for critical healthcare. Look for a local doctor that speaks English for routine healthcare. We have Medicare in the USA, so we could return there for hospital care if desired. Most medications can be obtained without a written prescription (excluding opioids)," said one member in Managua.

Will I need to travel to see a specialist?

"Nicaragua is home to several cities that boast top-notch medical specialists. Managua is the country's capital and hosts a wide array of medical centers that offer a vast selection of specialists across a variety of fields. Granada, situated on the northwestern shore of Lake Nicaragua, also provides a stellar selection of medical experts. The capital city of Chinandega, located on the country's Pacific coast, is another excellent choice for medical care, with a wide range of specialists available. Furthermore, the beautiful coastal city of León, located to the northwest of Managua, is renowned for its top-notch physicians and surgeons. Other towns and cities throughout Nicaragua, such as Matagalpa, Esteli, and Juigalpa, also offer several highly skilled medical professionals," wrote one digital nomad living in Nicaragua.

"My wife had critical care for atrial fibrillation at Hospital Vivian Pellas, and we were very satisfied with their service. However she ended up needing cardiac ablation, which they were not equipped to perform. We went to a Johns Hopkins related hospital in Panama for that procedure. Also very good care there (my granddaughter also had cardiac surgery there.) Hospital Vivian Pellas has a discount program for their services, not really "health insurance". We joined the discount program since we have needed their services periodically. We are in our early 70's - we previously had international health insurance, but premiums increased every year while in our 60's and it became excessively costly or unavailable when we turned 70," said one foreigner in Managua.

Are common prescription medications available in Nicaragua?

"Prescription medications are available in Nicaragua, although the availability of certain medications may vary depending on the region. Many medications are available over the counter, while others require a prescription from a doctor. In general, most common medications are available in Nicaragua, although some may be more difficult to find than others," explained one digital nomad living in Nicaragua.

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Do you have anything more to add about local medical facilities in Nicaragua?

"At last count there were about 5 hospitals and a few clinics around Granada. At least 1 is private," said one foreigner in Granada.

"The quality of medical facilities and care in Nicaragua varies depending on where one is located. Some of the larger population centers have improved access to medical facilities and care, while rural areas may have limited or inadequate access. The quality of care at health centers and hospitals is often substandard due to limited resources, outdated equipment and lack of qualified personnel. Access to specialized medical treatment can be difficult to obtain and costly. Although Nicaragua has made an effort to expand access to basic healthcare, there are still many gaps in access and quality of care," remarked one member in Nicaragua.

As a foreigner living in Nicaragua, will I have access to public healthcare? What is it like?

"Yes, foreigners living in Nicaragua have access to public healthcare. The quality of care varies depending on the region, but generally the public healthcare system is considered to be of a lower quality than private healthcare. The public healthcare system is often overcrowded and underfunded, and there are often long wait times for appointments and treatments. However, the public healthcare system is still an important resource for many Nicaraguans, and it is available to foreigners living in the country," explained one digital nomad living in Nicaragua.

What have your experiences during the pandemic with the local healthcare system been like?

We asked expats in Nicaragua if they have access to public healthcare in Nicaragua. And, if they do have access, what is it like. They wrote...

"The pandemic has had a significant impact on Nicaragua's healthcare system. Access to healthcare has become increasingly difficult due to the lack of resources and the limited number of healthcare professionals available. Many healthcare facilities have been overwhelmed by the influx of patients, leading to long wait times and overcrowding. Additionally, the government has implemented strict restrictions on movement, making it difficult for people to access healthcare services. Despite these challenges, the healthcare system has been able to provide essential services to those in need," explained one digital nomad living in Nicaragua.

"The government in Nicaragua tends to downplay the pandemic, so it is hard to tell how well people are treated if sick. When we returned from a trip to the USA a few months ago, the government health authorities called to check on our health a few times after our return," said one member in Tola.

About the Author

Joshua Wood Joshua Wood, LPC is one of the Founders of Digital Nomad Exchange and serves as Co-President of Expat Exchange. Prior to Expat Exchange and Digital Nomad Exchange, Joshua worked for NBC Cable (MSNBC and CNBC Primetime). Joshua has a BA from Syracuse and a Master's in Clinical and Counseling Psychology from Fairleigh Dickinson University. Mr. Wood is also a licensed counselor and psychotherapist.

Some of Joshua's articles include Pros and Cons of Living in Portugal, 10 Best Places to Live in Ireland and Pros and Cons of Living in Uruguay. Connect with Joshua on LinkedIn.

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Parque Central Square in Leon, Nicaragua

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