Health insurance in Paraguay: options, real prices and the traps

Do I need health insurance for the residency?

No. Health insurance is not a requirement for the Paraguay residency. Under migration law 6984/2022 there is no mandatory insurance and no medical screening, so you do not have to present a policy or undergo an examination to file the application.

That sets Paraguay apart from many other countries that require international health insurance for a residence visa. In Paraguay, coverage is your own affair. That is exactly why it pays to compare the options soberly instead of taking the first policy someone wants to sell you.

The public system: free, but with long waiting times

The facilities of the Ministry of Health are free at the point of use, for everyone with a valid ID, foreigners included. So a basic network of care is open to you as soon as you can identify yourself.

The catch is quality and availability: the system is considered underfunded, overcrowded and slow. For an acute emergency it is there; for planned treatments or specialist appointments, newcomers report tests of patience. Those who can afford it therefore combine the public system in practice with private cover and often just pay for smaller specialist visits directly.

As a rough guide: a specialist consultation out of pocket runs, according to reports, at roughly 40 to 70 USD. That explains why many do not need an expensive policy for everyday life at all, but are rather looking for protection against the big, expensive worst case.

IPS: social insurance for employees, and the trap for the self-employed

IPS (Instituto de Previsión Social) is the Paraguayan social insurance. It formally covers employees, financed by contributions of 9% (employee) plus 16.5% (employer). Foreign employees pay in and are insured like locals, so for them IPS is the normal route to healthcare.

Now the decisive trap, and it affects the majority of newcomers: there is a voluntary IPS contribution for the self-employed under Ley 4933/2013, 13% of declared income. This contribution buys pension entitlements only, NO healthcare. For this group, the IPS health services are only unlocked when the pension starts, not during the contribution years.

In practical terms: if you pay voluntarily into IPS as a self-employed person, you are still not covered by IPS for illness beforehand. That is exactly why most self-employed and near-retirement newcomers need a local prepaga or an international policy, regardless of whether they pay voluntarily into the IPS pension or not.

Local prepagas: price ranges and their structural weaknesses

The private alternative within the country are the prepagas (medicina prepaga), comparable to private supplementary insurance. Recurring across several sources are Asismed, MediLife and Santa Clara. The rates are usually not published: MediLife, for example, names its tiers (Plan Inicial, Esencial, Vital, Integral, Tercera Edad) only on request. So expect to have to ask directly for concrete prices.

The following figures are experience values from expat and provider sources, end of 2025, not guarantees and varying by age and rate tier. Take them as rough ranges and always check the concrete premium with the provider.

• →Cap per case: often only about 100,000 to 150,000 USD. A severe case can exhaust a local policy; an intensive care unit costs, according to reports, roughly 3,000 USD per day.
• →Carencia (waiting period): usually 60 to 120 days for illnesses before benefits kick in. Accidents are generally covered immediately.
• →Paying directly as an alternative: a specialist consultation out of pocket runs, according to reports, at roughly 40 to 70 USD, and small private emergency or ambulance subscriptions (EME, GESE) at roughly 10 USD a month.

International insurers: more coverage, a deductible lowers the premium

Anyone who does not want the caps and the limited international validity of the local prepagas reaches for international health insurance. These providers cover Paraguay and pay out significantly higher sums in an emergency, but the premiums are higher. One important lever: a high deductible lowers the premium sharply, sometimes by 50 to 60%, and brings it close to a local policy.

Here too, all figures are ranges and experience values from 2026, age-dependent, not guarantees. The product lines of some providers (Genki and SafetyWing, for example) changed several times between 2024 and 2026. Always check the current premium and the exact terms directly on the provider's site.

Retirees, age and pre-existing conditions: what to watch for

For the retiree audience, health insurance is the real sticking point, not the residency. Important to know: Germany and Austria have no social insurance agreement with Paraguay, so your statutory health insurance from home pays nothing in Paraguay. With the final move away, membership usually ends. What that means for your German or Austrian health insurer and a possible expectancy insurance (Anwartschaftsversicherung) is a separate, individual question that belongs with your health insurer, not on a general guide page.

In Paraguay itself, premiums rise with age, and the local prepagas run their own rate tiers for older customers (Tercera Edad at MediLife, for example). Concrete age limits and exclusions for pre-existing conditions are usually not published by the providers; they only emerge from the individual quote. So here in particular: ask, read the terms carefully, watch the carencia and the per-case cap.