Written by
John Spencer
John Spencer is the founder of Compare Expat Plans, focusing on clear, neutral information to help people find health coverage abroad.
Last updated: January 29, 2026
Quick Summary: Health Insurance in Guatemala
- Health insurance is not required but strongly recommended—Guatemala City has good private hospitals, but coverage elsewhere is limited.
- Most expats live in Antigua or Lake Atitlán—both require travel to Guatemala City (45-90 min) for serious care.
- Private hospitals in Guatemala City have US-trained doctors and modern facilities at affordable prices.
- CA-4 visa allows 90 days; Pensionado or Rentista residency for long-term stays with $1,000/month income proof.
- Healthcare costs are very affordable: $25-50 GP visits, $50-100 specialists, making out-of-pocket viable for routine care.
Do You Need Private Health Insurance in Guatemala?
Guatemala does not require health insurance for visas. However, comprehensive coverage is strongly recommended. Guatemala City has several good private hospitals with US-trained doctors, but outside the capital—including popular expat areas like Antigua and Lake Atitlán—healthcare is limited. For complex procedures (cardiac surgery, oncology, major trauma), evacuation to Miami or Houston (2.5-hour flight) is common.
You likely need private insurance if:
- Expats in Antigua or Lake Atitlán—local clinics are limited; Guatemala City is 45-90 minutes away
- Retirees with chronic conditions—ensure access to Guatemala City specialists or US care
- Digital nomads wanting routine care access without out-of-pocket hassle
- Adventure travelers—volcano trekking, hiking, and travel carry risks
- Anyone wanting access to US healthcare for complex conditions
Public vs Private Healthcare in Guatemala
Public Healthcare
IGSS (Instituto Guatemalteco de Seguridad Social)
- Access: Guatemalan citizens and formal sector workers
- Cost: Employer/employee contributions for formal workers
IGSS covers formal sector employees but is severely underfunded with long waits and limited facilities. Ministry of Health (MSPAS) operates public hospitals available to all, but these are overcrowded with resource constraints. Expats rarely use public healthcare—even middle-class Guatemalans seek private care.
Private Healthcare
International or Local Private
- Access: Open to anyone
- Cost: $50-120/month (international); $30-60/month (local plans)
Guatemala City has several good private hospitals: Hospital Herrera Llerandi (top choice for expats, many US-trained doctors), Centro Médico (large hospital with multiple specialties), Hospital Universitario Esperanza, and Sanatorio El Pilar. Many doctors trained in US or Mexico. Antigua has clinics like Hospital Privado Hermano Pedro for routine care but serious cases go to Guatemala City. Lake Atitlán has basic clinics in Panajachel—evacuate to Guatemala City for anything significant.
Plan Options to Compare
Here are the most popular insurance options for expats in Guatemala. Each has trade-offs depending on your situation.
Cigna Global
Best for: Worldwide coverage and strong customer service
Not ideal for: Budget-focused expats staying only in Guatemala
Allianz Care
Best for: High-deductible savings and EU-based service
Not ideal for: Those wanting minimal out-of-pocket costs
BUPA Global
Best for: Pre-existing conditions and mental health coverage
Not ideal for: Those seeking the lowest premiums
IMG Global
Best for: Budget international coverage
Not ideal for: Those wanting premium service levels
Comparison Table: Top Expat Health Plans for Guatemala
Compare the leading options side by side. Click "Details" to learn more about each provider.
| Provider | Best For | Coverage Style | Includes U.S.? | Notable Limits | Learn More |
|---|---|---|---|---|---|
| Cigna Global | Worldwide coverage and strong | International comprehensive | Higher cost than local options | Details → | |
| Allianz Care | High-deductible savings and EU-based | International comprehensive | Deductibles apply to savings | Details → | |
| BUPA Global | Pre-existing conditions and mental | International premium | Premium pricing | Details → | |
| IMG Global | Budget international coverage | International standard | 12-month pre-existing exclusion | Details → |
Common Watch-outs for Guatemala
Keep these points in mind when choosing coverage:
- Antigua and Lake Atitlán are 45-90 minutes from Guatemala City hospitals. If living in these areas, know your evacuation plan for emergencies.
- Altitude: Guatemala City and Antigua sit at ~1,500m (5,000 ft). Most people adjust easily, but those with heart/lung conditions should consider it.
- Security: While improving, Guatemala City has high-crime areas. Private hospitals are in safer zones, but ambulance response in some neighborhoods is limited.
- Volcano and adventure tourism: Climbing Acatenango/Fuego or other volcanoes carries risks. Ensure coverage for high-altitude activities and evacuation from remote areas.
- US Medicare doesn't work in Guatemala. Retirees need private international coverage or plan to pay out-of-pocket.
Frequently Asked Questions
What are the best hospitals in Guatemala?
Hospital Herrera Llerandi in Guatemala City is the top choice for expats—modern facilities, many US-trained doctors, and English-speaking staff. Centro Médico is another major private hospital with comprehensive services. Hospital Universitario Esperanza is newer with good specialists. For routine care in Antigua, Hospital Privado Hermano Pedro handles basics. Lake Atitlán has only basic clinics—serious issues require Guatemala City.
How do I get residency in Guatemala?
Guatemala offers several residency options: Pensionado (retirees) requires proof of $1,000/month pension income. Rentista (investors) requires $1,000/month from investments. Temporary Residence for those with Guatemalan family ties or employment. No digital nomad visa exists—most remote workers use the CA-4 tourist visa (90 days in Guatemala, El Salvador, Honduras, Nicaragua combined) with periodic exits to Mexico or Belize to reset.
How much does private healthcare cost in Guatemala?
Guatemala City private hospital costs: GP consultation Q200-400 ($25-50), specialist Q400-800 ($50-100), private hospital room Q1,500-3,000/day ($190-380), MRI Q2,000-4,000 ($250-500), dental cleaning Q200-400 ($25-50). These prices are 50-70% less than US costs, making out-of-pocket viable for routine care. Insurance remains valuable for emergencies and potential US evacuation.
Should I get insurance if living in Antigua Guatemala?
Yes. Antigua has clinics for routine care, but anything serious—surgery, cardiac issues, complex diagnostics—requires Guatemala City (45-60 minute drive). International insurance provides: (1) access to Guatemala City private hospitals, (2) potential US evacuation for complex cases, (3) peace of mind for emergencies when Guatemala City trip isn't feasible. Many Antigua expats maintain US-including coverage for major issues.
When would I need US evacuation from Guatemala?
Guatemala City handles most medical needs adequately. US evacuation (typically to Miami or Houston, 2.5-hour flight) is for: advanced cancer treatment, complex cardiac surgery, specialized pediatric care, major trauma with neurosurgery needs, or if you simply prefer US healthcare for serious conditions. Air ambulance costs $15,000-30,000; commercial flight evacuation is cheaper for stable patients.
Related: Comparisons and Next Steps
Disclaimer: This guide is for informational purposes only. Healthcare policies, insurance requirements, and visa rules change. We are not insurance brokers, immigration consultants, or licensed advisors. Verify all information with official sources and insurance providers before making decisions.