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 Paraguay
- No insurance required—but recommended given public healthcare limitations outside Asunción.
- Easiest permanent residency in the Americas—achievable in weeks, not years. No minimum stay requirement.
- Asunción has decent private hospitals (Sanatorio Migone, Hospital Italiano); quality improving but limited specialists.
- Extremely affordable—private GP $20-40, hospital day $100-250, international insurance $50-100/month.
- Buenos Aires (1 hour flight) is the evacuation option for complex cases—some of South America's best hospitals.
Do You Need Private Health Insurance in Paraguay?
Paraguay doesn't require health insurance for visas or residency—part of what makes immigration so easy. However, given public healthcare limitations and the lack of complex care options in Asunción, international insurance with evacuation coverage is strongly recommended. Many expats get permanent residency in Paraguay specifically because it's easy, then obtain insurance separately.
You likely need private insurance if:
- All expats—public system underfunded; private insurance essential for quality care
- Retirees and those 50+—limited specialists in Asunción; Buenos Aires evacuation may be needed
- Expats outside Asunción—Ciudad del Este has some private clinics; rest of country very basic
- Those with complex conditions—Paraguay can't handle advanced cancer, transplants, rare diseases
- Flag theory practitioners—many get PR for tax/banking reasons but live elsewhere; need coverage wherever they actually are
Public vs Private Healthcare in Paraguay
Public Healthcare
MSPyBS (Ministry of Health) / IPS (Social Security)
- Access: Paraguayan citizens; IPS for formal employees
- Cost: Free (MSPyBS); IPS via payroll (~9% employer + ~9% employee)
Paraguay's public healthcare is underfunded with significant gaps in medications, equipment, and specialists. IPS (social security system) is better than MSPyBS general hospitals but still basic. Main public hospitals in Asunción: Hospital de Clínicas, Hospital Nacional de Itauguá. Long waits, limited English, and medication shortages are common. Expats typically use public healthcare only as a last resort.
Private Healthcare
International or Local Private
- Access: Open to anyone
- Cost: $50-100/month (international); $30-70/month (local plans)
Private healthcare in Asunción is improving. Top hospitals: Sanatorio Migone-Battilana (best overall), Hospital Italiano, Sanatorio San Roque, Hospital Bautista. Quality is decent for routine care and moderate emergencies—comparable to secondary cities in Argentina or Brazil. Ciudad del Este has Hospital Regional and private clinics. Costs are very low—among the cheapest in South America. For complex cases, Buenos Aires (1 hour flight, 5-6 hour drive) offers world-class care at Hospital Italiano, Hospital Alemán, or Fundación Favaloro.
Plan Options to Compare
Here are the most popular insurance options for expats in Paraguay. Each has trade-offs depending on your situation.
Cigna Global
Best for: Medical evacuation to Buenos Aires or São Paulo for complex procedures
Not ideal for: Budget expats in Asunción—Sanatorio Migone handles most needs affordably
Allianz Care
Best for: Tax residency seekers wanting coverage that extends to Argentina/Brazil cross-border care
Not ideal for: Retirees staying primarily in Asunción with good local hospital access
BUPA Global
Best for: Pre-existing conditions with guaranteed evacuation to São Paulo for specialist care
Not ideal for: Healthy libertarian expats—Paraguay's low costs make premium plans overkill
IMG Global
Best for: Budget coverage for entrepreneurs testing Paraguay's business-friendly environment
Not ideal for: Those with complex medical needs requiring specialist access
Comparison Table: Top Expat Health Plans for Paraguay
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 | Medical evacuation to Buenos | International comprehensive | Higher cost than local options | Details → | |
| Allianz Care | Tax residency seekers wanting | International comprehensive | Deductibles apply to savings | Details → | |
| BUPA Global | Pre-existing conditions with guaranteed | International premium | Premium pricing | Details → | |
| IMG Global | Budget coverage for entrepreneurs | International standard | 12-month pre-existing exclusion | Details → |
Common Watch-outs for Paraguay
Keep these points in mind when choosing coverage:
- Immigration ease vs. healthcare reality: Paraguay's famous easy residency attracts many expats, but the healthcare doesn't match the immigration convenience. Get PR for banking/passport/tax reasons if you want, but have a healthcare plan that accounts for Paraguay's limitations.
- Buenos Aires dependency: For serious conditions—complex cardiac surgery, advanced oncology, transplants, specialized pediatrics—you'll evacuate to Buenos Aires. Ensure your insurance covers Argentina without issues. Flight time is 1 hour; driving is 5-6 hours via Posadas border crossing.
- Specialist scarcity: Even Asunción's best hospitals have limited specialists. Some subspecialties don't exist; others have only one or two doctors in the entire country. For complex conditions, many expats schedule planned treatment in Buenos Aires or São Paulo.
- Language barrier: Paraguay is bilingual (Spanish and Guaraní), but English is rare even in private hospitals. Some doctors trained abroad speak English; most staff don't. Bring a Spanish speaker or translation app for medical appointments.
- No minimum stay requirement: Paraguay's PR has no minimum days requirement—you can get PR and immediately leave. Many 'permanent residents' actually live elsewhere. Your health insurance needs to cover where you actually live, not just Paraguay.
Frequently Asked Questions
How does Paraguay's famous easy residency work?
Paraguay offers one of the world's easiest permanent residency programs. Requirements: Police background check from home country (apostilled), birth certificate (apostilled), passport, bank deposit of ~$5,500 (held briefly, then returned), medical certificate, and application forms. Process takes 3-8 weeks typically. No language test, no income requirements, no minimum stay. You receive cedula (ID card) allowing banking, business ownership, and path to citizenship after 3 years. Many use Paraguay PR for 'flag theory'—diversifying residency for banking, tax, or passport options.
Is Sanatorio Migone comparable to Argentine hospitals?
Sanatorio Migone-Battilana is Paraguay's best private hospital—reasonable facilities, trained doctors, and improving equipment. It handles routine care, general surgery, cardiology basics, obstetrics, and emergency care adequately. Comparison to Argentina: roughly equivalent to a good provincial Argentine hospital, but below Buenos Aires's top facilities (Hospital Italiano, Alemán, Favaloro). For everyday healthcare needs, Migone is fine. For serious or complex conditions, Buenos Aires provides meaningfully better care.
What's the expat community like in Paraguay?
Paraguay has a growing expat community, primarily in Asunción. Main groups: North American retirees (attracted by low costs and easy residency), Mennonite communities (Gran Chaco region), Brazilian business people (Ciudad del Este), and 'flag theory' practitioners (digital nomads, international entrepreneurs using Paraguay for banking/residency). The community is smaller than Ecuador or Panama but growing. Expat groups exist for healthcare recommendations, Spanish classes, and social connections.
How do costs in Paraguay compare to other South American countries?
Paraguay is one of South America's cheapest countries for healthcare. Comparison of private GP visits: Paraguay $20-40, Argentina $40-80, Chile $50-100, Brazil $40-80. Hospital day: Paraguay $100-250, Argentina $300-600. Common surgery (appendectomy): Paraguay $2,000-4,000, Argentina $5,000-10,000. International insurance for a 40-year-old: Paraguay $60-100/month. The tradeoff: lower costs reflect simpler facilities and fewer specialists compared to Argentina, Chile, or Brazil's major cities.
Should I get local or international health insurance in Paraguay?
International insurance is strongly recommended. Reasons: 1) Covers evacuation to Buenos Aires—essential given Paraguay's limited complex care, 2) Works when traveling (important if you're a 'flag theory' resident who doesn't actually stay in Paraguay), 3) Better claims processing and English support, 4) More reliable for expensive treatments. Local insurers (ASIS, Medical) are very cheap but typically don't cover evacuation or treatment abroad. Best approach: International plan with evacuation (Cigna, Allianz, IMG), pay cash for minor Asunción care (it's so cheap insurance often doesn't make sense for small claims).
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.