Health insurance for expats & residents in Paraguay (2026)

TL;DR

What to buy

• Paraguay does not require health insurance to get residency. Ley 6984/2022 stripped out the old medical exam and insurance proof — you need a passport, apostilled birth certificate, apostilled police record, and photos. Nothing else.
• IPS (the public social-insurance fund) only covers you if you are formally employed. Employee pays 9% of salary, employer 16.5% (total 25.5%). Self-employed 'voluntary' affiliation buys a pension, not health cover. If you are a retiree or remote worker, IPS is generally not an option for you.
• Local prepaga from a private sanatorio costs roughly US$ 40-80/month (a 2026 estimate — get a current quote) and gets you fast access to good private clinics — but plans carry a hard financial ceiling per event and never include international evacuation.
• International plans (Cigna, Allianz, GeoBlue, APRIL) run roughly US$ 150-400/month and include worldwide treatment, evacuation, and repatriation — the right choice if a major illness would otherwise bankrupt you.
• The common, sensible setup for a new resident: a local prepaga plan for day-to-day care plus a standalone medical-evacuation membership for the worst case.

At a glance

Local vs international vs IPS

Three categories, three very different trade-offs. Costs below are 2026 estimates for a healthy adult, not quoted prices — confirm the current figure with each provider, since prepaga premiums rise with age and are adjusted annually.

For where these clinics and hospitals actually are and how good they are, see the healthcare guide.

The honest part

Residency does NOT require health insurance

This trips up people coming from countries (and other Latin American visa programs) where proof of cover is mandatory. Under Ley 6984/2022, administered by the Dirección Nacional de Migraciones (DNM), the old medical examination and any health-insurance requirement were removed. The standard administrative residency needs only four core documents: your passport, an apostilled birth certificate, an apostilled police-clearance / background check, and passport photos — plus roughly US$ 460 in government fees. There is no investment minimum, no income proof, and no language test on the standard route, and no line item for insurance. That said, 'not required' is not the same as 'not needed'. You are moving to a country with a competent but stretched public system and excellent-but-paid private clinics. Going uninsured means paying cash, and a serious event can run into five or six figures. Buy something — just don't let anyone tell you the DNM is checking for it.

• No medical exam for residency since Ley 6984/2022.
• No health-insurance proof required by the DNM.
• Required docs: passport, apostilled birth certificate, apostilled background check, photos. See the document checklist.
• Apostille first, then sworn Spanish translation in Asunción — details on the apostille page.

Plan types

Who provides what

Local prepaga companies are regulated by Paraguay's Superintendencia de Salud, which maintains the official national registry of prepaid-medicine entities (EMPP). Most are run by, or tied to, a private sanatorio, so the plan effectively buys you priority access to that hospital network. International policies sit on top and are usually bought from a broker abroad. Verify every provider, its current registration, and any quote directly — the names below are established players, not endorsements.

• Local prepaga — Santa Clara, Asismed, SAMAP

  Domestic medicina prepaga tied to private sanatorios (e.g. Santa Clara, Asismed, and SAMAP at the Sanatorio Adventista de Asunción). Roughly US$ 40-80/mo for an individual as a 2026 estimate — entry-level plans can be cheaper, fuller plans more. Fast access to private clinics, low co-pays, but capped coverage and Paraguay-only. Regulated by the Superintendencia de Salud; check a provider is on the current EMPP registry before you buy.

• International — Cigna, Allianz Care, GeoBlue, APRIL

  Worldwide inpatient/outpatient, emergency evacuation, repatriation, maternity, chronic-condition management. Roughly US$ 150-400/mo and up as an estimate. Portable across countries — useful if you split time between Paraguay and home. Watch for pre-existing-condition exclusions and deductibles, and confirm the insurer actually writes cover for residents in Paraguay.

• Public IPS (Instituto de Previsión Social)

  The social-insurance fund. Real coverage, but you must be formally employed — employer files you and both sides contribute (9% employee, 16.5% employer of salary, 25.5% total). Covers you and registered dependents. Not a buy-in option for retirees or remote workers seeking health cover.

• Medical-evacuation membership — Global Rescue, Medjet

  A standalone product, not insurance. Typically sold as an annual membership (entry plans from roughly US$ 100-400/year per person), it covers the thing local plans don't: getting you to a higher-level hospital or back home in a true emergency. Many experienced residents pair this with a local prepaga plan; confirm current pricing and what triggers a transport directly with the provider.

The public option

IPS: only if you're employed

There is persistent confusion about IPS, so be precise. IPS health coverage is tied to formal employment. A registered employer files you with IPS; the employee contributes 9% of gross salary and the employer 16.5% (25.5% combined), and a defined slice of that pool funds the enfermedad y maternidad (sickness and maternity) benefit that covers you and your registered dependents (derechohabientes). The trap: the 'voluntary affiliation' that IPS offers to independent/self-employed workers funds the pension (jubilación) fund — it does not by itself buy you health cover. Some categories (such as homemakers and certain business owners) contribute only to pensions and have no IPS health benefit at all. So if you are a retiree living on foreign income, or a remote worker / digital nomad with no Paraguayan employer, IPS is generally not a health-insurance route for you — you go private. One genuine path in: if you employ household staff and register them with IPS, that worker gets IPS health for themselves and their dependents.

• IPS health = formal employment only (9% employee + 16.5% employer, 25.5% total).
• Self-employed 'voluntary' IPS = pension fund, NOT health.
• Retirees and remote workers: plan to go private. See retirement and digital nomads.
• Always confirm current rates and rules directly with IPS — figures are set by law and can change.

Read this before you buy

Coverage ceilings and evacuation — the blunt truth

The single most dangerous assumption new residents make is that a cheap local prepaga plan covers them 'fully'. It does not. Local plans typically carry a hard financial ceiling per event or per year — which can sound large until an ICU stay, a complex surgery, or a cancer course burns through it. Many plans also exclude or limit long-term and serious-illness treatment, and none of them pay to fly you to a better-equipped hospital or repatriate you home. The actual ceiling varies a lot by plan, so don't assume — read the number in your own contract. That gap is exactly what a standalone medical-evacuation membership (Global Rescue, Medjet) closes, typically sold as an annual membership. If your concern is a catastrophic event rather than routine doctor visits, the honest answer is an international policy that includes evacuation and high or unlimited limits — you pay several times more, but you remove the bankruptcy and the 'stuck in a regional hospital' scenarios at once. Read the per-event limit, the exclusions list, and the evacuation clause on any plan before you sign.

• Find the per-event and annual coverage ceiling — in writing.
• Check for pre-existing-condition and chronic-illness exclusions.
• Confirm whether international medical evacuation is included (usually not, on local plans).
• If not, add a Global Rescue / Medjet membership.
• Confirm which sanatorios/clinics are in-network.
• Check the waiting period before maternity, surgery, or major procedures are covered.

A workable setup

What most new residents actually do

There is no single right answer — it depends on your age, health, budget, and how mobile you are. But a few patterns recur. Budget your premium alongside the rest of your move; Asunción runs about US$ 1,082/month all-in for a single person, so a US$ 50-150 health line is real but manageable. See the cost-of-living breakdown.

• Healthy and on a budget: local prepaga (~US$ 40-80/mo estimate) plus a medical-evacuation membership.
• Older, or a serious-illness risk you can't self-insure: an international plan (Cigna / Allianz / GeoBlue) with evacuation built in.
• Formally employed in Paraguay: you'll have IPS automatically — many still add a prepaga plan for faster private-clinic access.
• Retiree on foreign income: IPS isn't available to you for health; go private and price evacuation in. See retirement.
• Just visiting / pre-move: keep your travel or international policy until your cédula and a local plan are in place.

FAQ

Health insurance in Paraguay — common questions