Panama

Panama is one of the most established expat destinations in Latin America, home to an estimated 25,000–30,000 American residents and known for using the US dollar as legal tender alongside the balboa. Panama City offers modern infrastructure, a Johns Hopkins-affiliated hospital (Punta Pacifica), and a cost of living roughly 40–50% lower than major US metros according to Numbeo (2025). The State Department maintains a Level 2 advisory (July 2024) urging increased caution primarily due to crime in specific neighborhoods and the Darién region near the Colombian border. The country is best known among retirees for its Pensionado visa, widely regarded as one of the world's most generous retirement programs, offering discounts on healthcare, transportation, and entertainment. Panama also offers a Qualified Investor visa and the Friendly Nations visa, which was restructured in 2021 to require an investment or work contract rather than simple proof of economic ties. English proficiency is 'moderate' per the EF EPI 2024, concentrated in Panama City, the former Canal Zone, and Boquete, while rural areas are predominantly Spanish-speaking. Healthcare is considered the best in Central America, with private insurance typically costing $100–$200/month for expats under 60. Major expat hubs include Panama City (urban, cosmopolitan), Boquete (cool mountain climate), Coronado (beach), and Pedasí (remote coastal). Considerations include seasonal heavy rainfall, bureaucratic delays in visa processing, and rising real-estate costs in Panama City.