If you are traveling to the United States or other countries outside of Panama; your plan covers medical emergencies reported within 48 hours with a (co-pay of $ 5.00). It covers accidents reported within 72 hours (NO CO-PAYMENT). Medical Emergencies are defined under Section 5 in your plan brochure. If you are under POS - the plan covers you 100% of POS benefits. If you have the FFS plan - you pay, and the plan will reimburse you 50% of the reasonable and customary rate. The medical services received during a trip out of the service area with conditions not severe enough to be classified as emergency cases will be reimbursed under the FFS benefits.

When you travel to any country outside of Panama, you must purchase the medications and file the claim to PCABP, P.O. Box 31-0940, Miami, Florida 33231-0940.

When traveling to any country outside of Panama, the members can go to any doctor or hospital. The providers are not contracted therefore they do not have to accept the Panama Canal Area Benefit Plan. This may require you to pay for your services and submit your claims to the U.S. to process. If you are over 65, it would be of your best interest to choose a participating Provider with Medicare, and your claim in the United States would be reimbursed according to Medicare rates.

Under the preventive care benefit, you are entitled to 1 visit to your gynecologist, without referral and without co-payment.

You need to visit your Primary Care Physician (PCP) to obtain a referral for the specialist (ENT-otorhinolaryngologist) you will be required to have a hearing test done, then send the results of the hearing screening along with the PCABP form to PCABP office for the proper approval. Once you obtain the approval you must take the approved PRE-AUTHORIZATION to the assigned doctor and clinic, you are required to pay the co-payment of $ 5.00 dollars to obtain the device.

Maintenance of Oral Prophylaxis limited to two (2) visits per year. Dental Surgery, Dental Periodontics, Endodontics, prior to these treatments you are required to submit a complete estimate on the Dental Treatment form to obtain approval for the treatment of these benefits.If approval is not obtained, we will limit benefits to 50% of the fee schedule.

In order to obtain your diabetes medications before traveling, your Primary Care Physician (PCP) or endocrinologist should complete the Diabetes Disease Management Prescription Form, detailing the medication prescribed. Attached to this form you must submit the results of glycosylatedhemoglobin test and your doctor should write a note stating how long you will be traveling.

It is not recommended that a specialist be a Primary Care Physician, but the specialist may request additional consultation.

The grandchildren are not eligible members of the plan, however if you have the Guardianship and Custody for the grandchild and the grandchild lives with you, then that grandchild may be an eligible member in your plan.

Under the preventive care benefit, you are entitled to one (1) PSA test a year. If you have a pre-existing condition, for example, Prostate cancer or elevated PSA, then there is no limit.