Before you start

For IPS: employment registered by your employer, which is what creates the cover
For the public network: nothing — MSPBS services are free at the point of use
For private plans: a cédula and the ability to pay a monthly premium

Step-by-step

1
Find out whether your employer has registered you with IPS
Registration is the employer's obligation and the resulting 'constancia de asegurado' is the document that proves it. Check it exists rather than assuming; it is also one of Migraciones' accepted proofs of economic solvency.
Via employerWho: Your employerOn hiring
2
Register with your nearest USF for the public network
The Unidades de Salud de la Familia are the MSPBS's primary-care entry point and are free. This is the layer most newcomers ignore and then need at eight on a Sunday evening.
In personWho: You
3
Price a prepaid plan if you want scheduled care without queues
Private medicina prepaga is the standard middle-class answer to waiting times for non-urgent specialist appointments. Premiums are modest by international standards; read the exclusions and the waiting periods carefully.
In personWho: You
4
Save the emergency numbers
141 reaches SEME, the health ministry's ambulance service. 911 is the police. The Hospital de Trauma on (021) 204-800 is the national referral centre for major injury and is in Asunción.
OnlineWho: You

Documents you’ll need

Cédula de identidad
IPS constancia de asegurado, where applicable
Employment contract for IPS registration

Things most newcomers don’t know

IPS is a health system, not just an insurer.

It owns and runs its own hospitals and clinics, so being an IPS member sends you to IPS facilities rather than reimbursing you at someone else's. That is a different mental model from a European or American plan.

Asunción concentrates the country's specialist medicine.

The Hospital de Trauma, the Instituto de Cardiología and the general paediatric hospital serve the whole of Paraguay from the capital. It is a genuine advantage of living here rather than in the interior, and a genuine strain on the facilities.

Most middle-class households run two layers.

IPS or the public network for the big events, a prepaid plan for scheduled specialist care. Relying on one alone is what produces the complaints about waiting times.

Common mistakes to avoid

Assuming IPS registration happened. It is the employer's duty and it does not always get done.
Assuming a prepaid plan covers pre-existing conditions from day one — waiting periods are the norm.
Not knowing 141. It is the ambulance number and it is not 911.

Some of this may be out of date. Spotted something inaccurate? Help us keep it right for the next newcomer.