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<iYou will need to return to the US every so many years to retain your citizenship....

Completely INCORRECT. If you are a US green card holder (i.e. a resident alien) you must return to the USA every one to three years. It used to be every 3 years. GWB may have changed this but I'm not sure.

You will have no medicare insurance there......and if you return to the US, you won't have it unless you sign up for it day one.....signing up for it after 65 is extremely punative......

IIRC, you can participate in Panama's socialized health care system for VERY CHEAP. You can also buy private medical insurance in Panama.

If you want that private insurance to cover your bills in the USA, you'll have to be able to prove Panamanian residency, that you actually live there. And that you're only in the USA to visit. Of course, you'll have to pay a premium if you want "visitors" coverage while in the US and A.
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