Ecuador's healthcare system is composed of both public and private healthcare options. The public healthcare system is called the Ecuadorian Social Security Institute (IESS) and is available to all Ecuadorian citizens and legal residents. Foreigners (digital nomads and expats and digital nomads) are allowed to use the public healthcare system in Ecuador, however, they are not eligible for the same benefits as Ecuadorian citizens. The public healthcare system is used by foreigners, but it is not recommended for serious medical emergencies or major surgery. Public hospitals in Ecuador are often overcrowded and understaffed, and the quality of care can be inconsistent. Ecuador's Private Healthcare System Private healthcare in Ecuador is more expensive than public healthcare, but it is often of higher quality. Expats primarily use private hospitals, and they are recommended for serious medical emergencies and major surgery. Private hospitals in Ecuador are typically well-equipped and staffed, and the quality of care is generally good. Ecuador's Top Hospitals Some of the most well-known hospitals in Ecuador include: Hospital Metropolitano in Quito (private) Hospital de Especialidades in Guayaquil (public) Hospital Carlos Andrade Marín in Quito (public) Hospital Vozandes Quito (private) Hospital del Valle in Cuenca (private) Hospital de Clínicas in Quito (public) Hospital de la Policía Nacional in Quito (public) Hospital del Río in Guayaquil (private) Hospital de Niños Benjamín Carrión in Quito (public) Health Insurance Companies in Ecuador The most popular private health insurers in Ecuador are Pacifico Seguros, Mapfre Seguros, and Banco Pichincha Seguros. Expats and digital nomads typically use these companies or specialized expat health insurance providers. Insider Tips from Expats in Ecuador: How to Navigate the Health System It is good for a non life-threatening emergency or routine ailments, but anything complicated or that requires technology or advanced treatment, you'd have to go elsewhere, commented one expat living in Canoa, Ecuador. I don't require prescription medication, however, many digital nomads and expats in the community have shared that availability of prescription medications and the costs are extremely low compared to North America. They have their prescriptions translated into Spanish for simplifying the process at the pharmacy, mentioned one member living in Ecuador. There is essentially no healthcare options in my town but there are good options 3 hours away or acceptable ones just 45 minutes away, said an expat in Ecuador. Socialized medicine has many flaws versus private medicine. Due to age and prior conditions , government medical plans are the only play , remarked one expat in Ecuador. Do sign up for IESS national healthcare. Note that as of July 2017 the rate will be based on Verified Income. The rate will be 17.6% and an additional 2.4% per dependent. An expat on $1200 Social Security with one dependent would therefore pay $240 a month for Health coverage, commented one expat living in Montanita, Ecuador. Go to the best hospital instead of the government hospital. Use the private clinics for basic healthcare and pay out of pocket, mentioned one member living in Ecuador. If you need medical care and have good knowledge of Spanish, the state system IESS may be your choice, however if you are retired they raised the rates to about 17.5% of retirement income. I have cheap (low quality) insurance which reportedly doesn't pay, which is fine for me because I would rather pay 45 per month for insurance that I can't use than 75/mo for insurance I won't use, said an expat in Ecuador. IESS (federal system) is cheapest insurance here UNLESS you came on retirement income visa, where it can be quite expensive (they they charge 17% of your income for the insurance). Almost all non-opioid prescription meds in the US are available here OTC, remarked one expat in Ecuador. I let them know about public and private insurance options. This with chronic conditions should enroll in Ecuadorian IESS public system. But even without insurance the medical care in Ecuador is much more affordable than in the US, said one member living in Ecuador.