Healthcare & Health Insurance 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," wrote one digital nomad living in Cuenca, Ecuador.

"In the cities, the medical services are the best we have seen in our travels outside of France, (the best in the world). From a home and the decision to see someone, to seeing a specialist can take as little as 20 minutes at a cost of $40. Tests and operations can be set for the same day. We grew up with national medical care and were advised on arrival, by those who have that background, to get insurance. We did so for three years but dropped it in angry disgust. It is demeaning being privately health-insured if you are not used to it. We self-insure and cover the expat requirement (when there is one from time to time) with IESS (never used)," said one foreigner in Cuenca.

"Go to the best hospital instead of the government hospital. Use the private clinics for basic healthcare and pay out of pocket," remarked one member in Quito.

"Choose carefully where you plan to live. In many Ecuador cities emergency care is often very limited or even non-existent. As we age good quality emergency care can mean to live or die. The same goes with good quality health care in general. Many small cities lack more than one doctor and medicines and supplies can be difficult to obtain in an emergency. This also happens with dentists as well. I suffered an injury to a tooth and had to travel for over an hour to find a dentist that could provide the needed treatment. And as we age we may find that the uneven pavement (or lack of pavement) in most Ecuadorian cities and towns will become a hazard to getting around. Again, choose carefully where you live," explained one expat living in Cuenca, Ecuador.

"Healthcare services in Ecuador are provided by both public and private institutions. The public healthcare system is managed by the Ministry of Public Health and is available to all Ecuadorian citizens and legal residents. The quality of public healthcare varies depending on the region, but generally it is considered to be of good quality. Foreign residents are able to access the public healthcare system, but they must first register with the Ministry of Public Health. Expats in Ecuador typically use the public healthcare system, as it is often more affordable than private healthcare. However, some expats opt to purchase private health insurance to access private healthcare services," said one digital nomad in Ecuador.

"Medical services in Ecuador are generally of a good standard, with a wide range of public and private hospitals and clinics available. The public health system is free for Ecuadorian citizens, and there are also a number of private health insurance plans available. The country has a number of highly trained doctors and specialists, and the quality of care is generally good. Ecuador also has a number of specialized medical centers, such as cancer treatment centers, and a number of medical research centers," remarked one member in Ecuador.

"Note that you will not find current US style healthcare in most areas outside of large cities, it is more like 1980s. Good, adequate, not fantastic. Fine for daily stuff, maybe not good for you if you have some more complicated medical issues. My guess would be a beach town near a large city where you can go for more advanced healthcare. Larger cities will also be more likely to have English speaking doctors and dentists," explained one expat living in Ecuador.

"So far we have been paying out of pocket for our medical needs. I just received my Visa last week. We do now have private health insurance for about $100 a month total for both of us. It doesn't really cover much but we were told it was needed in order to get our Cedulas. After we get the Cedulas, we can opt out of the private ins if we want. We are going to keep it and also enroll in the public health insurance for the bigger stuff. I believe it is about $90 a month each. Like I said, now we have been paying out of pocket for medical stuff. You can have a doctor come to your house, yes, a house call, for about $20. Medication is way cheaper here than in the states. No prescriptions are needed for most medications. Some common OTC medications in the States can be hard to find here," said one foreigner in Crucita.

"Hospitals are everywhere. I have three hospitals within 1 mile of my home in Cuenca. The public hospital is OK if you have lots of time and very little money and the issue is not life threatening. The private hospitals are every bit as good as in the US. I was in one just a week ago in fact (pneumonia)," explained one digital nomad living in Cuenca, Ecuador.

"My experience was with Santa Ines near Centro. Full hospital and emergency services. Great quality of care," said one member in Cuenca.

" I am closest to a hospital that is a private hospital, and is less than a mile away. Another hospital about 2 miles away is also a private hospital. A public hospital is about 5 miles away. The quality of care at most hospitals is excellent, yet the public hospitals have a lower grade of care, a higher population waiting for service and because of the high volume of patiensts, a lower class service to the patient and a longer waiting period for service. The level of caring for the patient varies, with the highest level of caring at the private hospitals. The most expensive private hospitals charge a fraction of the price that you would pay in the United States. The level of care and the success of recovery is so much higher than in the United States in my opinion and in the opinion of both the local people and the expat population. In addition, there is a freedom of choice of medical care. So Cancer patients are not only offered Chemo, Radiation and Surgery. There are Natural Health healers, Homeopathy and many other practitioners with successful records of reversing serious life-threatening disease conditions. ," explained one expat in Cuenca.

"I live in Montañita, the middle of the Ecuador coast and the north of the province of Santa Elena. Closest hospital is one town away (Manglaralto). It is public. Better hospitals about 90 minutes south (Salinas, Santa Elena, Libertad) and World class medical three hours by car (Guayaquil)," remarked one global nomad in Montanita.

"Emergency services in Ecuador are generally reliable and efficient. In the event of an emergency, you can call 911 to request an ambulance. The emergency services personnel are trained to respond quickly and provide medical assistance. Additionally, the Ecuadorian government has implemented a system of emergency medical centers throughout the country to provide medical care in the event of an emergency," explained one digital nomad living in Ecuador.

"We do most of our doctor's visits in Otavalo, or Ibarra depending on the availability of specialists. The system for booking appointments needs work but it's getting better. I've been seen by probably ten different general practitioners and both my wife and I have settled on a couple that we feel very confident with. With a bit of luck and an occasional wait we manage to book appointments with doctors of our choice, though the others would certainly be fine in a pinch. Appointments are usually within a few days of the date when I first did the search. They are very proactive with profalactics, booking a full blood, urine and feces panel twice a year. A yearly EKG. I had a lung issue during the pandemic and had three different chest x-rays with no wait. An ongoing uncomfortable but not disabling knee issue led to an x-ray and a visit to the orthopod within a week or so. My wife gets annual pap smears and mammograms and is regularly seen by her gynecologist, who also a doctor we both feel very sure of. I do have northern=transplant friends who have had major surgeries and they all feel they got excellent care," explained one person living in Cotacachi, Ecuador.

"I have been able to find providers for all health issues here in Cuenca and all have been of good quality and excellent availability," wrote one digital nomad living in Cuenca, Ecuador.

" I would return to Ecuador for any serious health issues, because of the high level of care and the high level of successfully reversing serious health problems. The lower cost is just another bonus available to the patient. Some specialists here are not only trained and certified here in Ecuador, but have advanced medical certification education in other countries. So you get the benefit of other International modalities. ," said one foreigner in Cuenca.

"In my area people go for more specialized services to Cuenca which is 4 hrs away. That would be heart surgeries, hip or knee replacements, etc. I would not return to the US for medical care. I believe I get adequate care here. I had an ovarian cyst surgery 2 years ago and I was very pleased with the quality of care in a private hospital," remarked one member in Loja.

"Guayaquil Cuenca and Quito are world class centers for cardiology and oncology. Specialists: Quito also has an English speaking psychiatrist on staff at Metropolitano. Cuenca has a world reknown plastic reconstruction surgeon Dr. Pablo Salamae. Dr. Salamae provides his skills free of charge for life altering surgery to the children of Ecuador. Cuenca also has an English speaking Multiple Sclerosis specialist, Dr. Piedra. Guayaquil has excellent cardiologists at the Kennedy Norte area," explained one expat living in Montanita, Ecuador.

"Almost all non-opioid prescription meds from the US are available OTC here. No prescription needed -- though of course it is recommended to see a doctor to verify you need the same drugs here. We are at 8500' altitude, so some meds might be adjusted due to elevation," explained one person living in Cuenca, Ecuador.

"As for prescription medicines we have have trouble with only one item we needed which we could not get here in Cuenca which was a type of estrogen medication my wife needed. Everything else we have needed in the past 3 years we have lived here we have been able to find locally without problem and most items (though prescribed by the Doctor) did not require a prescription for any needed renewal. Cost for most items were less than in the US," wrote one digital nomad living in Cuenca, Ecuador.

"There is a Basic Hospital with an Emergency Room in our town. More series cases are taken to Loja, 40 min away. The local hospital is public and offers free healthcare. There are several public and private hospitals in Loja, well equipped with quality of medical care," remarked one member in Vilcabamba.

"The medical care in Ecuador is generally good and modern in the larger cities and main tourist destinations. Many doctors and surgeons are able to speak English and have had training abroad. In the more rural locations and smaller towns, the health care is often basic and limited to basic care and diagnosis, with a much more limited range of treatments. Ecuador has many reputable private clinics and hospitals which offer excellent quality medical care, but the cost of private care is often considerably higher than in most other Latin American countries," explained one expat living in Ecuador.

"There is an emergency clinic 5 minutes from my house but the hospitals are in Salinas (45 minutes) or Guayaquil (3 hours) away. Fortunately, I've not had much need for health care but my friends and neighbors have been very pleased at both the quality and the price of procedures here. Although you can find English speaking doctors, it really helps in crisis situations to speak Spanish," said one digital nomad in Rio Chico.

"There is a local clinic with a doctor who is on call 24 X 7. The nearest hospital is located in Bahia, 30 minutes North. Additional hospitals are located in Manta or Portoviejo, 45 minutes via car," commented a person living in San Jacinto, Ecuador.

"There are no hospitals in the town and the nearest quality hospital is in Manta one hour away. There are smaller hospitals in Bahia and Portoviejo I have heard. I have only used a local doctor for stomach issues so I am pretty unfamiliar with the medical care," explained one digital nomad living in San Clemente, Ecuador.

"Permanent residents in Ecuador can enroll in public healthcare system or get private insurance at any age. The cost for public system is about $80 a month and pre-existing conditions are covered after 2 months. There are public hospitals in major cities and some smaller towns. The quality care may depend on the area but many expats in Ecuador enroll in the system due to low cost," explained one expat living in Loja, Ecuador.

"Yes, foreigners living in Ecuador have access to public healthcare. The public healthcare system in Ecuador is generally considered to be of good quality, with many hospitals and clinics offering a wide range of services. The public healthcare system is funded by the government and is free for all Ecuadorian citizens, as well as for foreigners who are legally registered in the country. The quality of care may vary depending on the region, but overall, the public healthcare system in Ecuador is considered to be reliable and accessible," said one digital nomad in Ecuador.

"I'm a Canadian transplant and I've been in the north of Ecuador (near Cotacachi) for nearly five years, married to an Ecuadorian and affiliated with EISS, the Ecuadorian version of medicare. I'm nearly 74, with no serious health problems other than blood pressure, which has been well controlled for more than ten years. All of our basic meds are covered and only occasionally do we have to go to a pharmacy to get something the doctors have prescribed. The cost to me for the two of us is $95/month.. Coming from almost fify years in the Canadian healthcare system I would give the IESS system pretty high marks. Access to the necessary care might be easier here," commented a person living in Cotacachi, Ecuador.

"The pandemic has had a significant impact on the healthcare system in Ecuador. Many hospitals and clinics have been overwhelmed with the influx of patients, leading to long wait times and limited access to medical care. Additionally, the government has implemented strict measures to limit the spread of the virus, such as closing borders and restricting movement. This has made it difficult for people to access medical care, especially in rural areas. Despite these challenges, the healthcare system in Ecuador has been able to provide adequate care to those in need. The government has also implemented various initiatives to ensure that people have access to the necessary medical supplies and treatments," said one digital nomad in Ecuador.

"Have not had any need but each time I have had to go to a doctor or for a test, every patient is given a questionaire and has their temperature taken. Those with symptoms receive a much more thorough screening," commented a person living in Machala, Ecuador.