Healthcare & Health Insurance in Ecuador

"One important point to make that might make a difference: My Spanish is fluent so all of my conversations with doctors are in their native language, not mine. I never even ask if they speak English, and I don't know how many there are that do and to what degree. Another interesting point is more of a cultural difference. My wife accompanies me to all my doctor's visits and I to hers. We both address the issues with the doctors and are privy to their explanations. I find that very comforting. And there are times when I can't understand the doctor because of regional dialects and the ever-present masks and my wife, who speaks no English, doesn't translate, but rather paraphrases into language I can understand. Between the three of us clear communication usually results," explained one expat living in Cotacachi, 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," said one digital nomad in Cuenca.

"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," commented a person living in Cuenca, 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," explained one digital nomad living in Loja, Ecuador.

" We have private insurance which costs $100 per month per person with $90 deductible. Our doctor copays are $5 for office visit (general and specialty). My husband had physical therapy for $15 each visit since deductible was not met yet. Normal blood tests are about $50. Colonoscopy $150 with anesthesia. I have gone for lab tests without rx for thyroid and other issues. About $12-20 each cash pay. There are doctors who will make house calls also, probably Spanish speaking. Costs are cheap without using insurance except for discounts. Rarely use it for meds because very little require rx. Just go talk to local friendly pharmacist about your issues and they will recommend a variety of meds and give you the pros and cons of each. They will also advise when you REALLY need to go to doctor. My lab test for infection ($12) gave me a list of meds that could be used to kill that bacteria. Took lab results to pharmacy to discuss which med would be the best for me. The amount of attention that the doctors in USA are able to give has made us fairly educated medical consumers. The system here makes it easy and cheap to get care," said one member in Ecuador.

"Surprised by the ease in getting doctor's appointments and the speed at which patients are processed - much less waiting time than in the States. No wasted or unnecessary medications or treatments. Doctors and nurses here are for the patients not for profit," wrote one digital nomad living in Machala, 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," said one foreigner 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," remarked one member in Ecuador.

"Private health insurance here is a fraud. The only people buying it are US expats who were trained that you need it in the States. Here, health care is so cheap that you will NEVER recover your premiums. Example - insurance quoted me $400/mo insurance. I just spent 2 weeks in the hospital in a private room with excellent care, and the total cost (no insurance used) was just over $5,000. IOW, one year of premium to pay for 2 weeks hospital, Unless you are in the hospital a LOT, you are better off self-insuring (as we do)," explained one person living in Cuenca, Ecuador.

"Do get IESS insurance. It will cover your coasts in the event of an accident or illness. As of July 2017, IESS will require payment on verified income, closing a loophole that allowed payment on claimed income. The obligated amount is 17.6% of the monthly verified income and 2.4% for each additional dependent. As an example, an expat on a limited pension of $800 a month would pay $140.80 A retired married couple living on their $1200 a month pay. $240. ," wrote one digital nomad living in Montanita, Ecuador.

"I relocated to Ecuador April 2022. On May 2nd 2022 I woke up with slight left hand arm pain. As the day progresses I became nauseated and dizzy. On the 3rd of May I had a buddy take me to a local clinic. They were impressive and within an hour diagnosed me with onset of heart issue and suggested I see cardiologist. Being as I was here only 3 weeks in Ecuador I personally decided to return to Houston Texas immediately and flew back. On the 4th of May I was admitted to Memorial Herman Hospital Woodlands Texas. I received a Quintuple Bypass (CABG) Graft the following day. I recuperated 7 weeks and returned to Ecuador. I fly back to Houston every 6 months and see my Cardiologist for exams and stress test. I've talked to expats who've had good results from Cardiologist in Ecuador and one even had a double bypass surgery in private hospital and is quite happy. I personally carry no private insurance. I'm okay with their health personal they diagnosed my health issues very impressively. Would I go through major health surgery in Ecuador. No. Not unless it was life threatening. But that's just me. ," said one foreigner in Ecuador.

"The cost of medical care if much cheaper than the United States. I had back surgery for $8,000 and I only had to pay $1,000 deductible," remarked one member in Quito.

"I have chosen to keep both my US Medicare supplemental and also IESS public insurance here in Ecuador. As you may know the local healthcare here has been experiencing EXTREME financial difficulties so I haven't been so quick to drop my Medicare in the US. I am three years out of cancer and just don't want to take a chance yet in depending on soley on IESS. I've unfortunately watched it fail horribly for some friends. At least with both, I know that I can always return to the US if I need advanced healthcare. If you do plan on dropping it, it's one of those things that needs to be done from the US so something to keep in mind. For me the price is worth the piece of mind to keep both and it's honestly about the same price of getting private insurance here. I pay $170 supplemental in US and $78 here for IESS. Private insurance because of my pre-exisiting here was quoted at $350. Hope that helps! Just my experience," explained one expat living in Malacatos, Ecuador.

"I am one block from a clinic, Clinica Primavera. Services there are fine (to see a doctor for a cold or flu). Three blocks away is a very good hospital, Los Valles. Both are private. I have been to the ER in Los Valles a couple of times. The cost was around $300 (once for stitches and once for back pain which included a MRI scan). The quality of care in both were great," explained one person living in Quito, Ecuador.

"The Big Public Hospital in Cuenca is Moscosa, which is about a mile away. I've been to the bathroom there and wouldn't recommend it, because if the bathrooms aren't clean, I wouldn't trust the service (same goes for restaurants.)," wrote 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 foreigner in Cuenca.

"We live within 3 blocks of a major hospital with 24 hour Emergency care and within 5 blocks of a similar major hospital also with 24 hour emergency care. Both hospitals are excellent and offer quality care.," remarked one member 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)," explained one expat living in Montanita, 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," commented a person living in Cotacachi, Ecuador.

"I am young and in good health so these don't concern me. I only have insurance because the law requires it," explained one digital nomad living in Cuenca, Ecuador.

"Yes, common prescription medications are available in Ecuador. Most medications can be purchased at pharmacies without a prescription, although some require a prescription from a doctor. Prices for medications in Ecuador are generally lower than in other countries, making them more accessible to the general population. Additionally, the Ecuadorian government provides subsidies for certain medications, making them even more affordable," explained one person living in 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," wrote one digital nomad living in Cuenca, Ecuador.

"Pharmacies in Ecuador have most medications. Some like antibiotics and others are available without prescription. I take Eutirox pill for my thyroid and buy it without prescription. The cost is about $2-$3 for a month supply," said one foreigner in Loja.

"Prescription medication is inexpensive and readily available. If you are on the typical 5 at 50 plan, you can come buy your meds have a nice vacation and still save money over doing the same in the U.S," remarked one member in Cuenca.

" Yes, we have common prescription medicines available throughout the city at different competing pharmaceutical chains. So you often may find one pharmacy with a competing pharmacy within a block or two. Prices are a fraction of what you would pay in the States. Prescriptions are required for most controlled medications, but natural medicines are also readily available. An example of the costs are from an experience of a gal that was bit by a dog and needed a tetanus shot. In rural Asia where this happened she paid $20. When she got to Europe, she had to pay $800. and when she got home in California, she had to pay $5,000. These were the same exact medicine and the same brand. It is a popular brand used for tetanus. ," explained one expat living in Cuenca, 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," commented a person 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," wrote one digital nomad 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 foreigner in Ecuador.

"Just want to tell about my experience with IESS during covid. I was diagnosed with high risk prostate cancer in January 2021. As no so called elective surgeries were being done by IESS I had a catheter for 5 plus months until I paid out of pocket for what is called TURP surgery. Even before that I started hormone therapy at IESS. So it took about 4.5 months for me to start treatment. After that it was about another month before I started radiation treatments. I know a lot of folks rag on IESS but to be honest considering covid and full hospitals I was satisfied with the time frame. I stayed in Quito and received 38 radiation treatments, treatment everyday 5 days a week. I was treated with respect and never met anyone who wasn't professional and very friendly. All questions I had were answered and they made sure that I understood what was happening with my treatment. So I just want to give a shout out to IESS and let expats know that you can have a good experience if you just show a little patience and stay on top of things. I won't know my prognosis for about 4 more months but feel the complete experience was very positive," remarked one member 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," explained one expat 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 a member 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," explained one person living in Machala, Ecuador.