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," said one foreigner in Cotacachi.

"Seeing a doctor in Cuenca is an easy matter. No appointment necessary in most cases. Excellent service and good quality for a much lower cost that the U.S," remarked one member in Cuenca.

"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," explained one expat living 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," said one digital nomad in Montanita.

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

"The cost of average minor surgery is about $1500-$2000, The office visit range from $25 - $40. I have private insurance that has large network of providers with most private hospitals. Four hospitals are in the network in the city near me. I chose my insurance based on price and positive reviews from people who have used it," wrote one digital nomad living in Loja, Ecuador.

"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," said one foreigner in Malacatos.

"I would pay out of pocket if it were still available, because doctors are cheap. With my cheap insurance, I will still have to pay out of pocket and maybe get reimbursement if I'm lucky. Insurance here is a government sponsored racket, as whenever government requires something the drops and prices go up, that's why governments do it. If it were a service people actually wanted it wouldn't be required," remarked one member in Cuenca.

" We got private insurance during pandemic because the hospitals were full and one family member (Ecuadorian citizen) had to go to the hospital but there was no room. Ended up in a private clinic for 10 days at $1000 per day. You need to assess your risks. We got $30k private insurance each for $100 per month. Family member was young and healthy 30s but imagine if he had to be there for a month. Normal hospital bills are not bad, but with covid. I think the private clinics can charge what they want. Your visa requires medical insurance," explained one expat living in 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 digital nomad in 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.)," remarked one member in Cuenca.

"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," wrote one digital nomad living in Cotacachi, Ecuador.

"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," said one foreigner in Montanita.

" 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. ," remarked one member in Cuenca.

"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 expat living in Ecuador.

"Many common meds are available without prescription for a fraction of the price. New meds may not be available and can be expensive if they have to be imported. Names of meds are different than in the U.S., and you may have to go to a doctor initially to get them translated. Bringing your prescription forms from home will help," said one digital nomad in Cuenca.

"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," commented a 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," explained one digital nomad 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," remarked one member in San Clemente.

"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 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," said one digital nomad in Vilcabamba.

"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.

"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.

"Yes, every expat is required by law to have insurance. The federal system is available, and costs $68/mo for a couple. However, health care is so cheap that I skip the (underfunded and long lines) IESS (federal system) and pay out of pocket for private health care anyway," said one digital nomad in Cuenca.

"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," commented a person living in 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," explained one digital nomad living in 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 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 expat in Machala.