15 Expats Talk about Health Insurance and Healthcare 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," remarked one expat living in Cotacachi.

"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 one expat living 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," mentioned 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 who moved to Montanita, 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," mentioned one expat 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," commented one expat who moved to 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," remarked 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," wrote one expat.

"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. ," commented one expat who moved to 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," said one expat.

"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," remarked one expat in Malacatos.

"We tried private insurance here. Even though we got to the two years when prior conditions must be accepted by Ecuadorian law, we cancelled it. We come from a country where medical coverage is universal. We found the private insurance process deeply humiliating and we are not trained to tolerate it. The Cuenca medical services are great, superior to most in the world. It is a world medical/dental tourism destination. It is cheap.. though no serious illness is costless. We have the resources to pay as we go and like most developed world expats, at the very worst, we can return from where we came and get our coverage back in 3-4 months. If Ecuador decides to stopping letting expats in who cannot prove they have insurance, we pay 90$ a month in IESS premiums That is not to say that hospitals are not without payment annoyances in Ecuador. If you do not pay before leaving, they will not unhook you from their stuff. And it is hard to go downstairs and pay at Accounting when you are in bed undressed with tubes still running into you. Ecuadorian credit cards will not cover (without tedious special arrangements) amounts over $1000 and even then, the hospital won't believe it. Happily, Ecuador may not be a credit/debit card place but it is a cash one. Unlike the developed countries, banks here have gobs of the stuff on hand. My wife and I get an estimate and the non-hospitalized one has the cash on hand. (shrug)," remarked one expat living 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. ," remarked one expat living 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)," said one expat living in Montanita.

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

"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," commented one expat who moved to 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.)," remarked one expat living in Cuenca.

"I have been able to find providers for all health issues here in Cuenca and all have been of good quality and excellent availability," said one expat.

"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 expat in Loja.

"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," said one expat.

"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 one expat living in San Clemente, Ecuador.

"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," wrote one expat.

"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," commented one expat who moved to 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 expat.

"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 expat living 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," remarked one expat in Machala.

"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," remarked one expat living in Ecuador.