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Healthcare and Health Insurance in Ecuador | Digital Nomad Exchange
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15 Expats Talk about Health Insurance and Healthcare in Ecuador

By Joshua Wood, LPC

Last updated on Sep 05, 2024

Summary: The quality of medical care in Ecuador is generally considered to be good, although it is not as advanced as the medical care available in the United States. Emergency services are available in Ecuador, and ambulances can be called by dialing 911. In some areas, private ambulance services may also be available.

William Russell
William Russell
William Russell
William Russell

How are healthcare services Ecuador?

When we asked expats and global nomads about the quality of medical care in Ecuador, they replied:

"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," wrote an expat living in Montanita.

"This is the best medical care in terms of caring for you and really identifying the best way to correct the medical issues of people. Doctors really care for their patients, and spend time talking and testing for the real problem and thus coming up with a real solution to your specific issue. And all done at a bargain price," said an expat 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," commented one expat living in Ecuador.

"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," wrote one expat.

"Go to the best hospital instead of the government hospital. Use the private clinics for basic healthcare and pay out of pocket," commented one expat who moved to Quito.

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What are medical services in Ecuador like?

When we asked expats and global nomads about the quality of medical care in Ecuador, they replied:

"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 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," wrote one expat.

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Are healthcare and health insurance expensive 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 an expat living in Loja.

"Healthcare and health insurance in Ecuador can be expensive, depending on the type of coverage and services needed. Generally, public healthcare is available at a lower cost than private healthcare, but the quality of care may not be as high. Private health insurance can be expensive, but it can provide access to higher quality care and more specialized services. Additionally, many employers offer health insurance plans to their employees, which can help to reduce the cost of healthcare," said an expat 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," commented one expat living in Quito, Ecuador.

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What are emergency services like in Ecuador?

When we asked about emergency services, members in Ecuador wrote:

"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.," said one expat.

"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)," remarked 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," remarked one expat living in Quito.

"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," said one expat living 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.)," mentioned one expat in Cuenca.

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Will I need to travel to see a specialist?

"I am young and in good health so these don't concern me. I only have insurance because the law requires it," commented one expat who moved to Cuenca.

"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 expat.

"Pretty much every specialty can be covered right here in town (Cuenca), We even have a cancer center hospital specifically for that (which is free if you paid for IESS) that has gotten rave reviews from two friends who recently went through cancer treatments. I have two heart specialists myself (stents in 2005 in the US). They seem very competent, though I have had no heart issue since coming to Ecuador," remarked one expat in Cuenca.

"I have gone to a specialist in Quito for back surgery. I had two surgeons for my back surgery. They were great. The language barrier can be the only issue but I had help from friends," remarked one expat living in Quito.

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Are common prescription medications available in 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 expat.

"Yes, common medicines are found at the pharmacies and are often available without prescriptions. Medicine is fairly cheap," remarked one expat in Quito.

"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 expat living in Cuenca.

"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," said one expat living 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. ," mentioned one expat in Cuenca.

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Do you have anything more to add about local medical facilities in Ecuador?

"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," remarked 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 expat living in Rio Chico.

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As a foreigner living in Ecuador, will I have access to public healthcare? What is it like?

"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," said one expat.

"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," remarked one expat in Cuenca.

"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," remarked one expat living in Cotacachi.

"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," said one expat living in Loja.

"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," mentioned one expat in Ecuador.

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What have your experiences during the pandemic with the local healthcare system been like?

We asked expats in Ecuador if they have access to public healthcare in Ecuador. And, if they do have access, what is it like. They wrote...

"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.

"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," said one expat living in Machala.

What advice do you have for expats having a baby in Ecuador?

We asked expat moms who gave birth in Ecuador about their experiences and advice they have for other moms to be. They said:

"Make sure to research the medical facilities in the area beforehand and select one with a good reputation. Visit the medical facility before your due date to familiarize yourself with the policies and procedures. Consider registering in a pre-natal class and hiring a doula or private midwife to increase your chances of having the birth experience you want. Be aware of cultural differences between what you may be used to and what is done in Ecuador. Make sure you have the necessary paperwork in place prior to the birth such as your Ecuadorian residency documents, insurance paperwork, and other birth documents. Lastly, be prepared for a few surprises along the way as every birth is unique," explained one expat living in Ecuador.

"Insist on taking a tour of the places where you could possibly have your child. Even if they refuse, (it's not Ecuadorian culture to allow tours in hospitals) try your best to see everything first and understand the conditions before your decision. All public hospitals offer free service for deliveries and C-sections, but since it's free they're usually packed with people. Be prepared ahead of time with everything you will need, but keep a close eye on what you bring in and what's going on around you. Things like baby shampoo, soap, a towel, and clothes are a MUST, because public hospitals won't provide any of it. If you don't bring soap or a towel, you will go home with a dirty baby with wet clothes because you had to dry it off with them. If you go to a clinic, be sure to know the circumstances of your labor and if it's absolutely necessary to have a C-Section if the doctor suggests it, because many have been deceived into the operation unnecessarily because it costs more than a normal delivery. Many doctors are just looking for more money. I'm not sure about the clinics in other cities, but at least in Otavalo, pain medication isn't given in clinics or in the hospital. Be prepared," said one expat in Otavalo.

Are healthcare services good in Ecuador?

We asked people if they have access to good medical care in Ecuador. They wrote:

"In Ecuador, healthcare services exist throughout the country, with primary health care clinics, private clinics and hospitals, and public hospitals all providing healthcare to citizens. Access to healthcare is provided on a sliding scale, with fees being assessed based on income. Primary health care clinics emphasize preventive medicine, but also provide diagnosis, treatment, immunizations and referrals to specialists in the public health system. Private clinics and hospitals provide higher quality services, but often at a much higher cost. Public hospitals generally do not provide healthcare services for free, but may offer subsidized services depending on the situation. Access to specialized and hospital-based care is limited, but increasing as Ecuador invests in greater access and quality of care," remarked one in Ecuador.

"Your choice of the free hospital or higher cost facilities. Also qualify for the Social Security hospital here 100% coverage for $72 a month," explained one expat.

About the Author

Joshua Wood Joshua Wood, LPC is one of the Founders of Digital Nomad Exchange and serves as Co-President of Expat Exchange. Prior to Expat Exchange and Digital Nomad Exchange, Joshua worked for NBC Cable (MSNBC and CNBC Primetime). Joshua has a BA from Syracuse and a Master's in Clinical and Counseling Psychology from Fairleigh Dickinson University. Mr. Wood is also a licensed counselor and psychotherapist.

Some of Joshua's articles include Pros and Cons of Living in Portugal, 10 Best Places to Live in Ireland and Pros and Cons of Living in Uruguay. Connect with Joshua on LinkedIn.

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