15 Expats Talk about Health Insurance and Healthcare in Ecuador
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.
How are healthcare services Ecuador?
When we asked expats and global nomads about the quality of medical care in Ecuador, they replied:
"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)," commented one expat living in Cuenca, 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," wrote one expat.
"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," commented one expat who moved to Cuenca.
"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.
"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," remarked one expat in Cuenca.
What are medical services in Ecuador like?
When we asked expats and global nomads about the quality of medical care in Ecuador, they replied:
"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 an expat living in Ecuador.
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Are healthcare and health insurance expensive 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 an expat in Crucita.
" 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," commented one expat living in 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 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.
"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 one expat.
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What are emergency services like in Ecuador?
When we asked about emergency services, members in Ecuador wrote:
"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)," wrote an expat living in Montanita.
"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 an 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 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 expat.
"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," commented one expat who moved to Ecuador.
With Offices in BOTH Ecuador and the US, Ecuador Visas with Attorney Sara Chaca is the No. 1 Visa Law Firm for Your Move! Specializing in Ecuador Residency Visas plus converting from Temporary to Permanent Residency, Containers, Real Estate Closings, Wills and Estate Planning, Driver Licenses, Opening Businesses & Citizenship!
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With Offices in BOTH Ecuador and the US, Ecuador Visas with Attorney Sara Chaca is the No. 1 Visa Law Firm for Your Move! Specializing in Ecuador Residency Visas plus converting from Temporary to Permanent Residency, Containers, Real Estate Closings, Wills and Estate Planning, Driver Licenses, Opening Businesses & Citizenship!
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Will I need to travel to see a specialist?
"The city of Quito is widely known as a medical hub in Ecuador, boasting a wide range of specialists in the fields of cardiology, orthopedics, neurology, ophthalmology, obstetrics and gynecology, pulmonology, and dermatology. The coastal city of Guayaquil is also home to a vibrant medical community with a diverse selection of medical specialists at its disposal. Additionally, the city of Cuenca is renowned for its high-quality healthcare system and its wealth of top-rated medical professionals. Other notable cities with a strong presence in the medical field are Santo Domingo, Loja, and Manta," said an expat in Ecuador.
"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," commented one expat 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. ," wrote one expat.
"I have been able to find providers for all health issues here in Cuenca and all have been of good quality and excellent availability," commented one expat who moved to 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," said one expat.
Are common prescription medications available in Ecuador?
" 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. ," wrote an expat living in Cuenca.
Do you have anything more to add about local medical facilities 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 expat living in Vilcabamba.
"We are about 7-8 minutes away by bus from the hospital in Catamayo. We have not been there but for 3-4 incidents, and found they helped to assist with the trouble really quite well! You have an option of buying both for general or public insurance. More serious health issues require more distant hospitals such as Loja, Cuenca or Quito," mentioned one expat in Catamayo and Loja.
As a foreigner living in Ecuador, will I have access to public healthcare? What is it like?
"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," commented one expat who moved to 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," 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.
"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," remarked one expat living in Loja.
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," commented one expat who moved to 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.
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," remarked one expat 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," explained one expat living in Otavalo.
Are healthcare services good in Ecuador?
We asked people if they have access to good medical care in Ecuador. They wrote:
"Your choice of the free hospital or higher cost facilities. Also qualify for the Social Security hospital here 100% coverage for $72 a month," remarked one in Cuenca.
"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," explained one expat.
About the Author
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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