9 Important Tips about Healthcare for Expats in Ecuador

1. Quality of Medical Care in Ecuador

When asked about the quality of healthcare in Ecuador an expat in Cuenca, Ecuador cautioned, "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. 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."

"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. 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," said one expat.

2. Cost of Medical Care in Ecuador

In a discussion on the cuador forum about Medical Prices, one expat reported, "I have been here five years... here being Ecuador. Re: insurance, medical.....keep in mind that very often the price of the procedure here is a quarter to a fifth of what it is in the USA. Which is to say, it's the deductible. The first month I was in Ecuador, five years back, I had a echo cardiogram done. Walked into the clinic, the test was with Siemens equipment (on a short list of the best). I am watching the image of my heart pumping. The clinician is pointing out the measurements the computer is making. No hurry. Between my Spanish and his English we communicate. The cost was $70. In the states $450 would be the average for this. The full (panel?) of tests for various body fluids, $110 last time I did that. Visit to a cardiologist, $50 including an ekg. Test for parasites, $20, meds for Amoeba (a year back) $40. Bad water in Vilcabamba.....gringo land lord swore it was fine."

3. Public Healthcare through the IESS in Ecuador

Many expats choose to pay for voluntary membership in the Ecuadorian national health care system. The IESS or Instituto Ecuatoriano de Seguridad Social.

There seems to be a bit of debate about the cost of healthcare through the IESS. One expat said, "It's free if you pay your 'contribution' to the social security system here as an IESS Voluntary Member (Afiliacion voluntaria) or if you are employed, where your employer would pay. The cost is 17.60% of the current basic salary ($366/mo) or $64.41. You spouse would be an additional 3.41% or $12.48." Others expats living in Ecuador debated that the cost would be higher, because an expat must have a higher salary to stay in Ecuador.

An expat in Guayaquil described his experiences with IESS Social Security Health Insurance, "The 100% is paid as long as you use IESS facilities and doctors, including medications, however sometimes the IESS pharmacies do not have what you need and you have a choice to purchase yourself or wait on them to obtain it. The system is pretty darn good though from my personal experience, including major surgery and even though experiences vary I would strongly suggest you only listen to those that have had "actual" experiences with the system so the info is first hand since the procedures can be quite different than we are used to, like having to supply your own toilet paper, towels, utensils etc. Emergencies are treated differently than normal issues in many cases, but again that will or can differ depending on the facility..it is NOT all equal. The facilities in the larger cities are quite good..smaller towns not as much and the further out you go away from any facility you may find them pretty sparse. I can attest to Guayaquil and Bahia de Caraquez personally...perhaps others can give you some direction to their areas. The $70 per month is a drop in the bucket compared to most places for health care...the private insurers are good too and you can take different deductibles...and the differences that I can tell will be in the facilities not in the care or experience of the doctors, nor necessarily in the equipment either as the IESS has some of the best, at least in Guayaquil they did."

4. Private Health Insurance for Expats in Ecuador

"Keep in mind that if you're paying out of pocket a catastrophic illness will still probably bankrupt you. If your waiting for gov't treatment for cancer or something similar, there is a good chance you'll die waiting," asserted one expat.

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5. Public vs. Private Hospitals in Ecuador

"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 patients, 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," explained one expat.

An expat mom who had a baby at a public hospital in Ecuador describes her experience, "I gave birth to my little baby girl in the main hospital in Otavalo, Ecuador. I had been told that in the clinics I could get better attention, but also that sometimes the doctors tell the women that they need C-Sections just because they earn more money from the surgery. I couldn't afford the clinic costs and the hospital is free, so I decided to go there. What I encountered was a large room full of women waiting to have their babies, separated by thin sheets and a few midwives and nurses running between each sector to assist the women. No pain medication is given in the hospital, so it was all natural. When women are at the point of given birth they're led to the surgery room which, thankfully, only allows one woman at a time. I was given the choice to give birth laying down, sitting up or standing, as many of the indigenous Ecuadorian women do. The whole experience was hard and long, but as far as the attention at the hospital I was taken care of pretty well. The only unsettling part was the shared labor room where we all waited until we were far enough along in the labor to give birth. Hearing a dozen screaming women all around you is a bit unpleasant. I gave birth to my baby girl in the afternoon, stayed the night in a room with 2 other new mothers, then went home the next morning."

6. Ecuador's Climate and Depression

One expat shared how moving to Ecuador benefitted her mental health, "I came here when the opportunity presented itself for my health. As many here now I am a person who suffers from depression, specifically what was called manic-depression (like Carrie Fisher) and one of the leading causes of both the ups and downs is the change of seasons and change of light as days get longer and shorter. Ecuador, on the equator, has 12 hours of day and 12 hours of night, 365 days a year. That has been hugely beneficial and for me the ultimate treatment. You can't bottle that and you can't work around it (not with exercise, vitamin D or a light box). My health and my future are much improved and there is no greater value than that.

7. Availability and Cost of Prescription Drugs 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," explained an expat living in Cuenca, Ecuador.

Most meds are included in generic forms. However, some choices are limited and others just are not in the formulary. For example I am on an anti-epileptic med. A similar form of this med is in the formulary. When I asked the Dr about changing he said it was better to stay with the one I was on because it has fewer side effects. So it will really depend on what meds you are on," said another expat in Ecuador.

"We just had our first appointment at IESS. We were able to get most of our meds at the farmacia there at no cost. They may prescribe another generic equivalent if that is OK with you. However, if you choose not to change or your med is not included in the IESS formulary you can get them at a farmacia. The other however is that they may not have some newer meds either at IESS or farmacias, then you will have to decide what to do about those," commented one expat in Ecuador.

8. Diabetic Supplies in Ecuador

With regard to availability of diabetes supplies in Ecuador, one expat said, "We arrived in Ecuador in August. I have the RX's but haven't used. We just took our bottle of meds to the pharmacy and have gotten them filled. The exception being one med they don't have here. Make sure the bottles show the generic name of your med. We just got one of my husbands insulin pens refilled which was no more expensive than buying a bottle of insulin, plus they included the special needles for the pen. It would also be worth the time and effort to find out the generic name of your meds in Spanish. Another thing that happened is that I have a dose of one med that they didn't have, however the tablet they did have is scored so I can break in half for the right dose."

9. Bringing Prescription Medicines into Ecuador

"Every year I bring back from the states a three month supply of the two meds I take for HT and arrhythmia. They're slightly cheaper at Walmart. After they get used up I switch to locally sourced drugs. I also bring enough aspirin for nine months. The fish oil caps are much cheaper in the states. I try to balance the usage rate with the use by date. Never had a problem at customs but I usually pack the prescription and receipt with the meds just in case. Other people here may ship stuff in. I imagine they will give you their experience too," confessed one expat.