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:
"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," said one expat living in Cuenca.
"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," mentioned one expat in Cuenca.
"I let them know about public and private insurance options. This with chronic conditions should enroll in Ecuadorian IESS public system. But even without insurance the medical care in Ecuador is much more affordable than in the US," commented one expat who moved to Loja, Ecuador.
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 one expat.
Are healthcare and health insurance expensive 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," wrote an expat living in Quito.
"We didn't use our U.S. insurance because the deductibles would have been more than what we paid for care in Cuenca," said an expat in Cuenca.
"Private health insurance here is a fraud. The only people buying it are US expats who were trained that you need it in the States. Here, health care is so cheap that you will NEVER recover your premiums. Example - insurance quoted me $400/mo insurance. I just spent 2 weeks in the hospital in a private room with excellent care, and the total cost (no insurance used) was just over $5,000. IOW, one year of premium to pay for 2 weeks hospital, Unless you are in the hospital a LOT, you are better off self-insuring (as we do)," commented one expat living in Cuenca, 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," wrote one expat.

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What are emergency services like in Ecuador?
When we asked about emergency services, members in Ecuador wrote:
"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.)," said one expat living 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," mentioned one expat in Quito.
"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.," commented one expat who moved to Cuenca, Ecuador.
"I live in small town 40 min from a major city of Loja. But we have a basic hospital with an emergency room. In Loja we have a public IESS hospital and several private hospitals like: San Agustin and UTPL. You can call national emergency number 911 for any help," remarked one expat living in Loja.
"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)," commented one person.
Will I need to travel to see a specialist?
"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.
" 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 expat in Cuenca.
"I am young and in good health so these don't concern me. I only have insurance because the law requires it," 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 living in Cuenca.
"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," mentioned one expat in Ecuador.
Are common prescription medications available 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," commented one expat who moved to Cuenca.
"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.
"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," remarked one expat in Loja.
"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.
Do you have anything more to add about local medical facilities in 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," said one expat living in San Clemente.
"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," mentioned one expat in Rio Chico.
"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 one expat who moved to San Jacinto, 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.
As a foreigner living in Ecuador, will I have access to public healthcare? What is it like?
"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," commented one expat living in Loja, 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," wrote 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," commented one expat who moved to 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," said one expat.
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...
"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 living 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," said one expat living in Ecuador.
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," said 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," remarked one 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," explained one expat living 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," said one expat in Cuenca.
About the Author
Joshua Wood, LPC joined Expat Exchange in 2000 and serves as one of its Co-Presidents. He is also one of the Founders of Digital Nomad Exchange. Prior to Expat 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.
Other Questions:
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- Is there a lot of crime in Ecuador?
- What do I need to know before retiring in Ecuador?
- Is there a lot of diversity? Are people in Ecuador accepting of differences?
- What are the schools in Ecuador like?
- Is the cost of living in Ecuador high?
- What advice do you have for expats having a baby in Ecuador?
- What are healthcare services like in Ecuador?
- Is the cost of living in Ecuador high?
- What type of recreational facilities are in Ecuador?
- What is the weather like in Ecuador?
- Are there good restaurants in Ecuador?
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- Are healthcare and health insurance expensive in Ecuador?
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- Are foreigners allowed to own property in Ecuador?
- What appliances are typically included in a rental?