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:
"Go to the best hospital instead of the government hospital. Use the private clinics for basic healthcare and pay out of pocket," wrote 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," commented one expat who moved to Cuenca.
"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," said one expat.
"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," remarked one expat in Cuenca.
"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," remarked one expat living 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," remarked one expat living 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," said one expat living in Machala.
"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.

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Are healthcare and health insurance expensive in Ecuador?
"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 living in Malacatos.

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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.
"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," mentioned one expat in Ecuador.

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Will I need to travel to see a specialist?
"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," said an expat 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," commented one expat living in Cuenca, Ecuador.
Are common prescription medications available in Ecuador?
"Most medication is available over the counter. Medication that is narcotic, sedative, opiod, such as anti anxiety drugs and pain medication is restricted to severely restricted. Medications such as antidepressants (SSRI & NSRI), thyroid medications, insulin, and NSAID are available though not every type or formulation. At certain times basic drugs may be embargoed. An example is embargo on NSAID drugs (ibuprofen, naprosyn, aspirin) during a mosquito borne virus outbreak. Benadryl (diphenhydramine) is a common antihistamine in the USA that is not available in Ecuador," commented one expat living in Montanita, Ecuador.
"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," wrote one expat.
Do you have anything more to add about local medical facilities in Ecuador?
"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," remarked one expat in Catamayo and Loja.
"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," remarked one expat living in San Jacinto.
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 living in 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," mentioned one expat in Cotacachi.
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," mentioned 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," commented one expat who moved to 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:
"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 expat in Otavalo.
"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.
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," wrote a person living 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 living in Ecuador.
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:
- How do I meet people in Ecuador?
- What is life like as an expat in your area?
- 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?
- Where will I buy groceries and do other shopping in Ecuador?
- What are the visa & residency requirements in Ecuador?
- Are healthcare and health insurance expensive in Ecuador?
- What do I need to know when buying property in Ecuador?
- Are foreigners allowed to own property in Ecuador?
- What appliances are typically included in a rental?