15 Expats Talk about Health Insurance and Healthcare in Ecuador

"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," remarked one expat in Ecuador.

"One important point to make that might make a difference: My Spanish is fluent so all of my conversations with doctors are in their native language, not mine. I never even ask if they speak English, and I don't know how many there are that do and to what degree. Another interesting point is more of a cultural difference. My wife accompanies me to all my doctor's visits and I to hers. We both address the issues with the doctors and are privy to their explanations. I find that very comforting. And there are times when I can't understand the doctor because of regional dialects and the ever-present masks and my wife, who speaks no English, doesn't translate, but rather paraphrases into language I can understand. Between the three of us clear communication usually results," remarked one expat living in Cotacachi.

"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," said one expat living in Cuenca.

"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," mentioned one expat in Cuenca.

"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 who moved to Cuenca, 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," remarked one expat in Machala.

"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 one expat living in Crucita.

"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. ," mentioned one expat in Montanita.

" 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 who moved to 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.

" I am convinced that health insurance is a scam and that the cost of medical care is a scam in the USA. It has been proven to me by my experiences and the experiences of others in Ecuador and throughout Mexico, Central and South America. The Allopathic medical system has the worst record in losing patients to life threatening diseases, but the best records in trama cases where you have to air lift a patient to a hospital. I will only opt for Natural healing methods, which really work. I have also seen in the rural areas, a free health clinic with Allopathic medical doctors offering 24 hour service 7 days a week, being ignored by the local population, except in trauma cases. These rural folks go to their local healers and pay a very low fee for herbal and other healing preparations. Why? Because their experience is that the herbal preparations work and also have no side effects. They therefore do not opt for health insurance. ," commented one person.

"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," said 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," mentioned one expat in Ecuador.

"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)," 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.

"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 living in Montanita.

"I have been able to find providers for all health issues here in Cuenca and all have been of good quality and excellent availability," mentioned one expat 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," commented one expat who moved to Ecuador.

"In my area people go for more specialized services to Cuenca which is 4 hrs away. That would be heart surgeries, hip or knee replacements, etc. I would not return to the US for medical care. I believe I get adequate care here. I had an ovarian cyst surgery 2 years ago and I was very pleased with the quality of care in a private hospital," remarked one expat living in Loja.

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

"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," commented one expat who moved to Loja, 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," remarked one expat living in Cuenca.

"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," commented one expat who moved to San Clemente.

"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 an expat living in Cotacachi.

"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," said an 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," commented one expat living in Loja, 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," 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.

"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 an 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 living in Ecuador.