Healthcare & Health Insurance in Ecuador

"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," explained one expat living in Cuenca, Ecuador.

"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," said one digital nomad 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 a person living in Loja, Ecuador.

"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," explained one digital nomad living in Cuenca, Ecuador.

"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)," said one member in Cuenca.

"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 digital nomad living in Ecuador.

"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," said one foreigner in Ecuador.

"We tried private insurance here. Even though we got to the two years when prior conditions must be accepted by Ecuadorian law, we cancelled it. We come from a country where medical coverage is universal. We found the private insurance process deeply humiliating and we are not trained to tolerate it. The Cuenca medical services are great, superior to most in the world. It is a world medical/dental tourism destination. It is cheap.. though no serious illness is costless. We have the resources to pay as we go and like most developed world expats, at the very worst, we can return from where we came and get our coverage back in 3-4 months. If Ecuador decides to stopping letting expats in who cannot prove they have insurance, we pay 90$ a month in IESS premiums That is not to say that hospitals are not without payment annoyances in Ecuador. If you do not pay before leaving, they will not unhook you from their stuff. And it is hard to go downstairs and pay at Accounting when you are in bed undressed with tubes still running into you. Ecuadorian credit cards will not cover (without tedious special arrangements) amounts over $1000 and even then, the hospital won't believe it. Happily, Ecuador may not be a credit/debit card place but it is a cash one. Unlike the developed countries, banks here have gobs of the stuff on hand. My wife and I get an estimate and the non-hospitalized one has the cash on hand. (shrug)," explained one person living in Cuenca, Ecuador.

"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)," wrote one digital nomad living in Cuenca, 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," said one foreigner in Malacatos.

"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," remarked one member 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," explained one expat living in Ecuador.

"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 one foreigner in Cuenca.

" 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 patiensts, 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. 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. ," remarked one member in Cuenca.

"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," explained one expat living in Loja, 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)," said one digital nomad 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," commented a person living in Ecuador.

"I am young and in good health so these don't concern me. I only have insurance because the law requires it," said a member in 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," explained one person living in Cotacachi, Ecuador.

"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," wrote one digital nomad living in 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," said one foreigner in Loja.

"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 member in Cuenca.

"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," explained one expat in Montanita.

"Yes, common medicines are found at the pharmacies and are often available without prescriptions. Medicine is fairly cheap," remarked one global nomad in Quito.

" 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. ," explained one digital nomad living in Cuenca, Ecuador.

"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," said one digital nomad in Rio Chico.

"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," commented a person living in Vilcabamba, 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," explained one digital nomad living in Catamayo and Loja, 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 member in San Clemente.

"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," wrote one digital nomad living in Loja, Ecuador.

"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 one foreigner in Cuenca.

"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," remarked one member 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," explained one expat living in Cotacachi, 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 digital nomad in Ecuador.

"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 digital nomad in 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," commented a person living in Machala, Ecuador.