Healthcare & Health Insurance in Ecuador
Summary:
What are healthcare services like in 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," remarked one member in Cuenca.
" We have private insurance which costs $100 per month per person with $90 deductible. Our doctor copays are $5 for office visit (general and specialty). My husband had physical therapy for $15 each visit since deductible was not met yet. Normal blood tests are about $50. Colonoscopy $150 with anesthesia. I have gone for lab tests without rx for thyroid and other issues. About $12-20 each cash pay. There are doctors who will make house calls also, probably Spanish speaking. Costs are cheap without using insurance except for discounts. Rarely use it for meds because very little require rx. Just go talk to local friendly pharmacist about your issues and they will recommend a variety of meds and give you the pros and cons of each. They will also advise when you REALLY need to go to doctor. My lab test for infection ($12) gave me a list of meds that could be used to kill that bacteria. Took lab results to pharmacy to discuss which med would be the best for me. The amount of attention that the doctors in USA are able to give has made us fairly educated medical consumers. The system here makes it easy and cheap to get care," explained one expat living in Ecuador.
"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," said one digital nomad in Loja.
"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," commented a person living in Cuenca, Ecuador.
"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," explained one digital nomad living in Cuenca, Ecuador.
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What is the quality of medical care in Ecuador like?
When we asked expats and global nomads about the quality of medical care in Ecuador, they replied:
"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," wrote one digital nomad living in Machala, 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.
"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 member in Ecuador.

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Are healthcare and health insurance expensive in Ecuador?
"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," explained one expat living in Crucita, 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," said one digital nomad in Quito.
"I would pay out of pocket if it were still available, because doctors are cheap. With my cheap insurance, I will still have to pay out of pocket and maybe get reimbursement if I'm lucky. Insurance here is a government sponsored racket, as whenever government requires something the drops and prices go up, that's why governments do it. If it were a service people actually wanted it wouldn't be required," commented a person 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," explained one digital nomad living in Ecuador.
"The cost of average minor surgery is about $1500-$2000, The office visit range from $25 - $40. I have private insurance that has large network of providers with most private hospitals. Four hospitals are in the network in the city near me. I chose my insurance based on price and positive reviews from people who have used it," said one member in Loja.
What are emergency services like in Ecuador?
When we asked about emergency services, members in Ecuador wrote:
"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.
"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.)," commented a person living in Cuenca, Ecuador.
"My experience was with Santa Ines near Centro. Full hospital and emergency services. Great quality of care," explained one digital nomad living in 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," said one member 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)," explained one expat in Montanita.
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 one member 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," explained one expat in Cuenca.
" 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 global nomad 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," explained one digital nomad living 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," said one digital nomad in Cuenca.
"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 a person living in Loja, Ecuador.
"Yes, common medicines are found at the pharmacies and are often available without prescriptions. Medicine is fairly cheap," explained one digital nomad living in Quito, 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," 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.
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Click connect to have our partner contact you via e-mail and/or phone.
SJB GlobalSJB-Global is a top-rated financial advisory firm specializing in expat financial advice worldwide, offering retirement planning & tax-efficient solutions with a regressive fee model. Our clients benefit from their country’s most favorable tax environment by utilizing the efficient investment vehicles we offer. Our commitment to quality service is reflected in our stellar reviews, with over 300 testimonials boasting 95% five-star ratings.
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Do you have anything more to add about local medical facilities in 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," explained one expat living in Rio Chico, Ecuador.
"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," said one digital nomad in San Jacinto.
As a foreigner living in Ecuador, will I have access to public healthcare? What is it like?
"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 digital nomad 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 foreigner in Ecuador.
"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," remarked one member in Loja.
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...
"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," explained one person living 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," wrote one digital nomad living in Machala, Ecuador.
About the Author
Joshua Wood, LPC is one of the Founders of Digital Nomad Exchange and serves as Co-President of Expat Exchange. Prior to Expat Exchange and Digital Nomad 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.

SJB Global is a top-rated financial advisory firm specializing in expat financial advice worldwide, offering retirement planning & tax-efficient solutions with a regressive fee model.
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