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Plaza San Fransisco in Quito, Ecuador

15 Expats Talk about Health Insurance and Healthcare in Ecuador

By Joshua Wood, LPC

Last updated on Feb 06, 2023

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:

"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.

"I have SaludSA and it is $100 per person per month. Check your options before using IESS. Depending on your situation private might be more cost effective, especially when you have to go to IESS facilities and medicine has limited availability. We go to private clinic in the local shopping mall and pay $5 copay for office visit, $90 deductible each person," said another expat.

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"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.

"I don't require prescription medication, however, many expats in the community have shared that availability of prescription medications and the costs are extremely low compared to North America. They have their prescriptions translated into Spanish for simplifying the process at the pharmacy," mentioned another expat in San Jacinto.

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William Russell's private medical insurance will cover you and your family wherever you may be. Whether you need primary care or complex surgery, you'll have access to the best hospitals & doctors available. Unlike some insurers, we also include medical evacuation and mental health cover in our plans (except SilverLite). Get a quote from our partner, William Russell.

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William Russell Health Insurance

William Russell's private medical insurance will cover you and your family wherever you may be. Whether you need primary care or complex surgery, you'll have access to the best hospitals & doctors available. Unlike some insurers, we also include medical evacuation and mental health cover in our plans (except SilverLite). Get a quote from our partner, William Russell.

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Are healthcare and health insurance expensive in Ecuador?

" 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," added another expat.

"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," commented one expat who moved to Loja.

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William Russell's private medical insurance will cover you and your family wherever you may be. Whether you need primary care or complex surgery, you'll have access to the best hospitals & doctors available. Unlike some insurers, we also include medical evacuation and mental health cover in our plans (except SilverLite). Get a quote from our partner, William Russell.
William Russell Health InsuranceExpat Health Insurance in Ecuador

William Russell's private medical insurance will cover you and your family wherever you may be. Whether you need primary care or complex surgery, you'll have access to the best hospitals & doctors available. Unlike some insurers, we also include medical evacuation and mental health cover in our plans (except SilverLite). Get a quote from our partner, William Russell.
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What are emergency services like in Ecuador?

When we asked about emergency services, members in Ecuador wrote:

"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," wrote an expat living in Loja.

"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 an expat in Cuenca.

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William Russell Health Insurance

William Russell's private medical insurance will cover you and your family wherever you may be. Whether you need primary care or complex surgery, you'll have access to the best hospitals & doctors available. Unlike some insurers, we also include medical evacuation and mental health cover in our plans (except SilverLite). Get a quote from our partner, William Russell.

Learn MoreGET A QUOTE

William Russell Health Insurance

William Russell's private medical insurance will cover you and your family wherever you may be. Whether you need primary care or complex surgery, you'll have access to the best hospitals & doctors available. Unlike some insurers, we also include medical evacuation and mental health cover in our plans (except SilverLite). Get a quote from our partner, William Russell.

Learn MoreGET A QUOTE

Will I need to travel to see a specialist?

"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," commented one expat living in Loja, Ecuador.

"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," added another expat.

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Are common prescription medications available in Ecuador?

"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," said an expat in Loja.

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

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"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 one expat living in Vilcabamba, 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," added another expat.

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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," mentioned another expat in Loja.

"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," commented one expat who moved to Cuenca, Ecuador.

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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 another expat in Machala.

"Used the public health center over several months for a recurring skin rash with limited success. Ultimately referred to a specialist in the public hospital 2 towns over. Both the clinic and the hospital suffer from a lack of infrastructure, medicine and medical equipment, computer systems, no A/C or comfortable facilities, but the services are free, so one has to accept the limitations," commented one expat who moved to Canoa, Ecuador.

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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:

"Be sure to check the local birth policies and registration processes for having a baby in Ecuador before you give birth. It's recommended to check in with your embassy or a relocation expert for any additional specific requirements for your baby's birth to ensure you have all of the necessary paperwork and documents sorted in advance. Be aware that health care in Ecuador is generally of a lower quality than what you may be used to. Make sure you have a thorough understanding of the quality and range of medical resources available to you in the area where you plan to have your baby. Additionally, it's wise to have an extensive list of contacts in hand, so that you have options to reach out to in case of any medical issues that arise during the course of your pregnancy. Make sure you have a strong support network and have planned in advance for the extra funds that may be required to cover medical costs during and following the birth," said another person 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 another expat in Otavalo.

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Are healthcare services good in Ecuador?

We asked people if they have access to good medical care in Ecuador. They wrote:

"Healthcare services in Ecuador are generally of good quality and are provided mainly by the public sector. The public sector consists of five levels of health services: essential primary health care, secondary health care, specialized health care, tertiary health care, and emergency and critical health care. The country also has a well-developed private health sector. Health insurance, both public and private, covers a portion of the cost of medical care, and there are also several charitable and religious health care organizations operating in the country. In Ecuador, HIV/AIDS, malnutrition, and infant mortality rates are still high but have been decreasing in recent years. The government is working to improve healthcare infrastructure and access in rural areas and provide quality healthcare for more citizens," remarked another expat in Ecuador.

"Yes. I had an issue when I fist moved here. A doctor visit cost $40. I paid $40 for a nutritionist and $70 for a cardiologist included an EKG. Full lab cost $70. Excellent care and follow up. I was able to communicate directly using WhatsApp and they spoke English. I now have the national health insurance for $75 per month," explained one expat living in Manta .

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About the Author

Joshua Wood 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.

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