18 Expats Talk about Healthcare and Health Insurance in Ecuador

Expats in Ecuador offer insight into the quality of healthcare in Ecuador, proximity to hospitals, cost of health insurance and more.

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," commented an expat living in Otavalo, Ecuador.

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What are medical services in Ecuador like?

When we asked expats and global nomads about the quality of medical care in Ecuador, they replied:

"Yes, Fortunately, we live in an area where we can walk to hospitals, clinics, pharmacies. There are all kinds of insurance options, however we are required to have insurance in Ecuador," commented an expat living in Cuenca, Ecuador.

"I teach TESOL and have access to their health insurance. Medical Care is much cheaper than in the US and of excellent quality," said another expat in Cuenca.

"Yes - Bahia has good medical services and a new hospital is being built to replace the earthquake damaged one. Drugs are readily available and significantly cheaper than in the USA," remarked another in Bahia de Caraquez.

"There is a clinic 10 minutes from the house that handles basic needs. I've not used it but others say it's great and free or very low cost. I can say that my one prescription is $2/50 pills versus $10/30 with insurance in the States. For major stuff, i would have to go 2.5 hours to the big city, but I've been told doctors there are very good and the cost for a procedure is about what you'd pay for a deductible at home," explained one expat.

"Your choice of the free hospital or higher cost facilities. Also qualify for the Social Security hospital here 100% coverage for $72 a month," said another person 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 an expat 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," said another expat in Cuenca.

"Go to the best hospital instead of the government hospital. Use the private clinics for basic healthcare and pay out of pocket," remarked another expat in Quito.

"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," explained one expat in Montanita.

"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," said another expat in Cuenca.

"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 another expat in Cuenca.

What do you think about the cost of medical care 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," commented an expat living in Loja, Ecuador.

"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," said another expat in Cuenca.

"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," remarked another expat in Quito.

"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. ," explained one expat in Montanita.

" 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. ," said another expat in Cuenca.

"We didn't use our U.S. insurance because the deductibles would have been more than what we paid for care in Cuenca," remarked another expat in Cuenca.

What are emergency services like?

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," commented an expat living in Loja, Ecuador.

"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 another expat in Cuenca.

"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," remarked another expat in Quito.

"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.

" 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. ," said another expat in Cuenca.

"My experience was with Santa Ines near Centro. Full hospital and emergency services. Great quality of care," remarked another expat in Cuenca.

Are their specialists in the area or do you 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 an expat living in Loja, Ecuador.

"I am young and in good health so these don't concern me. I only have insurance because the law requires it," said another expat in Cuenca.

"I have gone to a specialist in Quito for back surgery. I had two surgeons for my back surgery. They were great. The language barrier can be the only issue but I had help from friends," remarked another expat in Quito.

"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," explained one expat in Montanita.

" 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. ," said another 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," remarked another expat in Cuenca.

Are most 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," commented an expat living in Loja, Ecuador.

"Prescription medication is inexpensive and readily available. If you are on the typical 5 at 50 plan, you can come buy your meds have a nice vacation and still save money over doing the same in the U.S," said another expat in Cuenca.

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

"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, 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. ," said another expat in Cuenca.

"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 another expat in Cuenca.

"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 an expat living in Vilcabamba, Ecuador.

"The public hospital is 20-25 minutes away. Many people use the local clinics. The ambulance service is one street from the Malecon in Salinas. The hospitals on the coast do a good job on most things but if you have major issues, you typically seek treatment in Guayaquil which is two hours away," said another expat in Salinas.

"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," remarked another expat in Rio Chico.

"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 expat in Loja.

"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 another expat in San Clemente.

"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 another expat in San Jacinto.

Do expats and global nomads in Ecuador 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," commented an expat living in Loja, Ecuador.