You NO LONGER need proof of travel health insurance in Ecuador when you visit or apply for your visa. Ecuador recently changed this rule so you only need proof of health insurance when you apply for your cedula, which is your government issued ID card.
You need a cedula before you can apply for the Public IESS universal healthcare plan so that means you’ll need to get a private health insurance plan in Ecuador before you can apply for the public health insurance plan.
Some of the private health insurance benefits don’t kick in for 30 days, so you may want to sign up before you move to Ecuador to make sure everything is covered when you arrive. The premium is automatically billed to your credit card and everything can be signed electronically.
Check out our recent interview with Carlos Ramírez from Blue Box Insurance for a detailed explanation about health insurance in Ecuador. Read more here: Ecuador Health Insurance: Private vs. Public IESS.
Private Health Insurance in Ecuador
We have health insurance with Confiamed, which is one of the largest private insurance companies in Ecuador, but there are other insurance companies to choose from. We haven’t filed a claim yet so we can’t attest to the overall quality of service or coverage.
The cost of health insurance in Ecuador varies primarily based on your age and smoking habit, and the rates increase as you age so they aren’t locked in.
As of this writing, we are 49 and 52 year old non-smokers. Our health insurance plan is currently $173/month for both of us and has a $10 copay, $100 deductible and 90% coverage in-network/80% out-of-network.
Our health insurance plan has a maximum coverage of $30,000/year/incident, which may not seem like a lot, but the cost of healthcare is roughly 1/3 to 1/10 compared to the US for comparable quality so it would take a serious health issue to cost more than $30,000.
Private health insurance in Ecuador has a 2-year waiting period for pre-existing conditions and even then, there is a low cap on coverage. Our plan has a $7,500/year/incident maximum coverage for pre-existing conditions, which wouldn’t go very far if you have a chronic health condition.
It does not cover vision or dental, and preventative exams are very limited.
Public IESS Health Insurance in Ecuador
The Public IESS health insurance is Ecuador’s version of Medicare/Medicaid. It ensures everyone has access to healthcare, whether they can afford it or not.
The monthly premium ranges from $50 to $80 depending on your age and income. There is no copay or deductible with the IESS plan and everything is covered at 100% regardless of the cost. However, there is now a 3-month waiting period for pre-existing conditions.
Due to the low cost of health insurance in Ecuador, some people opt to have both private AND public health insurance as a way to hedge their bets. While the IESS plan is a nice option if you’re on a tight budget or if you want to make sure everything is covered at 100%, the major downside is that you have to go to IESS doctors, pharmacies and hospitals, which aren’t as well staffed, stocked or funded.
In some cases, the IESS hospitals simply don’t have the doctors or medications to handle some medical needs so you may be referred to a private hospital or pharmacy. The IESS system is responsible for paying the private service providers, but you may encounter billing issues or delays, and there is growing concern that the IESS system may run out of money or become insolvent.
Because of these drawbacks, you may decide that private insurance is a better option for you, even if it does cost more.
Quality of Healthcare in Ecuador
According to CEOWORLD Magazine, in 2019 Ecuador had the best healthcare system in the Americas south of Canada. They looked at Overall Healthcare, Infrastructure, Professionals, Cost, Medicine Availability and Government Readiness. Ecuador ranks 25th among the 89 countries they evaluated, barely losing to Canada (23rd) and beating the US (30th). The top 9 countries are in Asia and Europe, and number 10 is Australia.
We have been very impressed with our healthcare over the past 3+ years of living in Ecuador. Our doctors are well-educated, speak English, and they work together to provide a more complete and holistic approach to healthcare. We are also able to see our doctors within a day or two rather than 2 or 3 months, which was customary back in the US.
Medical tourism is growing in Ecuador due to the low cost and high quality of care, so if you’re planning a visit or a move here, you can rest assured that your healthcare needs will be met.
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