Ecuador Healthcare for Expats: Complete 2025 Guide

Healthcare in Ecuador: What Expats Need to Know

One of the most common questions we get from clients is about healthcare. The good news: Ecuador offers quality medical care at a fraction of US prices. Here's everything you need to know.

The Two Systems

Ecuador has both public and private healthcare systems. Most expats use a combination of both.

IESS (Public System)

The Instituto Ecuatoriano de Seguridad Social (IESS) is Ecuador's public healthcare system.

How It Works:

• Monthly premiums based on income
• Covers most services including specialists
• Network of public hospitals and clinics
• Prescriptions included

Typical Costs:

• Monthly premium: $80-120 (based on declared income)
• Office visits: Free
• Prescriptions: Free or very low cost
• Surgeries: Covered

Pros:

• Very affordable monthly cost
• Comprehensive coverage
• No pre-existing condition exclusions
• Good for routine care

Cons:

• Long wait times for specialists
• Bureaucratic processes
• Limited English-speaking staff
• Facility quality varies

Private Healthcare

Private hospitals and clinics offer faster service and more amenities.

How It Works:

• Pay-per-service or private insurance
• Choose your doctors and facilities
• Shorter wait times
• More English speakers

Typical Costs:

• Doctor visit: $30-60
• Specialist: $40-80
• Lab work: $20-100
• MRI: $200-400
• Hospital stay: $200-500/day

Pros:

• Quick appointments
• Modern facilities
• English-speaking doctors available
• Higher perceived quality

Cons:

• Higher out-of-pocket costs
• Insurance premiums can be expensive
• Pre-existing condition limitations

Private Insurance Options

Local Ecuador Insurance

Companies like Salud SA, BMI, and Ecuasanitas offer plans for residents.

Typical Premiums:

• Basic coverage: $100-200/month
• Comprehensive: $200-400/month
• Varies greatly by age

What's Covered:

• Doctor visits
• Hospital stays
• Surgeries
• Some prescriptions
• Emergency care

Limitations:

• Pre-existing conditions often excluded
• Age limits (usually 65-70 max entry age)
• Network restrictions

International Insurance

Plans from companies like Cigna, Allianz, and GeoBlue cover you globally.

Typical Premiums:

• $300-800/month depending on age and coverage

Advantages:

• Use anywhere in the world
• Medical evacuation coverage
• Higher coverage limits
• No network restrictions

Best For:

• Frequent travelers
• Those needing coverage outside Ecuador
• People with complex medical needs

Our Recommendation

Most expats benefit from a combination approach:

1. IESS for routine care and prescriptions
2. Private insurance for specialists and hospitals
3. International insurance for emergencies and travel

This gives you:

• Low-cost routine care
• Quick specialist access when needed
• Emergency coverage anywhere

Quality of Care

Major Hospitals

Ecuador's major cities have modern hospitals with well-trained staff:

Cuenca:

• Hospital Santa Inés
• Hospital Monte Sinaí
• Hospital José Carrasco Arteaga (IESS)

Quito:

• Hospital Metropolitano
• Hospital de los Valles
• Hospital Vozandes

Guayaquil:

• Hospital Clínica Kennedy
• Hospital IESS Teodoro Maldonado

Medical Tourism

Ecuador is becoming a medical tourism destination. Many expats report excellent care for:

• Dental work (50-70% cheaper than US)
• Eye surgery
• Cosmetic procedures
• Joint replacements

Prescriptions and Pharmacies

Availability

Most common medications are available at pharmacies throughout Ecuador. Some differences:

• Many drugs available without prescription
• Brand names may differ
• Some US medications not available

Costs

Prescription costs are significantly lower than the US:

• Generic blood pressure medication: $5-15/month
• Diabetes medication: $10-30/month
• Antibiotics: $5-15 per course

Tips

• Bring a supply of current medications when you move
• Get generic names (not just brand names)
• Find a pharmacy you trust for ongoing needs

Emergency Care

How It Works

Emergency rooms operate on a pay-first model at private facilities. Public IESS hospitals will treat emergencies regardless of payment.

What to Do:

1. Go to nearest quality hospital
2. Present ID and insurance info
3. Receive treatment
4. Handle payment/paperwork after stabilization

Emergency Numbers

• 911: National emergency
• 131: Fire
• 101: Police

Enrolling in IESS

As a visa holder, you're required to register with IESS within 30 days of receiving your cédula.

Process

1. Visit IESS office with cédula
2. Complete registration forms
3. Declare monthly income
4. Receive enrollment confirmation
5. Begin monthly payments

Premium Calculation

IESS premiums are 17.6% of declared income:

• Minimum income ($460): ~$80/month
• $1,000 declared: ~$176/month

Many expats declare minimum income legally.

Dental and Vision

Dental Care

Ecuador has excellent, affordable dental care:

• Cleaning: $30-50
• Filling: $40-80
• Crown: $200-400
• Implant: $800-1,500

Many expats travel to Ecuador specifically for dental work.

Vision Care

• Eye exam: $30-50
• Glasses: $50-150
• LASIK: $1,000-2,000 per eye

Pre-Existing Conditions

IESS

The public system covers pre-existing conditions with no exclusions. This is a major advantage for expats with health issues.

Private Insurance

Most private insurers have waiting periods or exclusions for pre-existing conditions. Some options:

• Seek insurers specializing in expats
• Accept exclusion and use IESS for that condition
• Pay out-of-pocket for specific treatments

Healthcare and Your Visa

Health Certificate Requirement

All visa applications require a basic health certificate showing you're free of certain communicable diseases. This is a simple exam, not comprehensive screening.

Ongoing Requirements

Once you have your visa, there are no ongoing health requirements. However:

• IESS enrollment is mandatory
• Health insurance proof may be needed for some processes

Tips for Expats

Before You Move

1. Get copies of medical records in Spanish if possible
2. Stock up on specialty medications for first few months
3. Research doctors in your destination city
4. Consider a health check before departure

After Arrival

1. Register with IESS within 30 days
2. Find a primary care doctor you like
3. Locate nearest quality hospital
4. Join expat groups for doctor recommendations

Ongoing

1. Keep medical records organized
2. Learn basic medical Spanish or use translation apps
3. Consider a medical Spanish class
4. Don't delay care due to language concerns

Need Help with Your Visa?

Healthcare considerations are just one part of planning your move to Ecuador. EcuaPass helps with the entire visa process so you can focus on the logistics of your new life.

Contact us for a free consultation about your Ecuador visa options.