Expat Life: What is Health Care Like in Ecuador?

Edd:  When we announced we were moving to Ecuador almost 14 years ago, I remember someone asking what would happen if we got sick. Would we go to a doctor or a witch doctor? Maybe we should set the record straight for our blog followers.

Cynthia:  Witch doctor? Uh, no, but the subject of health care when living abroad does come up a lot, including a recent podcast we appeared on. So sure, let’s do it.

E:  The topic is covered in general terms on our FAQ page, and we’ve learned from our research and travels that world-class care is available in many countries for a fraction of the cost you are probably paying in the United States. But we certainly know more about the ins and outs of how it works here in Ecuador.

C:  We should begin by mentioning that, as is true most everywhere, the highest quality medical care is found in our largest cities — Quito, Guayaquil, and Cuenca. The farther you travel away from major metropolitan areas, the level of care becomes more basic.

E:  Ecuador has a national health care system called IESS (Ecuadorian Social Security Institute) that we have been members of for over 10 years. We have 100% coverage with $0 deductible and no restrictions for age or pre-existing conditions. The total premium for us both is, incredibly, less than $95 per month.

C:  Hospitals offer private insurance through their own facilities and resident physicians. There are also private national and international plans with varying levels of coverage and deductibles depending on your budget.

E:  Because overall costs are so low, many expats in good health simply pay out of pocket for treatment and medications. I’m sure readers are wondering, “How low?” A same-day appointment with a physician costs $35–$40. Medications, most of which can be purchased over the counter without a prescription, are sometimes one-tenth what you would pay in the States.

C:  You can’t choose your doctor with the national system. So we take a hybrid approach, treating the system as catastrophic coverage and paying directly for routine visits to specialists with whom we have longtime relationships like our dentist, dermatologist, and ophthalmologist.

E:  But we do have personal experience with the level of care through  IESS. I had successful hand surgery to correct Dupuytren’s contracture, and you spent a week in the hospital and were treated with what our doctor called “world-class protocol” after a bilateral pulmonary embolism.

C:  Another question we are asked frequently is what we do about Medicare. We maintain our coverage for two reasons: 1) we go back to the States frequently to visit family, and 2) you never know what the future holds. Opting out and re-enrolling incurs heavy penalties.

E:  Plus there’s this. You read over and over that Medicare doesn’t travel outside of U.S. borders. True for Original Medicare, but if you read the fine print, many Medicare Advantage plans offer emergency care in foreign countries. Ours does with a $50,000 per person annual limit. You have to pay the bill and submit receipts for reimbursement, but still…

C:  I want to mention something a bit counterintuitive. With our year-round temperate climate, abundance of fresh fruits and vegetables, and pedestrian lifestyle, currently we don’t need a lot of health care.

E:  Great point. Bottom line—our health care in Ecuador is outstanding and very affordable. So we’ve never met a witch doctor, much less been to one. There are shamans here who do all sorts of things that include administering “plant medicine,” meaning hallucinogenic Ayahuasca or San Pedro, and preside over the ceremonies that usually follow. These experiences haven’t been part of our world.

C:  Hope this brief chat quiets any concerns our followers have about health care here. And if there are specific questions we didn’t answer, please write us and we will get right back to you. Hey, you mentioned at the beginning that our 14th expat anniversary is coming up. Next chat let’s take a trip down memory lane.

E:  What fun. I can’t wait. 😀