Health insurance in Ecuador for foreigners – Practical considerations

Hello everyone,

As an expat living and working in Ecuador, I have noticed that health insurance is one of the most important — and often misunderstood — topics among newcomers.

Many foreigners arrive assuming that either public healthcare will be sufficient or that international travel insurance will cover long-term needs. In practice, the situation is more nuanced.

Here are a few practical points worth considering:

1. Public vs. private healthcare

Ecuador has a public healthcare system (IESS and public hospitals), but access, waiting times, and administrative processes can be challenging for foreigners.

Private healthcare, on the other hand, is generally of good quality in cities like Guayaquil, Quito, and Cuenca. Many specialists are internationally trained. However, costs can be significant without insurance.

2. International vs. local insurance

Some expats prefer international health insurance plans with global coverage. These offer flexibility but often come with higher premiums.

Local private insurance plans can be more cost-effective, especially for residents planning to stay long-term. The structure, exclusions, waiting periods, and pre-existing condition policies vary widely — so understanding the contract details is essential.

3. Age and medical history matter

Premiums and acceptance conditions depend heavily on age and medical background. It is generally advisable to arrange coverage earlier rather than later.

4. Administrative clarity is crucial

One common issue is misunderstanding what is actually covered:

– Hospitalization limits

– Deductibles

– Co-payments

– Network restrictions

– Emergency coverage

Reading the policy carefully — or having someone explain it clearly — avoids unpleasant surprises.

Recently, I wrote a more detailed overview of this topic here:

[link moderated]

The goal is simply to provide clarity for those planning a move or already living in Ecuador.

Health insurance is not just a formality — it is part of financial planning and peace of mind when living abroad.

I am interested to hear how other expats have structured their coverage and what experiences you have had with public or private healthcare in Ecuador.

—

Economist

Lassi Pensikkala

Creator of AmerExperience.com and SegurosAmer.com

Hailing from Finland, living in Samborondón, Ecuador