Healthcare in Ecuador

CaliFemme wrote:

I also recommend writing or typing up a list in your host country's native language that includes your your name, DOB, emergency contact information, medical conditions, the generic names of the prescriptions & OTC meds you take, past hospitalizations & reasons, & any other information pertinent to your health conditions & challenges.

What excellent advice!! I don't have much in the way of current medical conditions, but it wouldn't be a bad idea to let them know I have a fused spine from an accident. Thank you, CaliFemme!

Thank you for writing an incredibly detailed & thoughtful synopsis of your healthcare experiences in Ecuador.

I'm not "older," but I'm multiply medically disabled & there are only any exceptional few specialists, including my GP/Internal medicine specialist, spinal surgeon, & asthma, bronchitis, sinusitis, & allergy specialist who have been able & willing to take on the numerous health challenges I have.

I also currently rely on MediCare & Medicaid for the much needed provision of my extensive and mostly out of area health care. You did well to also point out these forms of coverage don't extend beyond the States.

You've provided extremely helpful & detailed information to which I need to give careful consideration and attention. Thank you again; I believe your post will prove very helpful to many.

Kind regards,

So do I now. I'll need to look up some additional medical words & update my medical history en espanol.

Thank you for your kind reply, y buenos suerte a tu!

Salud,

CaliFemme

WORD TO THE WISE--re IESS,  things are changing in Ecuador.  Recall this is a developing country and things are TOUGH all over right now here with huge drop in oil prices, Ecuador's biggest export.  These are  tough times in this country in 2015.  Probably next year too and maybe 2017.  Be careful and prudent about your healthcare needs, stay well and be careful when using IESS.  Read and talk with others and completely inform yourself.  And then and only then -- buy IESS seguros and use their system..

FACT:  IESS has been partially defunded earlier this year.  My thought, based on experience :  more defunding will happen.

I am a careful consumer of healthcare anywhere i have lived in the world. I have been a big fan of IESS, all sounds good, read the law and thought this is for me -- and began the three month initial payment plan to get into the IESS system January 2015.  June 1st 2015 fully paid in --I had a scary TIA with associated issues and went to Santa Ines ER in CUenca  immediately -- knowing I had paid into IESS  and it was paying for emergency care, and whatever was needed,  etc. 

FACT:  NOT --  slow down, lady ---after 5 hours, tests and observation, Santa Ines staff DEMANDED and i mean demanded -- that I pay my bill with a credit card -- I was still quite ill and could have stayed overnight for observation but they would not DC me until the bill was paid. I paid-- so I could  go to the IESS hospital in Cuenca immediately by taxi for further instruction on the system.  Followed their staff instrucs and a long WAIT late at night and after another day or so and lots of scary health-related moments, I went to the IESS hospital in Cuenca for my neurology appointment to check on my status..  After waiting for 2.5 hours the office was found to be empty and no neurologist was found in the bldg.  I returned home and an uncertain future.  I prayed a lot and I am grateful to have overall excellent health.

FACT:  The IESS system serves some -- but not others.  It is basically pretty corrupt although there are effective government advocates in the system in Cuenca -- they admitted to me the bureaucracy is unmanageable and very intense.  I was told to file a complaint to a particular IESS functionary and I did with careful Spanish translation.   I patiently waited for the response which has never arrived...

FACT: I paid for all my care (I was fully paid up in IESS ) I cannot afford a situation like this ( who CAN?) Nothing was paid for nor was I reimbursed - to the tune of just under $1000 for emergency care in a scary situation.   

FACT: Thus I am a dropout of the IESS system.  Experience over 2.5 months this summer has taught me IESS is broke and cannot meet critical care pts' needs.  If  I had not worked in U.S. hospitals/clinics and healthcare systems and had good U.S. doc friends answering questions by Skype, God knows if I would be OK now.  I believe for me IESS failed utterly.
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FACT: Buyer beware.  If you are like me, you have limits on money for health care.  However
I will not stay involved with a broke system, period.    I will self insure, stay as well as I can and use the public clinic system or be self-insured as long as I am able to do so...   Good luck out there.. 

sueb4bs

CaliFemme wrote:

I'm not "older," but I'm multiply medically disabled & there are only any exceptional few specialists, including my GP/Internal medicine specialist, spinal surgeon, & asthma, bronchitis, sinusitis, & allergy specialist who have been able & willing to take on the numerous health challenges I have....

I also currently rely on MediCare & Medicaid for the much needed provision of my extensive and mostly out of area health care. You did well to also point out these forms of coverage don't extend beyond the States.

Dear Cali,

You've been very kind in your posts on this forum, and I'd like to be encouraging.

Frankly, though, your medical history appears to make you a bad fit for Ecuador.

1.  Quito and Cuenca are widely considered to have the best health care of the Expat-friendly cities in Ecuador.  However, they are in mountainous areas not best-suited for persons with serious mobility issues.

Given your various respiratory issues, moving to either of these cities could be a recipe for disaster.   At 8,200 feet altitude (Cuenca) and over 9,300' (Quito) -- and with serious bus-pollution problems in both places -- it's challenging enough here to young and healthy people's respiratory systems.

2.  The EC Coast, the other Expat-friendly region, has not developed health care to the extent that it can be recommended to persons with serious pre-existing conditions.

3.  Following up on the b4bs post, navigating and effectively using the IESS system was challenging enough before the budget crisis.  Even then, according to many anecdotal reports, people were waiting months to see a specialist.  With you potentially needing multiple specialists, the situation is further complicated by likely delays.

4.  If you move to Ecuador, you cannot take advantage of the public system right away.  Getting your residency visa and ID card may take months.  After that, you have to wait for three monthly payments to process through your bank before you are allowed to schedule a non-emergency doctor's appointment.  Then, as mentioned above, there can be delays in getting appointments. 

Can you wait nine months to start seeing doctors for non-emergency care?  Can you wait months between appointments?

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Whatever you do, don't move to Ecuador without visiting first.

Why are you planning to leave a country where you already have health coverages?

cccmedia in Quito

^^^

Leaving and *planning to leave* are not the same thing.     Eventually reality rears its head challenging the best laid plans of - well you know.

We get a lot of posts here from expat wishfuls with a whole host of known serious pre-existing health problems. We rarely [never] get posts here from medically challenged expats who actually left their home countries and resettled.

New member Sandra R. Duncan and her husband, who is a 100-percent disabled veteran, have had it with the U.S. Veterans Administration's medical care available in Puerto Rico  She is interested in Ecuador or some other country where better care might be available.  Sandra says the V.A. in P.R. is "100 percent worse" than in the continental United States.

Puerto Rico is a U.S. territory, which is why V.A. services are available there.

Sandra made these comments at a New Members thread reserved for the introduction of new members, so further discussion had to be moved here to this health care thread.

Sandra posted that she's interested in knowing about the cost of renting at or near the beach in Ecuador .. the availability of good health care near the beach .. and the cost of health insurance in EC.

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Sandra, based on what you wrote, Ecuador is probably not a good solution, for the following reasons....

1.  Health care in Ecuador is strongest in the major cities, including the Expat-friendly highlands cities of Quito and Cuenca.  The Expat population at the oceanfront has been growing, but the expansion of health care has not nearly caught up with what is available in the big cities.

2. Thinking you can come to Ecuador and get health insurance for your husband's conditions is not practical.  All the insurance companies will refuse to cover the pre-existing conditions of an Expat who arrives here with "100 percent" disabilities.

3.  It would theoretically be possible to get IESS Ecuadorian-government coverage.  This is not insurance, per se, but full coverage without regard to pre-existing conditions.  But you would have to become residents, which might take several months .. then contribute into the IESS system for three months of payments before being eligible for any non-emergency attention .. then wait weeks or months longer to see a doctor and then a specialist.  All services including enrollment and requesting medical appointments would probably require Spanish-language skills from you or your representative.

It's a lot to do .. a lot of waiting, and perhaps hoping .. only to learn eventually that the IESS system was not designed for 100-percent disabled Expats and is not up to par compared to private health services in Ecuador .. which, as explained, are not available under insurance coverage in your husband's case.

cccmedia in Quito

Another factor to consider is related to the best health care and hospitals in Ecuador being in the highlands.

Quito and Cuenca are both above 8,300-feet altitude.  We don't know the nature of your husband's conditions, but we do know that a significant percentage of arriving Expats, including healthy ones, find it challenging to live at such altitude.

For most arrivals, it is impossible to know in advance how they will adjust to life in the highlands.  If you are still considering Ecuador, make sure to visit before deciding on a move here.

cccmedia in Quito