Health Insurance in Ecuador

Dear Lafrisee,

You may need assistance to sign up online in Spanish, but joining IESS is a reasonable start.

They cover existing conditions and take all comers no matter your age.

Be careful of the enrollment process. They've been trying to conceive a way to take a percentage of an Expat's worldwide income although that seems to be a failed effort at this point.  You may only need to disclose any pension income.  Most single Expats have been paying about $80 a month.

There has historically been a waiting period for services while your bank processes the initiation of your monthly-debiting for IESS coverage.

Once you are fully covered, you get free doctor visits and specialist visits .. and free medicine at the IESS hospitals if you're a patient at one where the orderlies don't steal the meds.  Specialist visits historically involve waiting for months at many IESS hospitals.

If you have a separate doctor who also has a part-time connection with IESS, you will probably be able to keep your G.P.

Many Expats maintain IESS coverage as a backup.  I certainly do.  For regular appointments and minor issues and prescriptions, I avoid the bureaucratic dance steps and schedule at my convenience at my regular doctor in Quito, Dr. Dolberg.

cccmedia

Lafrisee wrote:

I am moving to Rio Bamba at the beginning of Septembre.  I need to have health insurance to obtain my Visa otherwise, it would just be as a precaution.

This post covers insurance issues for tourists and separately, car insurance .. related matters but not necessarily pertinent to Lafrisee's concerns.

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Ecuador has just dropped its requirement that foreign tourists show proof of insurance in order to enter Ecuador.  Source: www.cuencahighlife.com, where this story is currently on the welcome page.

The announcement was made by the ministries of tourism and the interior.

It's no big surprise.  Ecuador was d*cking around for two years trying to figure out how to enforce the rule, and never got its act together.

It is still highly recommended, if not required, that USA Expat residents of La República maintain health insurance or coverage, especially since the government IESS coverage is so cheap (and comprehensive -- no exclusion for pre-existing conditions) compared to USA rates.

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At the Colombia-Ecuador border several months ago, I asked an on-duty agent for Ecuador about car insurance.  We spoke at her small office in the Rumichaca complex.  My Ecuador-plated car was parked nearby.

She told me that car insurance was not currently required.  I also learned that the cost incurred for killing a motorist is $5,000 if the at-fault driver is uninsured.  Does anyone have confirmation or an update on these two statements, or further explanation?

cccmedia

Mr. Media,

Hope you have been well. I have another question for you.

I thought once we obtained our residential visa that we signed up for IESS.  Do my husband and I need a health insurance policy before we get our residential visa approved? What is the best way to get health ins for Ecu if there is a "pre-existing condition" as called in the USA so ins companies do not have to pay?
How do we find out if a condition is covered under IESS?

I like that only pension is/can be considered.  How do we find a chart or someone to tell us with a pension what the IESS costs?

Thanks in advance for all the info!  Yes, that was more than one question!

Robin

RobinJoel wrote:

.
Mr. Media...

Do my husband and I need a health insurance policy before we get our residential visa approved? What is the best way to get health insurance for Ecuador if there is a "pre-existing condition" as called in the USA so ins companies do not have to pay?

1.  A health-insurance policy is not a pre-requisite for Ecuadorian visas.

2.  Historically, IESS has covered all conditions, including pre-existing conditions.  I am not aware of any plan to change that policy.  There is a variable waiting period, typically two to three months, after signing up for IESS coverage .. before receiving care.

3.  Last I checked, I was being billed about $85 a month (single male) via auto-debit of my Banco account.  Couples pay only slightly more, maybe 5-8 percent more.  Visit www.iess.gob.ec to sign up and possibly obtain information on payment schedules.  FYI, it's a Spanish-language site.

Your question about the best way to get health insurance confused me, so please simplify it a bit and re-ask if my answer in this post is unclear on what you need to know.

cccmedia

Mr. Media,

I was asking about getting an additional health care policy.  Some expats have them (along with IESS) so they can get to a specialist sooner.  I don't know where they get them or if they/we need them.

What are your thoughts?

Thank,
Robin

RobinJoel wrote:

I was asking about getting an additional health care policy.  Some expats have them (along with IESS) so they can get to a specialist sooner.  I don't know where they get them or if they/we need them.

What are your thoughts?

Thanks,
Robin

Thank you for making that question clear, Robin.

I bought a private health-insurance policy my first year in Ecuador, 2013.  Like all the private policies in Ecuador (as far as I know), it excluded coverage for my pre-existing condition(s).  The policy cost me about $240 a month.

As soon as my IESS coverage kicked in (early 2014), I canceled the private policy .. and have never regretted that decision to cancel.

Many Expats have reported they obtain IESS coverage as a backup plan for potential emergencies .. and pay out of pocket for anything that is routine or of a non-urgent nature.  I believe that is a good plan for most Expats.

As far as seeing a specialist promptly, cash patients can expect to schedule appointments with most doctors on a priority basis.  Insurance companies may limit which doctors you may see under the coverage.

cccmedia

Mr. Media,

Again, thanks for the good info!

Not to give too much  -  but I have a neuro-muscular issue (genetic) that needs treatment every three months. My neuro here knows Ecuadorain docs here in the USA and they know who to send me to in Quito.  I've lived with it for 35 years but still has to be treated.  Just learn to live with it and I have!

Pre-existing so not covered. Ok, will pay with cash until IESS kicks in.

Joel and I really appreciate all the good info you give us!  And so many others too!

Thanks,
Robin

Using an online multiplication calculator, I see that I have saved almost $10,000 since dropping private insurance about five years ago .. and paying only for IESS coverage.  IESS coverage cost me about $72 a month when I joined.

You can buy a lot of cash health-coverage with $10,000 .. although there was this visiting USA family in Guayaquil that said it ran up a $40,000 bill for its senior member.  Amounts like that can probably be re-negotiated, possibly with attorney assistance.

Snowbird USA-citizen Expats over age 65 should probably consider maintaining Medicare up to and including Part D .. given the penalties and hoops involved in re-entering the Medicare system after living overseas.

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A word you may hear when entering a clinic or hospital and requesting care is particular -- pahr-tick-oo-LAHR.   In this context it means cash for payment.  They are attempting to determine whether you have insurance .. or will be a cash patient.

cccmedia

Mr. Media,

Thank you again!  So much good info!
If we ever get to meet you, we will give you a special award!  I am a teacher - ok retired (that is hard to say)  - but I am very creative!

Robin

I had to overnight in April 2018 at Kennedy, a private hospital in Guayaquil for a GI infection. I got fantastic attention. My out of pocket was  around $400, maybe a little less. I didn't bother negotiating it.

I have paid more for insured doctor's visits in Cincinnati. Heck, I've paid more for hotel rooms- and I got better service at Kennedy

lebowski888 wrote:

I had to overnight in April 2018 at Kennedy, a private hospital in Guayaquil for a GI infection. I got fantastic attention. My out of pocket was  around $400, maybe a little less. I didn't bother negotiating it.

I have paid more for insured doctor's visits in Cincinnati.

Kennedy would be a much better choice than Maldonado if care is required in Guayaquil and the Expat can pay the freight.  Maldonado is the big hospital that was considered the IESS flagship hospital in Ecuador's largest city.

When the official report on Maldonado came out a while back, it was discovered that large amounts of medicine were being stolen by employees or their confederates.  And that was just one of the problems at the facility. 

PanAm Post headlined the story by calling the medicine-stealing ring  at Maldonado "mafia"-run.  An inspection team accompanying Ecuador's presidente found a dozen underground tunnels used to smuggle medications out of the hospital.  (PanAm Post)

The Big G is not Expat-friendly in various ways, including heat, humidity, lack of a coastal beach, street crime, taxi-related scams .. and the mess found at Maldonado.

cccmedia

cccmedia wrote:

The Big G is not Expat-friendly in various ways, including heat, humidity, lack of a coastal beach, street crime, taxi-related scams .. and the mess found at Maldonado.

cccmedia

Oh, I don't mind Guayaquil at all. It has its own peculiar charm if you decide to get to know it. I personally like it. But I acknowledge it isn't everyone's cup of tea

I believe the reputation of danger is overstated, though there certainly is petty crime. Google the "world's most dangerous cities" lists and G isn't on there. Yes it is hot and humid, but less than my former home of New Orleans in the summer. Certainly, there are more charming cities in LatAm.  But I don't think it is the worst.

However, I am in an atypical expat situation. I'm relocating because my girlfriend is a native Guayaquileña. She is a public highschool English teacher who has only just begun her career. She takes care of her mom. I happen to have a flexible work situation as I work on the internet with my own business. So I will be moving in with her and becoming part of her family in Guayaquil. Perhaps if she gets a better job offer we will relocate

Hi,ccc,Thanks! You gave me GREAT info more than a year ago, Now I'm getting ready to come.I'm 71,in good health,but have controlled high blood pressure.Do you know of a private Ecuadoihealth insurance co.that'd cover me and the approximate cost per month? Thanks, ***

Besides my subscription to the government/IESS program, I haven't priced private healthcare in Ecuador since 2013-14.

When IESS loosened the rules to allow Expats, I dumped my $250-per-month subscription to Salud private insurance and have been paying in the $70 to $80-something range to Salud ever since.

Like many Expats, I keep IESS for backup, catastrophic just-in-case insurance .. and pay out of pocket for direct access to my doctor for routine checkups.  I get to choose my doctor and set checkups for times I find convenient, two benefits over having IESS set the rules.

IESS does not impose pre-existing conditions limits, whereas private insurers do .. tremendously reducing the value of private insurance to many Expats.

I buy travel insurance when I am 'on the road', which has been most of the time the last couple of years.

cccmedia

Which travel health insurance.co. is best? Thanks! Frank

Which travel health insurance.co. is best? Thanks! Frank

I am using IMG.

A few years ago I used World Nomads, which had an age-restriction.

I elaborate more on the other insurance thread that you started today.

cccmedia

I use Allianz for insurance

Pre-existing conditions -- what are the rules

for private-insurance coverage in 2023?

Private insurance coverage of pre-existing conditions

does not go into effect during the first two years

after the policy is activated.

After this period, the insurer -- by law -- must cover

pre-existing conditions, but only up to the value of

20 basic Ecuadorian salaries, currently about

9,000 USD.

So if your health coverage is for up to 150,000 USD,

the private insurer will pay for only $9,000 worth

of medical care for pre-existing conditions,

and only starting in the third year of coverage.

Source.. "...health insurance for expats

more important than ever," interview with

principals of a Cuenca-based insurance company,

e-published on August 7 at www.cuencahighlife.com

I am a 58-year-old cancer survivor who is not more healthy than I've ever been because of my decision to move to Southern Ecuador.  I have used IESS since I moved here and have utilized the service twice in three years.  Both times were wonderful experiences.  I pay $78 per month. I believe with IESS there was a one-year wait for pre-existing where as Private is two years.

💜🌺🇪🇨🏥🚑👩🏻‍⚕️👨🏽‍⚕️Ecuadors IESS is expected to enable a digital scheduling service nationwide in mid-September (?), to streamline appointment services and improve upon the current (inefficient and frustrating long waits) means of scheduling, by calling 140 or in person. Currently, If an IESS member gets an appointment, it is likely to be outside of their community because the system identifies the availability of doctors or specialists that the patient requires, but in other cantons or even other provinces. The new appointment management software will allow you to choose the appointments according to the your availability and geographical location.

Appointment services by calling 140 will still be maintained, since it is the link to "guarantee the assignment of consultation shifts of affiliated citizens" ('confirm appointments for IESS members' ?). Also worth noting that the hours of consultation for specialties has been extended until 19:00 p.m. (7:00pm for civies) to ensure members with familial / work obligations have more opportunities to see the specialists they need.

https://elmercurio.com.ec/2023/08/31/ag … nca-azuay/

I am a 58-year-old cancer survivor who is not more healthy than I've ever been because of my decision to move to Southern Ecuador. I have used IESS since I moved here and have utilized the service twice in three years. Both times were wonderful experiences. I pay $78 per month. I believe with IESS there was a one-year wait for pre-existing where as Private is two years.
-@elcirculo090

,

,

,

Unless we're told otherwise, I will presume that El Circulo

meant to say he is now more healthy than ever,

instead of 'not more healthy'.

If IESS currently imposes a year-long waiting period

before covering  pre-existing conditions, that's a big change

from when I first enrolled in IESS about eight years ago.

At that time, the waiting period was three months or so

after the fiirst draw-down from the patient's bank account.

cccmedia