Healthcare in Ecuador

If you’re seriously considering moving to Ecuador, ¡felicitaciones! (congratulations!)

This country of contrasts comes with a UNESCO World Heritage Site for a capital, the stunning Cotopaxi volcano that’s surrounded by a national park with bears, llamas, and pumas, and the incredibly special Galápagos Islands.

But before you become one of the 8,595 American expats (United Nations,2019) enjoying life in Ecuador, you’ll want to learn what kind of healthcare you’ll have access to once you arrive.

And if you want to join the hundreds of thousands of people in Ecuador who have private health insurance, check out our list of recommended healthcare providers.

From there, you can request free quotes from whichever company suits your needs.

Ecuadorian healthcare: key stats

What’s on this page?

01 | How does the healthcare system work?
02 | Quality of healthcare
03 | Healthcare for foreigners
04 | Do I need health insurance?
05 | Benefits of private medical cover
06 | How much does health insurance cost?

Ecuador’s volcanoes and vicuñas are amazing, but its healthcare service isn’t ideal 

How does Ecuador’s healthcare system work?

Ecuador has a national universal healthcare system called the sistema nacional de salud.

In 2008, a new national constitution was drawn up that stated healthcare services “shall be governed by the principles of equity [and] universality.”

That means all residents can access a range of free medical services.

If you’re employed in Ecuador, you must contribute to social security, which is overseen by the independent Instituto Ecuatoriano de Seguridad Social (Ecuadorian Institute of Social Security, or IESS).

That allows you to receive care at IESS and government-run facilities, where you can access the following free services:

• Outpatient care
• In-patient care
• Specialist treatment
• Surgery
• Prescriptions
• Emergency care
• Diagnostic tests and imaging
• Orthotics and prosthetics
• Preventative dental services
• Extensive maternity care before and after delivery

Around 3% of the population have private health insurance.

Due to Ecuador’s low average wage and poverty rate of 25%, only upper and middle-class citizens can afford this level of coverage, though it’s relatively affordable for expats.

All private healthcare providers operate under the authority of the Ministry of Health.

Laws were passed in 2017 that stopped private companies from turning away anyone based on their age, gender, or pre-existing conditions, so you should be able to acquire coverage, whatever your situation.

Is healthcare free in Ecuador?

As with all universal healthcare systems, taxes fund the provision of health services.

If you have a job in Ecuador, your company must pay 9.45% of your monthly salary to the IESS, along with 12.15% of all employee earnings.

You’ll also pay a much higher proportion of the costs than you would in the US.

40% of health expenditure in Ecuador is out-of-pocket, according to the World Bank – nearly four times the US’s figure of 11%.

Quality of healthcare in Ecuador

Ecuador’s healthcare system comes 101st in the world, according to a 2018 study published in The Lancet and funded by the Bill and Melinda Gates Foundation.

That places the South American country below Syria, Uzbekistan, and Libya – and a gigantic 72 places behind the US in 29th.

The country has increased healthcare spending in recent years, and now dedicates more of its GDP (Gross Domestic Product) to healthcare than Greece, the Czech Republic, and South Korea, according to the World Bank.

This has produced positive results, but the country still has some way to go.

Its maternal mortality rate has fallen by 25% since 2010, but you still have a one in 1,695 chance of dying while giving birth – a higher chance than nations like Honduras, Kyrgyzstan, and Papua New Guinea, which all have a significantly smaller GDP per person.

There are 1.4 hospital beds per 1,000 people, which is less than half the US’s 2.9 figure, and the mortality rate for children under five is 14 per 1,000 – twice as high as the US.

But in general, your life expectancy in Ecuador is 78.4 – just 0.1 years lower than the US.

Healthcare in Ecuador for foreigners

To obtain an Ecuadorian visa, you’ll need to have healthcare coverage. That means either signing up to the public healthcare system, or getting private medical insurance.

If you already have a job when you arrive in Ecuador, your employer will register you with the IESS.

If not, you can sign up on the IESS’s website – though make sure you either speak Spanish or have someone around who does, as the site’s not available in English.

With IESS, you’ll be taxed 9.45% of your income each month. Retirees aged 65 and over only have to pay the minimum premium, which is $72.

If you go private, make sure the company you choose is registered with the superintendencia de compañías, which is the authority that monitors and controls businesses in the country.

Do I need health insurance in Ecuador?

Yes. Without it, you won’t be able to get a visa.

You can opt to stick with IESS coverage through your employer, or get a private medical policy – but either way, you’ll need insurance.

Benefits of private medical cover in Ecuador

• Shorter waiting times
• Peace of mind
• You’ll receive the highest level of care possible
• Medical equipment is typically more up-to-date
• Fewer unexpected out-of-pocket expenses means you can budget your healthcare in advance
• Staff will be more likely to speak English
• The paperwork is also more likely to be in English

How much does health insurance cost in Ecuador?

For an individual

You should expect to pay around $1,400 per year for private cover in Ecuador, which comes to $117 per month.

It’s worth getting a few different quotes though, as prices can vary hugely.

For a family

To cover a family of four in Ecuador, it’ll cost you around $5,400 per year.

That means you’ll pay about $3.70 per day, per person to secure peace of mind – and a better level of care, if you ever need it.

What’s next?

If you want to protect yourself and your family with private medical insurance in Ecuador, check out our list of recommended healthcare providers.

From there, you can request free quotes from whichever company suits your needs.

And if you’d like to know more about your new home, your first port of call should be our page on moving to Ecuador.