Cotacachi / Ecuador Cost of Living / Ecuador Health Care / View from the Roof

A View From the Roof: Ecuador Health Care and Insurance Offers Great Bargain gets many inquiries about health insurance and medical care.  While I cannot write a comprehensive article about this subject, I can give you some ideas about what to expect if you decide to move here and need health insurance coverage.

Many people opt to self-insure.  While this may cause many of you to gasp in horror, let me assure you that if you are in reasonably good health, this is not a bad idea. I have been self-insured for the last 15 years and Linda, for the last 26 years, six of which have been while we’ve been living in Ecuador.

We only signed up for health insurance about 6 months ago. Of course, we are very healthy and live a clean life style, no smoking, little drinking or general carousing.  We are also long-time meditators, which I believe is of great assistance in maintaining good health.

We are both fortunate that we have had no incidences of bad health during this time, with one exception.  I fell off my bicycle about 3 years ago and dislocated my shoulder pretty severely.

I was taken to the emergency room in the local hospital on a Sunday afternoon.  They telephoned the doctor on call.  I received several x-rays and some pain medication including shots.  I was there for almost 3 hours.

About 10 days later, I went to an Ibarra clinic to get a second opinion.  The doctor there again x-rayed me and gave me a Velcro sling.  After this, I went to a local Cotacachi clinic for physical rehabilitation and about 15 treatments with some fancy machines.   The entire treatment including everything was $90.

Recently, a friend went to the emergency room in Ibarra on a Saturday night for severe back pain.  He was there for almost 5 hours, had several x-rays, shots in his back for pain and was attended by four people.  The doctor was apologetic for charging $200 when he discharged him.

Another friend had a hernia surgery.  After three days in the hospital, with doctor bills and surgery room, the total bill came to $1,200.

Of course, some people just don’t feel comfortable without insurance. We recently went to a presentation by Coopseguros S.A. for their Golden Age program.  This plan is for people age 60 and over with no age limit.  The cost is $110/month/person.  After 30 days, the plan covers dental and acute illnesses, plus diagnostic support.

After 90 days, pre-existing illnesses are covered. This includes 80% coverage for clinical treatments, clinical laboratory diagnostic support and physical and respiratory therapies.

After 365 days, 80% coverage of surgical and intensive care unit, diagnostic support and MRI. All hospitals for this system are in the Quito area, a drawback if you live in Cotacachi, which is 2 hours from the city.

However, if you have an emergency situation, you will be taken to the nearest clinic in Ibarra or Otavalo.  Then when you are stabilized, they will move you to the hospital in Quito.

You cannot be dropped from this insurance and there is no age limit.  Maximum coverage for an illness is $5,000.  Additional coverage for high-cost illness is $3,000.   It doesn’t sound like a lot, but your medical dollar goes much further in Ecuador.

Another company you may want to consider is BUPA . BUPA is a British company formed in 1947 as a private alternative to the government-introduced National Health Service. It is probably the most well-known private health insurance company in Britain but in recent decades it has expanded into a global health and care organization.

It now has an international branch that covers health insurance for expatriates in 180 countries around the world.  The web-page has a quote calculator so you can plug in your numbers and information and come up with a cost for yourself. The benefits are extensive and can be seen here

Another  Ecuadorian company is Cruz Blanca (White Cross). People under 65 pay approximately  $60 a month.  After age 65, the price goes up to around $110. They have their own advanced clinics in Quito.  Where they don’t have coverage they reimburse you for emergency medical treatment.

Several friends in the Cotacachi area have this insurance.  Two friends in Quito–the husband is a retired medical doctor–have both had surgeries with Cruz Blanca and absolutely raved about the skill of the doctors and the quality of the medical care.

Another acquaintance specifically asked whether his policy would cover lengthy treatment for cancer or rehabilitation after a stroke or heart-attack and was assured that it would. In addition, some pre-existing conditions are covered too; of course premiums are higher.  Coverage for a child is around $40 per month.

Those of you who have never been to Ecuador may be struggling to conceive of what level of health care is typically available in a developing nation like Ecuador.  Yet thousands of foreigners come to Ecuador for high quality low cost dental and medical care.

Many foreigners come for plastic surgery to Ecuador and leave very happy with the results.  Others come for cardiac procedures and leave with smiles on their faces and a higher quality of life, not to mention a pocket book that still has some money in it!

There are also various types of alternative cancer treatments available in Ecuador too, as the FDA and the American Medical Association do not have much of an impact here.

Another health insurance company in Ecuador is EcuaSanitas.  They will cover you up to $15,000 per year for around $50 per month.

Another option some expats are using is the IESS, or Ecuadorian Social Security system.  Linda and I are now affiliated with this agency through our business.  It cost about $60 per month for each of us.

There is an IESS clinic here in Cotacachi where one goes to see a doctor.  Then if further treatment is needed, such as a specialist or hospitalization, one goes to the IESS hospital in Ibarra.  This service also covers optical and dental.  After a six-month waiting period, all medical problems are covered 100%.

We just recently used the system.  We walked into the Cotacachi clinic for our appointment and waited about 5 minutes to see a doctor.  He did an examination and prescribed some medicine.  After the exam, we went to the pharmacy in the clinic and were given the medicine free of charge.

There is no age limit on this insurance, but you must have a physical if you are over age 60 and they can turn you down in you are in bad health. We know one person who was hospitalized in Ibarra at the IESS hospital and gave good reviews for the excellent care.  You do need to file paperwork each month with the social security system, but you can hire a person to take care of it for you for $5 per month.

From what we have seen, medical care in Ecuador is top drawer.  A local expat exclaimed that his aging mother was treated at the Hospital de San Francisco de Quito in Cumbaya and the care she received was every bit as good as John Hopkins in the U.S.

So if you are in pretty good health, you should be able to find insurance coverage in Ecuador no matter your age.  It may not cover catastrophic incidents, but it will certainly provide adequate coverage.

Dental care is also first-rate, with highly trained dentists waiting to provide care at a fraction of the cost of dental care in the U..S.

By the way, your U.S. medicare coverage is of absolutely no use to you whatsoever in Ecuador.

And that’s today’s, View from the Roof.



  1. One unique option is to get BMI group plan rates through the FOPS program. Friends of Padre Simon. The largest non profit NGO in Ecuador. We have about 170 members currently. Rates start at $100 a month and cover up to $250K a year with a low $120 deductible. Medical & Dental. Even covers 30 days of foreign travel Covers all of Ecuador. $500 100% emergency coverage. Its 80/20% similar to a US program. for details.

  2. Has anyone had psychiatric care in Cuenca? I’m bipolar and concerned about getting the same medications there as in the US.

  3. Apparently, these above medical insurance companies don’t have an English translation link. If that’s the case, then I assume they are only interested in spanish speaking clientele!

  4. I read with interest your many blogs on Ecuador including the ones on health insurance . We have private health insurance here in the U. S. When we were in the Philippines on vacation, my husband had an accident and The company
    reimbursed every related expense we paid including surgery. I presume they will do the same if we retire in Ecuador but we are considering discontinuing it because of the high premium and switch to one of the above should we decide to stay there .
    Thank you for your website – it is very informative.

  5. Somer O'Brien says:

    Does anyone have any feedback on persons with diabetes moving into Ecuador from the US and changing insurance companies/getting supplies,etc? I believe diabetes is considered a pre-existing condition and some insurance companies won’t take on new members with pre-existing conditions. Any tips would be very much appreciated.

  6. larry green says:

    i have a few health issues but this is all positive , good news. ecuador is looking better and better to me every time i read one of the newsletters. i’m very anxious to visit and get a feel for the country

  7. Steve Juniper says:

    Medicare CAN be useful when you are here, if indirectly. Even though a resident here, I retain my comprehensive Kaiser coverage in Oakland, California (Senior Advantage, $78/month). I am covered for emergencies, which they will reimburse me for and when visiting there I get my regular checkups from my very long time wonderful GP, plus referrals, but note that my copay ($30) is about what I would pay outright here. My double hernia operation at Kaiser set me back $200.
    We have a good doctor and dentist in Otavalo and have had nothing but good experiences from them so I am certainly not criticizing them.

  8. Cecilia Dvorchak says:

    Thanks, this is just what I needed. I am finding great
    alternative healings here but am thinking of accidents, etc. that may come into play and am thinking of at least taking the social security,

  9. my wife is onl7 49 and on soc. sec. disability-she was a professor but broke her back. she has brittle bones severe osteoporosis. she just had a new hip put in last year. she is not in great health. she has a pension and ss disability. what type of ins. should she get=here in the states she hass medicare which is worthless. The hip surg. was over 100k dollars cuz they count every toothbrubsh, every piece of food , every aspirn that you take. she had problems so had to stay in intensive care. as you know, four days in intensive care is easily 50 k here. eaisily
    they charge for every breath on ventilator, it seems. what is the insurance that disabled foks get.
    btw we are interested in one of the propertie. please call me 3862667483 brian wilson in Florida