Healthcare in Ecuador

[RONALD YOUNG]

I am seriously interested in Ecuador as a retirement destination. I am age 76, male with a pacemaker and some cardiac stents. I still work 2-4 days per week. My cardiologist has discouraged me about Ecuador because he says the health care is not adequate. I have heard all sorts of stories about healthcare in Ecuador from it is top notch to it is terrible, including that you could easily die on a gurney in an emergency room at a hospital while waiting for care even in a large city. What has been the experience and recommendations of those “on the ground” regarding health care in Ecuador.

[SUZAN HASKINS]

Health care is all over the board… from inadequate in public facilities to fair-to-good in IESS facilities to top notch in private facilities. Public = free / IESS = $70/month for one and $11 more for dependent / private = more expensive, however at your age you will not qualify for private insurance so you would pay out of pocket for this option and that is not recommended.

With your health issues it is probably not advisable to be in a high-altitude location, limiting your options further.

[Brenda]

Hi Susan. I was wondering if before 60 would be the best time to become a resident to get private health ins Before it becomes more expensive or hard to get?

[SUZAN HASKINS]

Hi Brenda, yes, that’s true. Most private insurers will not accept anyone 65 or older. As of now, you can still qualify for the Social Security System (IESS) at any age… but that could change tomorrow.

[RICHARD MACATEE]

Are there “rumors” that the government is planning to limit the age at which someone can apply for th IESS?

[SUZAN HASKINS]

Richard, I have not heard those rumors, however there are ALWAYS rumors of all kinds floating around. In our small community, many expats have recently been dropped by several private insurance companies, being told something like “expats use a disproportionate amount of health care services.” Maybe that’s thanks to the typical diet and (lack of) exercise regime in North America, and they arrive in Ecuador with a host of health issues. Or maybe North Americans just seek medical help far more often, I don’t know.

As for now, expats are still able to use the IESS system. We hear great things from those who use IESS in Quito and Cuenca… but in smaller towns, we hear not-so-great things… so if IESS will be the route you go, this is good info to keep in mind.

IESS is government-run — and they may decide at any time not to allow expat inclusion. It’s anyone’s guess. The government does say they are committed to improving the system in every way, but… remember that the crash in oil prices means Ecuador is strapped for cash right now.

[KOWALEWSKI22795]

Hi everyone. I”m a first time reader/poster. I’m just wondering: Can I get private insurance where it’s written in the contract that I would not be discontinued for any reason such as “over-use” or age?

[SUZAN HASKINS]

Hi Kowalewski2, I have not heard of such a contract and if there were one, I am not sure I would have much faith in it. Too many loopholes.

[PETE DEBOER]

Hello Susan, I am here for the first time too. I am a healthy 69 year old and considering a move to the coastal region around Manta or Salinas early next year. I had not heard that 70+ people like were not insurable. Is that so? Is there some kind of policy one can obtain. I am pretty healthy and work out regularly and play some sports. My only condition is a little high blood pressure which is well under control with some simple medications.
What is the downside to obtaining health care there. From everything I read, pay as you go is doable until something goes haywire.

[SUZAN HASKINS]

HI Pete, there are some private insurance companies that will not insure anyone over 65 and there are some that extend that to 70. So if you are interested in obtaining private insurance you will want to get here and get residency and insurance before age 70. However, as my post above discusses, the company may decide at any time to drop you. IESS may be an option for you. And yes you can pay out of pocket, but if something serious happens you could find yourself in a pinch. A friend of mine with a bacterial infection spent 6 weeks in intensive care and 6 months in a care facility after that and racked up a bill of $100,000 — fortunately they catholic hospital is working with them on the bill, but a serious illness can wrack up serious costs. And you don’t want to go to a public hospital or an inadequate private hospital when you have a life-threatening situation. You might also consider an international policy. Discuss your options in that regard with broker John McGee: john@expatglobalmedical.com

[SHAUN LJUNGGREN]

My wife and I are in our early 40’s and will be moving with our 2 kids (10 and 8). I have a couple questions that maybe you all can help me with…

1. Are IESS and the public options available for all ages?
2. Does anyone know if US citizens would be forced to pay the Obamacare penalties if they chose to Pay-as-you go?
3. Does the US govt. recognize IESS and EC public options as adequate healthcare options? Meaning, would it satisfy the Obamacare requirements so that we wouldn’t have to pay the penalties?

[SUZAN HASKINS]

Hi Shaun, yes IESS and the public system are available to all ages. If you are living outside the US and can prove that (with a foreign resident visa, for example) my understanding is that you are exempt from the Affordable Care Act. To my knowledge, the ACA does not endorse or disqualify any health systems outside the US. The last time I checked there were still some questions about how the ACA would affect those living overseas in regards to taxes and penalties. I’d suggest you check with a tax advisor who specializes in expat situations. Mine is Matt Apodaca and I think he’d be happy to answer a simple question or two: matt@nchwealth.com

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