Ecuador Offers Healthcare As It Should Be

The hospital was so clean you could eat off the floor in the men’s room, without a spoon,” said my new friend Mike. He’d recently had angioplasty and a heart stent procedure in Cuenca, Ecuador.

Mike and I are expats here in Cuenca, and when we talk to others thinking of moving to Ecuador, they always ask about the medical.

One of the first things that impressed me is how personable the doctors are. They take their time to listen to and understand your medical situation and history. They’ll even give you their cell phone numbers.

Most doctors do not have nurses, and there’s no such thing as “physician’s assistants.” You speak directly with the doctor and many of them make house calls.

I often share the story of the afternoon I called my GP, Dr. Anthony Guillen about a bout of diarrhea. He prescribed medication and said, “Can you come see me tomorrow at 10 a.m.?”

Or the story about my friend Ellen Westover, a retired RN from El Paso, who had surgery on her hip for a torn labrum. She says of her physician Dr. Santiago Romo, who specializes in orthopedic surgery and rehab (and was formerly a Peace Corps doctor in Ecuador), ‘He followed up with visits to my house, and I had physical therapy.'”

New Jersey native Guy Madchen says, “My last three doctor visits in the U.S., where I shared my concern with an issue, were rushed-through exams, maybe 10 minutes. My doctor in Ecuador spent time listening to my issues and didn’t dismiss my concerns. She recommended medicine that is already showing promise in addressing my symptoms. My wife is a long-term medical professional and worked at high levels within large U.S. healthcare systems, and she is totally impressed.”

Healthcare Options in Ecuador

Ecuador’s healthcare system features world-class doctors, private and public hospitals, and high-tech diagnostic and treatment equipment.

The best private medical facilities and services are in Quito, Guayaquil, and Cuenca, and the latter has the lowest costs. Cuenca has 10 private hospitals and clinics, all of which offer emergency services.

Cuenca expats have experienced positive results for everything from respiratory illnesses to open heart surgery. Many doctors have trained in Argentina, Chile, and Cuba—all known for having some of the best medical schools in Latin America. Many doctors here also speak excellent English, especially if they’ve trained in the U.S. or Europe.

How Do Costs Compare?

Ecuador has a constitutional mandate that says no one in the country can be refused medical care.

Costs here are 10% to 30% less than they would be in the U.S. A private hospital room in Cuenca—with full medical service and meals—averages $225 a day, compared to $950 in the U.S.

A consultation with a general practitioner can range from $25 to $40, with specialists charging about $10 more. Follow-up visits, called “controles,” are often free. A set of simple x-rays runs about $45, while a comprehensive blood test costs about $75. Medicines also cost significantly less, with many available over the counter without a prescription.

Plus, you don’t need to be a citizen to benefit from Ecuador’s social security (IESS) healthcare system. Anyone with permanent residency status can join. I pay around $74 a month. All your medical costs will be covered, and there are no pre-existing conditions or age restrictions. There are also no deductibles or copays.

Susan B. says, “I had both knees replaced on separate occasions by IESS surgeons. The clinic staff was great, and the results were excellent.”

Six years ago, I experienced a successful and pain-free emergency gallbladder surgery at the IESS hospital. Aside from the fact that my surgeon looked handsome enough to be guesting on Gray’s Anatomy, he spoke excellent English, and made sure the staff attended to all my needs. I didn’t have a private room, but the environment was quiet and clean. And after four days, I was able to go home.

You can also get emergency service in any emergency room in the country, and IESS will cover it.

Having said all that, it’s important to remember that IESS is a government-run program. If your Spanish is limited, you may have difficulty navigating the paper-work. Also, there can be long lines for the IESS pharmacy, and not all medicines are available there.

Private Health Insurance Options

If you want to purchase private health insurance, the costs in Ecuador are still a fraction of what you’ll pay in the U.S. Monthly fees range from $40 to $100.

You’ll find a variety of specifications and deductibles. Just as in the U.S., costs for these will rise with pre-existing conditions and age. Also, you could be denied coverage altogether, especially if you’re 65 and older.

My husband and I, and many of our friends, do not pay for extra insurance. We pay into the IESS system monthly, and for day-to-day needs, we pay as we go. With private health insurance or a “pay-as-you-go” option, there are no long waits for appointments with specialists, or for medical tests and results.

“I had my hip replacement surgery done privately at Monte Sinai by a top surgeon for $7,000, including titanium prosthesis with ceramic liner,” says John Wilson.

Another expat, Arnold Brown, told me he had cataract surgery for a total cost of $1,270, which he chose to pay himself. “My deductible alone in the U.S. would have been twice that,” he says.

When I fractured my ankle on vacation in another country and returned to Ecuador, for the sake of expediency I chose not to use the IESS system. My doctor made a house call, sent me for x-rays, and referred me to an orthopedic surgeon who put a cast on my foot. My out-of-pocket cost for all of this, including follow-up, was less than $250.

In Ecuador you’ll also find a wide variety of choices for alternative healthcare, including acupuncture, acupressure, natural medicine, chiropractic, hydro-colonic therapy, and massage therapies.

Be aware, though, that private insurance may not cover all of these alternatives.

Choosing Your Doctor

As with any recommended major medical procedure you’d have done in the U.S., it’s a good idea to seek a second medical opinion and verify the costs of procedures and treatments.

Carlos Ramirez, an insurance agent with Blue Box Asesores, explains, “The cost of medical treatment in Ecuador is not regulated by any entity, which means the doctor decides the cost for the medical procedures they perform. Even so, there are rules and laws that regulate the doctors and health services you receive in our country.” He adds that you can verify that your doctor has a medical license registered in the government’s SENESCYT system and that the clinic you attend has permits issued by ACESS.

Expat Ralph D. says, “I was told by one doctor that I needed a knee replacement surgery. I saw another doctor for a second opinion and he suggested we try ozone treatment first. Since then, I have been pain-free and extremely active for the past six years.”

Doug Hackett, a retired Los Angeles realtor, says: “While living in the U.S., I was diagnosed with a bulging disc in my lower back. I had physical therapy, but continued to have pain. After an MRI here in Ecuador, it turned out I had another bulging disc. My doctor gave me a set of ozone injections (these are used to relieve pain and treat disease). The first ones were done in his clinic with imaging to determine the correct sites for injection. The following injections were performed in my house. I am happy to say I am pain-free… for the first time in 16 years! I am walking and exercising and feeling great.”

What About Dental Work?

When my husband—with a broken tooth and just a few dollars in his pocket—visited a new dentist for a consultation, the dentist offered to fix it on the spot. “You can come back and pay me tomorrow,” he added. The cost was $30.

Dental work in Cuenca is highly affordable. A filling may be $30 to $40, a cleaning about $30, and a crown $250 to $400, depending on the type of material used. An implant costs about $1,200.

Dr. Daniel Pinos, an English-speaking dentist who does crowns, cleaning, dentures, extractions, and fillings, also works with a group of specialists for more complicated needs like dental surgery, implants and pediatric dentistry. He says that while there is a dental school at the University of Cuenca, “dentists also train in other countries like Brazil, Chile, and Colombia. But not so much in the U.S., as it is so expensive.”

You’ll find it easy to find English speaking dentists and dental staff, especially in Cuenca.

Home Healthcare

VIP Home Healthcare is a Cuenca service that offers a medical alert system, with a staff of licensed nurses and doctors on call. My husband (who’s 90), wears their medical alert monitor. The deposit for the device was $100 and we pay $40 a month for the service. VIP was recently voted “Cuenca’s Best Home Healthcare Provider.”

Sharon Jackson has lived in Cuenca for the last nine years. When her husband fell in the bathroom, with his back blocking the door for entry, he used the medical alert monitor to call VIP for assistance. Sharon says, “This medical alert system is excellent and well worth the cost.”

You may choose to hire a medical facilitator to help you navigate Ecuador’s medical systems and translate for you. An hourly fee for this service can be around $20, with transportation included.

The best way to find a facilitator or any other medical professional if you are new to Ecuador is to ask the expat community. They’ll be invaluable in seeking local medical information and referrals for your specific needs.