GringosAbroad Ecuador

Do I Need Health Insurance in Ecuador? What Residents & Travelers Need to Know

Posted in: Ecuador Travel, Living in Ecuador

If you’re planning to move to (or even visit) Ecuador, you’ve probably heard about the new health insurance requirements. Do you need to buy health insurance in Ecuador? Here’s what you need to know.

health insurance in Ecuador

“Do I Need Health Insurance in Ecuador?”

Last week, a reader asked this question:

“However, one thing still confuses me considerably – that is – the requirement for insurance and exactly how that works. Could you please explain further how this new law impacts expats – the particulars, pros and cons of it? Thank you.” – Neil

Do Residents Need Health Insurance in Ecuador?

If you spend any time in the forums and groups, you’ll know that there are many opinions about this. And while there is (or was) truth to much of it, things continue to change.

To clarify this question, we asked a Cuenca immigration lawyer to weigh in. Here’s what Nelson Idrovo (of Idrovo & Velastegui Attorneys) had to say:

“The new law states it is obligatory for all residents, permanent or temporary, to have health insurance that covers them in Ecuador.  This applies to all residents, without exception, whether they are new residents or became residents before the new law went into effect.

They can elect to use the public insurance IESS or contract a private company.  The law further states that foreigners that have insurance have 90 days from August 3, 2017 to provide proof of insurance at the Ministry of Foreign Affairs.” – Nelson Idrovo

So yes, Ecuador residents require health insurance. They can choose either from IESS (public insurance) or a private company. What’s important (and required) is that a policy be established and that proof be provided to the Ministry of Foreign Affairs.

What is IESS?
The Ecuadorian Social Security Institute (Spanish: Instituto Ecuatoriano de Seguridad Social (IESS)), is an autonomous entity that is part of the social security system of Ecuador and is responsible for implementing the mandatory universal insurance, according to the Constitution of the Republic, in force since 2008. via Wikipedia

Pros and Cons of Ecuador Health Insurance

Now about the pros and cons of Ecuador health insurance. First of all, this is obligatory. So in one way, it’s irrelevant if it’s good or bad. Expats wanting to remain in Ecuador must have this. That being said, there are some benefits.

  • Pros: You’ll be covered for any serious medical condition should something arise. While we lived in Ecuador, Drew and I both had surgery and I was hospitalized for food poisoning. I also got bit by a dog and we all had parasites. Many expats we’ve heard from didn’t have insurance and had to pay out-of-pocket.
  • Cons: The biggest negative for most expats is the cost. Many expats move with limited funds and the thought of being forced to spend additional money makes some unhappy. There is an argument that this is just another layer of tramites (red tape) by the federal government. That being said, the government is legislating the health and safety of its foreign residents and that is a noble objective.

If you are a resident in Ecuador, you’ll need to consider what type of insurance you’ll use when you travel outside of the country. Here are 5 great travel insurance options for expats. Our Ecuador resident readers most frequently travel with Atlas Travel Insurance and World Nomads.

Ecuador health insurance

Do Tourists Need Health Insurance in Ecuador?

So you might be wondering, does the law apply to tourists as well – or only residents?

Here’s what Nelson had to say:

“The law states that all tourists entering Ecuador are required to have travel insurance that covers them in Ecuador for the duration of their stay.

Starting in the first part of March 2018 the authorities will begin requesting proof of said insurance upon entry.” – Nelson Idrovo

travel insurance in EcuadorYes, tourists do require health insurance to visit Ecuador – but it isn’t being enforced yet. That being said – a little insurance is never a bad idea. And who knows if they might begin enforcing this law earlier than stated?

And there you have it: both residents and tourists require health insurance in Ecuador.

If you are traveling to Ecuador, here are some great short term travel insurance options. Our readers most frequently travel with Atlas Travel Insurance or World Nomads.

Your Turn

Do you usually travel with a travel insurance policy? Have you already bought your resident health insurance in Ecuador? Did you choose IESS or a private policy? Let us know in the comments!


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Meet the Author

Bryan Haines is co-editor of GringosAbroad – Ecuador’s largest blog for expats and travelers. He is a travel blogger and content marketer. He is also co-founder of ClickLikeThis (GoPro tutorial blog) and Storyteller Media (content marketing for travel brands). Work with GringosAbroad.

34 comments… add one
  • Marika Roberson Nov 21, 2017, 8:37 pm

    What qualifies as “health insurance?” Does an Emergency Medical Care and Medical Evacuation policy qualify? Are there minimum coverage requirements for tourists? I read “health insurance,” but nothing about what is considered health insurance. Thanks.

  • Dimitri Favvas Nov 18, 2017, 9:41 am

    Hi Brian
    As a resident of Quebec (Canada) I am covered for the same amount that the Quebec health insurance plan pays for the same health problem here in Quebec. This is when I am outside the country. Do I need to purchase health insurance if I travel to Equador?
    One thing that bothers me here is also the fact that if you have a claim to an insurance bought in Canada (has happened to my wife) the insurance will pay only whatever is left after settling with all other sources but you are not getting any discount considering these sources at the time of purchasing the insurance

  • J. Lane Nov 11, 2017, 11:59 am

    My insurance company asked me what kind of proof will Ecuador require? A card? A letter? Does this document have a name? Unless they read the fine print of each policy how will they know that I am covered in Ecuador?

  • Amy Nov 10, 2017, 4:49 pm

    My husband and I bought our insurance this week through Confiamed we are in our 40’s and the policy was $600 a year for both of us ($50 a month). We don’t really go to doctors much and bought something that was inexpensive but made us legal. It isn’t too bad of a policy though. They will write this policy up to age 70 I believe.

  • Michele Oct 21, 2017, 7:23 pm

    Just wanting a clarification of mandatory insurance requirements. My husband and I are covered under Tri-care for life. An insurance for retired military. As I understand the customer rep from Tri_care, we will be covered in Ecuador. However, several issues have risen concerning Tri-care in the US. Have you heard from ex-pats using Tri-care in Ecuador?

    • Grace Velastegui Oct 24, 2017, 4:31 pm

      Dear Michelle,
      We haven´t heard from ex-pats using Tri-care in Ecuador. However, if the insurance covers you internationally, it will be accepted in Ecuador.

  • Mari Oct 15, 2017, 7:45 pm

    It will be interesting to see how this new law, if challenged, holds up against the Ecuadorian constitution that affords all the rights of citizenship to all residents, since this new law targets only foreigners.

  • Irene Oct 15, 2017, 6:47 pm

    I am still confused. I have read the new “Ley y Reglamento de Movilidad” and still cannot find where exactly it does mention foreigners that are already residents. The way I read it is only for new applications. Can anybody please indicate where does exactly mention foreigners with visa already? Thank you

  • Mark Kashmar Oct 15, 2017, 3:11 pm

    Hi, you mentioned you have coverage with World Nomads while living in Ecuador – I looked at the site and couldn’t find mention of long-term coverage. Can you help me find information on long-term coverage through World Nomads?

    Mark Kashmar

    • Bryan Haines Oct 16, 2017, 6:39 am

      We used World Nomads when we traveled from Ecuador to other countries. Initially, we looked into insurance from Canada, but didn’t qualify because we weren’t Canadian residents anymore. And while we did have international coverage with our health policy in Ecuador, the coverage (in my opinion) wasn’t sufficient for international travel. So we used World Nomads when traveling to the US, Canada and the Caribbean as residents of Ecuador.

      • Mark Kashmar Oct 16, 2017, 10:15 am

        Hi Bryan, thanks for your reply. What insurance do you use when you’re not traveling, when you are at home in Ecuador? I am aware of the national insurance, and I’ve read there is a number of private companies. Through my little research, I’ve seen that IESS would be very expensive for me (age 66) if I choose to stay in Ecuador for awhile. How can I get ahold of a list of private companies?

        Would you please speak to the differences between Atlas Travel and World Nomads? I’m wanting to come for a short visit in Feb. and am starting to think about insurance for that trip.

        I appreciate your patience with naive questions – you must have heard about everything by now. Thanks, mark Kashmar

        • Bryan Haines Oct 16, 2017, 11:01 am

          Hey Mark,

          We’ve only used World Nomads. They had the coverage that we were looking for – and it was a simple purchase process. I’ve included Atlas Travel because hundreds of our readers have traveled with them.

          Atlas Travel covers residents of more countries and older travelers – where World Nomads has age restrictions. Here are the details on both.

          I hope this helps. All the best on your plans!

  • TravelnLass Oct 15, 2017, 12:06 pm

    Though I seriously hesitate to wade into yet another contradictory discussion of the subject, I must say…

    Under the heading above of “What is IESS?” (and directly above the Pros and Cons of it) you state:

    “Now about the pros and cons of Ecuador health insurance. First of all, this is obligatory. So in one way, it’s irrelevant if it’s good or bad. Expats wanting to remain in Ecuador must have this. ”

    This is utter rubbish. Indeed, stating such ( contradicts your very own legal resource (Nelson Indrovo) who – just a paragraph above is clearly quoted as stating:

    “They can elect to use the public insurance IESS or contract a private company.”

    No doubt you mean well, but suffice that all you’ve done here is muddle the already well-muddled waters on the subject. Sigh…

    • Bryan Haines Oct 16, 2017, 6:34 am

      Sorry you found that confusing. Actually, both are true. The obligatory component is that expats have health insurance (as stated in your excerpt). Expats can choose either public or private coverage.

      To clarify, I’ve added a subheading above the pros and cons.

      • TravelnLass Oct 16, 2017, 12:49 pm

        Precisely (i.e. “Actually both are true.”) That’s why as written, it’s confusing).

        Yes, better a subheading/clarification that “First of all, this is obligatory…Expats wanting to remain in Ecuador must have this.” be removed from the “Pros and Cons of ECUADOR Health Insurance” section above. And state clearly that – yes, a medical insurance policy is “obligatory” but that policy needn’t necessarily be IESS. It can be either private (either domestic – i.e. an Ecuadorian company, or International e.g. WorldNomads, IMG, etc.) ***OR*** IESS. Fully your choice.

  • Connie Giffin Oct 14, 2017, 9:21 pm

    Thanks for bringing some clarity to this subject. One theing that remains foggy still: Is health insurance required by the Ecuadoran government when I travel to the US or Canada?

  • Carol Mitchell Oct 14, 2017, 8:25 pm

    Great article Bryan, but there is always a but. I spoke to an expat in Mindo area she is from BC and according to her if you are a traveller then the insurance you have in Canada, I’m in Ontario and have OHIP would be considered as valid insurance in Ecuador. Can you check this out. As most insurance companies insist you pay the bill first then get reimbursed when you get home, OHIP would cover the bill as the medical rates in Ecuador are lower than Ontario. Just some food for thought. Thanks Bryan

    • Grace Velastegui Oct 16, 2017, 2:47 pm

      As long as you can submit proof that your insurance covers you in Ecuador it will be valid.

  • Bob Oct 14, 2017, 7:13 pm

    I understand why Ecuador is doing this. They are trying to stop the ugly American from using their system. I think will slow, or stop expats from making Ecuador their retirement place either now and in the future. A couple of expats friends are leaving Ecuador due to this and retiring to another country.

  • Ana Victoria Lopez Oct 14, 2017, 3:24 pm

    Hi, very good question for us as we are retired and living abroad and spend four-five months of a year in Ecuador. I am Ecuadorian and own a house by the beach, Will I be needing insurance? my husband, Spaniard of 48 years, loves to spend winters in Salinas, he is a tourist! Of course, he is going to need one! Right? We are securing a VISA for his stay, $450. ( double today, To stay more than 180 days 😡. In order to become resident, he needs to spend one year in Ecuador! We do not want to spend that much time as we have family abroad and love to spend summer with them. Any suggestion about cutting the expense for visa off? Thanks

    • Grace Velastegui Oct 16, 2017, 3:30 pm

      Because you are Ecuadorian you do not need to show proof of health insurance. In the case of your husband if he enters the country as a tourist he should only show insurance that will cover him for the time he will be in Ecuador. When your husband obtains the Temporary Residence ($ 450) will be required to present proof of insurance that covers him for the full time.
      To answer your question regarding the options to cut expenses our recommendation is for your husband to come as a tourist and request extensions whenever he wants to stay more than 90 days. Another option would be to apply for citizenship based in the marriage with an Ecuadorian citizen, as long as he meets the requirements. We will be happy to assist you with any process you require.

      Grace Velastegui
      Attorney at Law


  • Jean Marie Mayer Oct 14, 2017, 3:12 pm

    I have found that Allianz was the best for international travel insurance and very reasonable.
    Check it out.

  • Mark Kashmar Oct 14, 2017, 2:35 pm

    I have a question about insurance. I have blue cross blue shield through a state teacher retirement plan. Does this meet current requirements for travel in Ecuador?


    • Dena Jo Kanner Oct 15, 2017, 8:30 pm

      Only if the insurance covers medical expenses in Ecuador.

  • Kristy Oct 14, 2017, 2:23 pm

    Hasn’t the IESS insurance gone up to over 15% of an expat’s income? Up from $83 per person and $12 for spouse? This is a HUGE increase! While we planned on moving to Ecuador this has made us consider Panama or Mexico as our retirement destination. Also, what are the costs of the private insurers within Ecuador? Is IESS the ONLY option for expats? These are things I would like to know.

    • Grace Velastegui Oct 16, 2017, 3:34 pm

      You also have the option to buy private insurance, there are plans beginning in $110 per month for senior applicants and less for younger applicants.
      Grace Velastegui
      Attorney at Law


  • Robin Oct 14, 2017, 1:49 pm

    Retired ~ 70 yrs. old ~ Does my Humana Health plan cover me on a trip , or during possible residency ???

    • Grace Velastegui Oct 17, 2017, 2:59 pm

      If your Humana covers you internationally. You need to contact them directly for clarification on their coverage.

  • Samantha Oct 12, 2017, 5:35 pm

    Re: “That being said, the government is legislating the health and safety of it’s residents and that is a noble objective.”

    Not true at all as it only applies to non citizens. That leaves about 16 million Ecuador citizens who aren’t required to have health insurance.

    • Bryan Haines Oct 13, 2017, 7:37 am

      You’re right. I’ve adjusted the post to read “foreign residents” which was the intent of the original statement. I took a quick look and the number of IESS insured Ecuadorians stands at 2,207,000 (2016). This number has been decreasing over the last few years. Of course, there are many who also opt to insure with a company in the the large private insurance industry.

  • Rebecca Oct 10, 2017, 11:33 am

    Very well written, Bryan. Thank you for the clarification.

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