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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
Update (April 16, 2018): Beginning May 1, 2018, all travelers will have to produce proof of health insurance as an entry requirement. Here is the official government announcement.

Ecuador Health Insurance Requirements

This post is divided into two sections. Here are the short answers:

  1. Expat requirements: All Ecuador residents (permanent or temporary) require health insurance. This can be through public IESS or private company.
  2. Traveler requirements: All travelers to Ecuador require proof of health insurance as an entry requirement.

Need travel health insurance? Check out our set of recommended health insurance providers

Now, here are all the details.

“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 May 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 (but it will be in May 2018). That being said – a little insurance is never a bad idea.

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 Travel.

60 comments… add one
  • Jeff Feb 29, 2020, 8:22 pm

    My wife and I have residency Visas for living in Ecuador. We already have insurance in the United States that we are affordable healthcare act demands we carry. We used to have insurance here through belginica, But I hear they went under. The insurance mentioned on the site seems to apply for Ecuadorian residence expats who are traveling outside of Ecuador, what do we need anything inside the country, and what are some suggestions. AnxiouslyWaiting for your response thank you.

  • Steve Froess Jan 1, 2020, 9:35 pm

    Which document(s) will suffice?
    * Medical insurance card I have through my employer?
    * Travel insurance (Allianz)?
    * Global Rescue?

    What ‘proof’ do they need?
    * A card?
    * A paper?
    * The whole stack of papers that is ‘the policy’?
    * A Policy number?


  • Cindy Gonzales Sep 24, 2019, 12:28 pm

    I read something about the requirement for insurance for those traveling to Ecuador has been rescinded, only the Galapagos has it. If that is the case, an update on this story may be in order, as us folks here in the states looking to make the move need every bit of accurate info we can get! 🙂

  • Jan Moore Apr 19, 2019, 8:17 pm

    We are traveling to SA the end of April 2019 and will be in Peru, Ecuador and Gallopegos for about two weeks. Told we had to have certificate of coverage but only have certificate of insurance thru Trip Mate. The trip is thru Vantage. Which do we need? Vantage says they are the same , certificate of coverage and certificate of insurance but they are not. The coverage one is from the SSA.

  • James Fisher Dec 30, 2018, 2:26 pm

    We are coming to Ecuador January 10th. What is the status of the health insurance for travelers regulation? Our AirBNB host on Galapagos says it has been postponed until further notice…

  • Denis Haman Oct 31, 2018, 2:20 pm

    Hi, we have just bought a house in Ballenita and an American friend living there is paying only 50$ a month for the full insurance package on IESS. That is only 60$ a month. I just read of a price hike, but I just came back a week ago. He must earn 50000$ a year over there.
    Did I get the price right?
    Considering the super low price of life over there including very cheap gas, food etc… I didn’t find it expensive. We plan on moving there within a year and a half, getting everything ready.

    • Denis Haman Oct 31, 2018, 2:23 pm

      I meant 600 per year, sorry my English is not the best!

  • Lukas Aug 1, 2018, 2:07 pm

    I just bought travel insurance because I thought it would be a part of the immigration process considering that it is being called a “travel requirement” here however no one check and now I feel like I wasted $200.00 usd….

  • Nicole Gelpi Jul 15, 2018, 6:41 pm

    I intentionally added Medigap or Regence Bridge Plan G to my Plan A and Plan B Medicare package because it covers international medical emergencies. Why would I need additional medical travel insurance?

  • Jim Fisher Jul 15, 2018, 4:17 pm

    Any updates on this? Seems to be an on again, off again thing…

  • Jim Davison Apr 13, 2018, 3:39 pm

    My medical insurance (a US Medicare Advantage plan) covers me only for “emergency medical care” when I am traveling to a foreign country such as Ecuador. Is this sufficient to meet the requirements of the Ecuador requirement for “medical insurance”?

    • Thomas PEREIRA Apr 16, 2018, 10:26 am

      I’m not exactly sure just yet, but I would think its ok, but if it’s not, travel insurance can be bought for as low as 50 cents a day, and you can buy it on your smart phone off a travel insurance company in less than 5 min.

      • Jim Davison Apr 16, 2018, 12:23 pm

        I will be staying in Ecuador for 6 months. For a simple “travel” insurance policy World Nomads quoted $812 and Atlas quoted $1195. This is far too much to pay for a program that is not significantly better than my existing “emergency care” policy. I look forward to some clarification from the Ecuador government on exactly what the requirements are and what documentation they will accept. Until then I won’t travel to Ecuador. Jim

      • Norma Mearns May 2, 2018, 3:27 pm

        I can not find the web site that offers travel insurance for 50 cents per day………can you help………my problem is that I am 79 and some insurers will not insure me???

        • Bryan Haines May 3, 2018, 7:14 am

          Here are a few options that will insure all ages. You might want to specifically check out Atlas Travel Insurance.

        • Maria V Jul 27, 2018, 7:16 pm

          I am sorry that you have to get medical insurance to travel to Ecuador. I have been there several times and always have bought travel insurance with Allianz. I hope you can find something that meets your needs. Good luck!

    • John Greenhalgh Apr 23, 2018, 9:06 pm

      This question (Medicare Advantage plan w/ emergency evacuation) is absolutely crucial for American tourists. Without confirmation that a Medicare card is adequate for tourist travel, the government policy is virtually meaningless– specifically, it fails to indicate whether you need to buy a third-party, short-term travel plan if you already have Medicare.

      Further question: Does anyone know if health insurance vendors will set up shop at airports? I assume so ! Any idea what procedures will be used if someone arrives without travel insurance (e.g., 10 day grace period, on-line purchase at the airport, etc)?

  • Thomas PEREIRA Mar 28, 2018, 6:31 am

    I am an American who runs a travel agency out of Montanita Ecuador called Go Montanita. When I flied to Ecuador today I was asked for travel health insurance. I used this websites recommendation and chose Atlas. I got a $50,000 policy with a $2,500 deductible, and I’m am 33 years old and the policy only costs me $7.63 for 10 days. Less than a dollar a day, so Atlas Insurance is cheap. Check it out guys. I have a group of two surfers flying in today as well, and I have already had them purchase there policies. It seems that yes, they are asking at the airport.

    • Bryan Haines Mar 28, 2018, 1:56 pm

      Thanks for the update Thomas.

    • Larry Mustaller Sep 19, 2019, 9:00 am

      I just looked at Atlas , heres a short of the coverage

      Atlas International | Most popular plan
      $1,000,000 Emergency Medevac
      $100,000 Emergency Reunion
      $10,000 Trip Interruption
      $10,000 Crisis Response
      Download Full Policy PDF

      However it mentions NOTHING with regads to local medical care, or hospitalization coverage?

  • Reinaldo E. Cestero Feb 20, 2018, 1:17 pm

    I will be traveling to Ecuador as a tourist and I haven’t seen a reply to the following previous questions:

    “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?”

    “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.”

    Can you provide a reply to these questions about medical insurance in Ecuador?

  • Mark Turim Feb 18, 2018, 5:04 pm

    Pathetic rollout. No one knows the whys, wheres and whens. I am 70, Went together full coverage which I do not need as I am fully covered in the USA 100% with gap etc. Braces I am 70It is $400 month just for me. No good information as to when they will check. Ecuador is overrated for retirement in many ways. Many way. Flight toMedellin in 2days, no return.

    • Bryan Haines Feb 19, 2018, 9:37 am

      I agree that there have been lots of mixed signals about this requirement. But confusing policy rollouts are not unique to Ecuador. Did you ask an immigration lawyer or depend on Facebook groups for information?

      All the best in Colombia!

  • Richard Dec 27, 2017, 11:07 pm

    I didn’t see any mention of Medicare from the Social Security in the States and havent been able to confirm coverage outside the States…any info available on your end? Thanks Richard

  • 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.

    • S, M Ristau Mar 4, 2020, 2:24 pm

      Amy, I live in Ecuador over 8 yrs. Insurance is something you have to check and
      keep up with all the time here. Two of my Insurance companies went bankrupt
      never back way in advance. I added coverage for myself because I am 74 yrs old
      Humania Insurance $210.00 a month. They paid on time but we followed all
      the rules and there are a lot of rules. It has nothing to do with Humana in
      America. Its a Ecuadorian insurance. They pay 90% of hospital and 90% of
      drugs. They do handle preexisting conditions with a wait. I found the
      government hospital did not work for me for many reasons. You get what
      you pay for.

  • 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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