On August 3rd, new legislation was passed affecting visa and insurance plan requirements for foreigners and tourists coming to Ecuador. Ultimately, the new requirement for insurance plans is a good thing, as plans ensure that the patient will be covered for a variety of situations, everything from dental cleanings to emergency care. There are plenty of options available: public care in Ecuador (IESS), private care in Ecuador, domestic insurance from a home country, or insurance from travel organizations. This article is a brief overview of the healthcare system in Ecuador, changes to visas, and insurance options.

Healthcare in Ecuador: An Overview

In the last 10 years, Ecuador has seen huge improvements to the number and quality of hospitals and clinics in the country; along with these improvements came a boom in medical tourism-- people coming here for medical and dental operations that they couldn’t afford in their home countries. So why come to Ecuador? Namely, the cost.

The cost of procedures in Ecuador runs 10-30% of those in the United States. The doctors are also highly-trained-- many of them studied in universities in the US, Europe, or other Latin American countries. Many of them speak some level of English as well.

Healthcare Systems in Ecuador

There are two types of public health care systems as well as private healthcare in Ecuador. The public social security healthcare system is called IESS; a nominal monthly fee (roughly $60) buys you access to hospitals, doctors, and medicine. The IESS plan covers the cost of everything, and there are no restrictions on age or preexisting conditions.

The second public healthcare system is free to all citizens, but with that comes some restrictions on the medicine, vaccines, and services available. This option is now no longer available to residents or tourists, but when a resident obtains citizenship, it becomes available.

The third option is private practitioners; many of them are still a fraction of the price of US doctors. Specialists for all types of procedures can be found in Quito, Guayaquil, and Cuenca. However, just because a clinic is private doesn’t guarantee that it is superior to public institutions. It’s important to research reviews of the doctors and facilities in advance. For a detailed read on the systems and prices of healthcare in Ecuador, read this article in CuencaHighlife.

The New Health Care and Visa Law

Presidential Decree No. 111, signed by President Lenin Moreno, includes the Regulation of Human Mobility Act, essentially a new outline of visa requirements for tourists and foreigners coming to the country. Visa laws change frequently in Ecuador, so it’s vitally important to read the most recent visa information before planning a trip to scout properties or embarking on your big move down south. A great overview of this new law and all of the new visa requirements (in English!) can be found here.

Tourist Visa Vs. Resident Visa

Temporary visitors, aka tourists, can come to Ecuador for 90 days without getting the visa in advance. Those 90 days can be renewed each year. Residency visa holders are now broken into two categories: temporary and permanent. The temporary residency visa is for 2 years and it covers a slew of categories: student, volunteer, missionary, work, etc.  A permanent residency visa can be obtained after 21 months as a temporary resident. After 3 years, permanent residency visa holders can apply for citizenship.

Article 30: Health Insurance Requirements

“In order to maintain temporary or permanent residence in Ecuador, all foreigners must have public or private health insurance, valid for the length of time the foreigner is authorized to stay in Ecuador. This insurance should be shown to the Human Mobility authority within 30 days of the issuance of the visa. Once the foreigner complies with this requirement, the Immigration authority will grant a cédula order, allowing the foreigner to obtain a cédula before the civil register.”

The stipulation also applies for tourists coming to Ecuador-- they must have an insurance plan for the length of their stay in the country. This is important information to pass on to anyone visiting you.

Permanent Residency Visa

To apply for IESS health care in Ecuador, a cédula (Ecuadorian documentation) is required. For permanent residency visa holders, you will receive a cédula within the first few weeks of starting your visa and you’ll then have 30 days to sign up for IESS or another insurance plan.

If you already have a permanent residency visa, then you will be contacted by the government office closest to you as to when you need to get your insurance plan. So, in the meantime, sit tight and think about options.

Temporary Residency Visa

For temporary residency visa holders, you do not receive a cédula, meaning that you will have to find an alternative insurance plan to IESS. Healthcare options include insurance from a home country, travel insurance from a variety of organizations (check out Seven Corners or this list in Frommer’s) or a private insurance plan in Ecuador.

Wrapping It Up

In conclusion, the government of Ecuador wants to ensure that people who are passing through the country or who are coming here to live or work are covered should anything happen. The new articles in the law exist to protect foreigners, as well as to guarantee that the Ecuadorian healthcare system won’t be financially drained. It’s important to have a printout or card of your insurance plan on you at all times, especially when traveling to and from the country, as there are monetary penalties for not adhering to the requirements of your visa.

As a final note, this new law is still very much in transition. Always check with the consulate office or government officials for detailed information as to the specifics of your particular situation. Lots of the details are ambiguous as the government figures out how to best implement all of the new requirements. It’s also encouraged if a government official tells you something that seems contradictory to the law (like how many days you can stay in the country each year), that you get a piece of paper with that information signed and notarized as proper documentation. You’ll have to be your own best advocate in the next few months as the law becomes the norm, but all you need to do is a little research before embarking on your adventure of Ecuadorian living.