Besides the financial problems of the IESS, now there are political issues that do not allow an agreement to be reached on how to manage public health in Ecuador.
The health system has been declared an emergency for some time now; and it is a priority issue for the National Government. Debts with private hospitals are still pending, doctors who worked at the IESS are resigning because they do not receive their salaries, there are not enough medicines, etc. As a result, the situation of the IESS is far from improving.
However, IESS can be useful for basic medical conditions such as: annual check-ups, pre-existing coverage (if they have the medicines or treatments, otherwise these must be purchased by the patients), simple blood tests, X-rays, endoscopies, etc. But if complicated illnesses occur, it is better to attend a private hospital to receive better care.
Expats and Ecuadorians who are affiliated with the IESS should consider complementing their coverage with a private insurance policy, or only enroll in private insurance. For example, a severe case of pneumonia and that requires Intensive Care Unit treatment; IESS maybe cannot offer it because of the lack of medical supplies. In that case you have no choice to go a private hospital for your treatment, and the bill will be very expensive. That is when you need a private insurance
Having only IESS coverage is like playing Russian roulette, our health and life is not a game, so we must review health insurance options that really give us peace of mind.
If you want to discuss about it, contact us!

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Daniela Cordero