In Ecuador, the Insurance Agent has to be just as great as your health insurance company. We know how the insurance system works; as I say to my clients, “If you do not trust me, this is not going to work”.
It is important to notify your agent that you are going to have surgery or any kind of medical procedure in advance. That way, we can ask for “hospital credit” from the insurance company. That means, that you will only pay the copay and deductible and not the rest and later be reimbursed. That said in case you don’t ask or apply for the credit, your agent should help to fill out and organize the necessary documents in order to present your claim.
If you have an accident, and you do not need hospitalization, you should notify your agent (this is what I ask my clients) this way, your agent will know which documents you need for reimbursement, including, Form 008, claim form filled by the ER doctor, etc.
Insurance tips for claims for expats
1 Always have paper claim forms with you when you visit a doctor.
2 Always ask your doctor for a Factura.
3 The most important thing to remember is that we only have 90 days to file a claim.
3. Take a folder and put all the invoices, test orders, results, etc. and then meet with your agent to review it. Do it immediately because if any documents are missing, we will still have time to ask for it.
4. You should keep your blood work prescriptions, results, receipts (factura) with your files.
5. The results of any tests. Doctors don’t keep them as they do in the US.
If you have any questions, let me know!

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Daniela Cordero