Ecuadorian Health Insurance Matters for Expats

Jan 2, 2023

When contemplating their relocation to Ecuador, or even when already here, it’s common for Expats to overlook or consider as an after-thought the issues related to Health Insurance in Ecuador, and the still fairly new requirement of the Ecuadorian Government by virtue of the 2017 law known in Spanish as the “Ley de Movilidad Humana” (in English that being the “The Human Mobility Act”), that every single foreigner Resident must at all times be insured in Ecuador with what is specifically referred to as “full health insurance coverage”, that term essentially being defined as any/all costs related to one’s health/medical appointments, emergencies, exams, interventions, labs, operations, prostheses, surgeries, testing, therapies, etc., being absorbable and therefore paid/payable on behalf of any Expat via a written Health Insurance Contract that is held and maintained by the foreigner with a qualified Insurer that covers them fully while in Ecuador (or even as the case may be while abroad/overseas) – see here for a link to a recent article that I wrote and published on “CuencaHighLife” for a more in-depth explanation of the New Ecuadorian Immigration Law for Expats moving to Ecuador. That said, the ORIGINAL stricter portion of the first above referenced law requiring EVERYONE (i.e. ALL Tourists, Residents & Citizens of Ecuador) needing Proof of Health Insurance to be able to ENTER/RE-ENTER Ecuador via any Ecuadorian port of entry (i.e. Airport, Land Border Crossing, Seaport, etc.) has now for all intents and purposes been FULLY ELIMINATED, which my immediate above statement per same is more comprehensively detailed, expounded upon and further clarified as per the fine print of the amendment/modification to the law, in this recently published article on “CuencaHighLife” affirming same (i.e. note that persons wishing to visit the “Galapagos Islands” WILL STILL in any case need to furnish Proof of Health Insurance in order to be able to do so at any/all times).

And so now, this article shall dive right into the details of what passes muster per the intents of qualifying any form of Ecuador Health Insurance Coverage, in the eyes of the Ecuadorian Immigration Ministry for Temporary Residency Visa & Permanent Residency Visa purposes, as well as later on with regards to qualifying to apply for Citizenship/Naturalization – FYI, your Ecuadorian Visa Attorney should be able to provide you with a high quality introduction (referral) to an English speaking Ecuadorian Health Insurance Broker (that being preferable to an Ecuadorian Health Insurance Agent who only represents one single health insurance company), so that at all times you remain in compliance with the herein discussed Health Insurance rules while living in Ecuador, and also don’t hesitate to request in ANY case that I provide that such FREE information to you upon your sending me an email asking for such a complimentary referral at for your/your family’s own protective benefit.

Thus, firstly, it’s important to note that there are two (well technically three) forms of Health Insurance available in Ecuador, each described as follows:

  1. Private Ecuadorian Health Insurance – this is generally contracted from or via an Ecuadorian Insurer (i.e. Confiamed, Humana and Salud SA are some Private Health Insurance Company options that come to mind per this type). The Ecuadorian Immigration Ministry has a list of Private Health Insurers in Ecuador that it considers to be providers of full coverage policies, and that such list is/will be amended and updated at any time in the discretion of the Ecuadorian Immigration Ministry; here’s the link to see that such ever changing and evolving list of approved Ecuadorian Health Insurance Companies which is current as of the date of this article’s publishing and will surely change again in the future at the whim of the Ecuadorian Immigration Ministry.
  2. Public Ecuadorian Health Insurance – this is generally provided per the Ecuadorian Government’s Health Plan, known as “IESS”, which for those foreigners who have serious preexisting conditions this is often a necessity (though not necessarily the best or most preferred option for those who have little to no preexisting conditions).
  3. *Foreign Health Insurance* – this is generally health insurance that an Expat ALREADY had/has prior to moving to Ecuador, and which their foreign health insurance covers them in Ecuador, regardless of whether it’s through a foreign Private Health Insurance Company (i.e. Aetna, Blue Cross Blue Shield, Cigna) or rather their foreign Government per their past service for it (i.e. FEHB, TRICARE, and certain other Government Healthcare Providers).

Of the immediate above referenced most common forms of Health Insurance, I have found in my experience that most Expats are usually happiest with the first above referenced form of Health Insurance – though once more, IESS is often vital for those foreigners having serious preexisting conditions, because those aren’t/won’t typically be covered by any Ecuadorian Private Health Insurer or even Foreign Private Insurer for a 2 year period. One of the most important reasons why Expats usually prefer Private Health Insurance over IESS is because of the freedom and rapidity with which the Expat can choose and go to their own desired Doctor in Ecuador (or even form of Doctor) and other type Medical Professionals, in addition to those of their own selection generally being of the English speaking variety and/or whom were educated and exposed to their chosen line of medicine and type medical practice in another country, such as the US, Canada, Europe or another advanced/first world country (not to mention the lack of waiting time for approvals or to be seen by their Doctor, absence of bureaucracy in coordinating and scheduling procedures and the like, inability to communicate with the same medical professional again or in English rather than in Spanish, etc.). And while Foreign Health Insurance can often above the rest be the most desirable to an Expat (assuming that the foreigner already had/has it in force prior to relocating to Ecuador), it can at times and in various instances be more difficult to use here in Ecuador as well as in proving its validity (i.e. getting its usually English documents certified with an Apostille or Legalization) to the liking of the Ecuadorian Immigration Ministry. And so, consulting with your Ecuadorian Immigration Attorney is usually a wise thing to do in advance of deciding upon which form of Health Insurance will best suit or be most usable by you and for purposes of your medical needs while living here in Ecuador.

While every Resident of Ecuador (whether as a Temporary Resident or a Permanent Resident) is supposed to have health insurance that provides the again first above described full coverage to them here in Ecuador at all times, the question of whether anyone will check or be able to punish an Expat for not having health insurance that covers them in Ecuador, the somewhat non-sensible answer to that is technically no (at least as of the writing of this article), as essentially just if/when a foreigner might need to do any future process(es) at/with the Ecuadorian Immigration Ministry is when they would AGAIN need to re-enroll with either an Ecuadorian Private Health Insurer or IESS, so as to (again/anew) cover them here in Ecuador so that such (then) future process can/will be done and completed (at which point thereafter once more no one as of the current law or way of doing things in Ecuador checks on or is presently [logistically] able to punish an Expat for not having health insurance).

All told per the above with respect to Ecuadorian Health Insurance, foreigners need to be and stay aware of what their options as well as requirements are per this most important matter when residing in Ecuador, as it both serves to their own personal benefit as well as to remain in compliance with the rules of their new country, which of course like any other nation has the obligation and right to manage and see to its finances so that (arguably) the largest standard regular expense that is directly attributable to the care and maintenance of its Citizens and Residents doesn’t/won’t cause or be the reason for others (i.e. immigrants) to become a burden or expense of the state in lieu of them paying for that such (universally) coveted benefit.

Attorney Sara Chaca

Sara Chaca (Attorney - Abogada) is a seasoned Ecuadorian Lawyer, who principally serves Expats in making their moves to Ecuador for Visa and Legal matter purposes, as her Expat clients begin their new lives here in her beautiful country. Sara resides in Cuenca with her family, and when not working, she enjoys spending time with her family in Cuenca’s majestic Cajas Mountains, including the many local parks & fairs of Cuenca, plus visiting the coast as well as many gem towns of Ecuador. Sara’s personal email address is and her law office's fully informative website is - her Ecuadorian cell phone number is 099-296-2065 and her Toll Free "800" phone number for US & Canadian callers is 1-(800)-655-1581. Sara has a less than 24 hour first response policy, in that if you email or call her, she WILL return your first email or first phone call in less than 24 hours (more typically in closer to 24 minutes!). Most importantly, all first time consultations with Expats for any type Visa or Legal matter(s) are always FREE OF CHARGE. VIEW ATTORNEY SARA CHACA'S SELF-PUBLISHED "KINDLE" BOOK ON MOVING TO ECUADOR, THAT'S AVAILABLE FOR YOUR PERUSAL ON AMAZON.COM HERE.

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