Top Private Health Insurance Plans for Expats in 2025
For the expat who has weighed the options and decided on the speed, quality, and flexibility of the private system, the next step is choosing a provider. This is a critical choice, as your plan will be your partner in navigating your health in a new country.
The market is generally divided into two main categories, and the right one for you depends entirely on your lifestyle.
- Local Ecuadorian Plans These plans are offered by Ecuadorian companies and are perfect for expats who plan to live full-time in Ecuador. They offer excellent, comprehensive coverage withinEcuador but little to no coverage if you travel abroad (though some may offer a limited travel rider). Because they don’t have to cover the hyper-expensive US medical system, their premiums are significantly lower.
- SaludSA: This is the “big one.” As one of Latin America’s largest health insurance companies, SaludSA is a popular and trusted choice for expats. A typical policy for a 60-year-old costs as little as $70-$72 per month. A common plan structure covers 80% of doctor visits, 100% of hospitalizations, and 60% of medications.
- BMI (Blue Medical Insurance), Confiamed, and Vida Buena: These are other popular local carriers that are well-regarded in the expat community. Many expats use a “gap” strategy, buying a very low-cost plan like Vida Buena (around $39/month) to cover the deductibles of a larger, high-deductible plan.
- Other Local Providers: The market is robust, with many other names like Ecuasanitas, Latina Salud, and Cruz Blanca available.
- Global International Plans These plans are more expensive, but they are portable. They are designed for the “global citizen”—the expat, the “snowbird,” or the remote worker who spends time in multiple countries. They typically cover you worldwide, with the crucial exceptionof the United States. Adding US coverage will cause the premium to skyrocket, so most expats exclude it and rely on travel insurance or Medicare (if they keep it) for short trips home.
- Cigna Global: A top choice for US expats, Cigna offers worldwide coverage (ex-US), access to a massive, trusted global network of doctors, and 20/7 customer support.
- Allianz Care: A world-leading provider for expats, Allianz boasts a network of over 1.9 million medical providers and high maximum benefits (up to $5 million).
- Bupa Global: Another giant in the field, Bupa offers tailor-made plans, guaranteed lifetime renewal, and 24/7 medical help via virtual care.
- Other Major Players: AXA Global Healthcare , NOW Health International , and IMG are also excellent, full-featured options.
The Single Most Important Piece of Advice: Use a Broker The web of local vs. international plans, deductibles, co-pays, and waiting periods (especially for pre-existing conditions) can be overwhelming, even in English. The single best thing a new expat can do is use a bilingual, Cuenca-based insurance broker. An expert broker (like Carlos Ramirez of Blue Box or Daniela Cordero of Cuenca Expat Insurance, who have been featured in many expat resources) understand both the IESS and private systems inside and out. They can help you navigate the options, compare the fine print, and ensure you don’t have dangerous (and expensive) gaps in your coverage. They cost you nothing—they are paid by the insurance company—and their expertise is invaluable.
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