Hi Alan,
Things have not really changed much on the costs of IESS coverage – only that expats are now required to provide proof of income to set their fee. The rates for IESS coverage are based on the income claimed. The primary enrollee (and it can be either spouse) will pay a monthly fee equal to 17.6% of their income. A spouse and other family members may be added for an additional 3.41% per month. So if you have a pensioner’s visa for the minimum amount ($800 + $100 for dependents), your monthly fee as a couple would be $168.08.
Keep in mind two things: first, it can be based on either spouse’s income. So in the example above, if you get your pensioners visa based on your $900/month social security, and your wife gets only $600/month, you could use her income as the base. Secondly, you do need to show all of your income if you have money coming from more than one source. It just has to be a steady monthly amount that you can document.
The coverage is for 100% (no co-pay) of your medical, dental, and eye care needs. This includes all visits, procedures, and medication prescribed by your IESS doctor. The down side is that if you are in an area with few IESS facilities, you may have to wait for an appointment.
Hope that helps, you could also check out https://members.internationalliving.com/country_clubs/ecuador/health-care/ for more information.
-jim
Salinas, Ecuador
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