Melinda S. Says:
Hi IL,
I’m considering a move to Cuenca, Ecuador in the next couple of years. I visited the city in 2022, and I love the whole vibe there.
The issue is, I’m asthmatic. The air was clean and I had no problems breathing when I was there. In fact, I felt better than usual. But it’s a lifelong condition and, when it gets bad, I sometimes need to visit a doctor for meds and treatment.
Do you have any insight into GP care in Cuenca?
IL Ecuador Contributor Donna Stiteler says:
Hi Melinda,
When I first moved to Cuenca, Ecuador, I started asking expats what they did for health insurance and was shocked when most answered, “Nothing.” But with healthcare in Ecuador being 80% cheaper than in the United States, you really don’t need insurance.
Because I am highly allergic to animals yet have four dogs and a cat, my first venture into paying out of pocket was going to an allergist.
I walked to the nearby Mt. Sinai Hospital and found an allergist by picking from the list of specialists pinned on a large lobby wall. I walked up to his office, made an appointment with the receptionist, and paid $40 for a consultation.
Again, no referral necessary or hoops to jump through to get the appointment. Fifteen minutes later, I was sitting in the doctor’s office, where I received a prick test and got a shot.
The prick test, prescriptions for an inhaler and asthma meds, the vial of medication, and shot added $50, bringing the total cost to $90.
Within 30 minutes, I walked out of his office breathing easily again for the first time in months. I still frequently use the out-of-pocket approach for my healthcare because of its low cost and easy access.
Eventually I signed up for IESS, the government’s medical program, which took me less than an hour to enroll in. The process consisted of waiting in line at their downtown office, a brief interview with an enrollment officer, and showing them my cédula (ID card).
It was that easy, and the program costs me $84 a month (though you could pay as little as $64). My plan was to use IESS for costly emergencies, and for the sake of convenience, continue to pay out of pocket for minor problems.
I first used IESS for my annual general checkup, which covered blood lab work, a mammogram, a pap smear, meetings with a general practitioner, and a gynecologist. My cost? $0.
That included prescription medicines and ultrasounds.
I waited only a few days for my appointments and was shocked when doctors handed me my lab work and ultrasounds. You own your own records in Ecuador—not the doctor, and keep all the results at no cost, so it’s easy to get a second opinion.
In other words, you can plan your own healthcare without waiting or qualifying through a medical system.
Imagine a place where if you wanted to check your A1C for type 2 diabetes, you can do so by just walking to a downtown laboratory and requesting the test, which will run you no more than $30.
If you have an infection and need antibiotics, you just go into a pharmacy and ask for it—you need a doctor for the initial prescription, but you can refill it indefinitely over the counter without having to go back to the doctor. I keep a box of antibiotics on hand, and refill it when I get low.
Or, as was my case, if you have a bronchial infection so bad that you can’t breathe, you just walk into a hospital, pick out a specialist, and have your appointment and treatment the same day and pay out of pocket.
If you want to do all of the above for free, just set your appointment with IESS. I use a medical translator, Diana Vera, to do the heavy lifting of appointment setting and translations. That runs me around $20 per appointment. I feel it’s worth it, as she also picks up my free medications and drives me to my appointments.
When asked by newcomers about healthcare, I freely share my positive experiences with IESS and out-of-pocket care. I can see the disbelief in their eyes, but they soon find out how inexpensive and reliable the medical treatment is in Ecuador.
They too eventually end up touting the benefits of living in a country where medical care is affordable for all.Overall I find my life in Ecuador to be healthier, happier, and more affordable.
You can read about how moving here saved my life in this article I wrote for IL magazine.
Got a Question?
Send your thoughts to mailbag@internationalliving.com. We’ll post and respond to as many of your emails as we can right here in the e-letter.