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Health care in Ecuador just got a whole lot easier

Ecuadorian flag on top of Santa Ana hill with a church and the city of Guayaquil visible in the background in Ecuador.
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Ecuadorian flag on top of Santa Ana hill with a church and the city of Guayaquil visible in the background in Ecuador.

For more than three years, my wife, Rita, and I have lived in Ecuador without any form of Ecuadorian health insurance. When we first arrived, we checked into getting private plans, but we found them to be a little difficult to use, and questioned whether they were worth the expense.

After all, healthcare for most common problems in Ecuador is inexpensive. You can buy all but heavy pain medication without prescription in any farmacia, and doctor's office visits are often only $20 or so—we even have a couple of doctors in Salinas who make house calls. We can get blood work done cheaply and without a doctor's orders. Just walk in to one of the many labs around town, choose from a menu of tests, and get results the same day.

You can choose your tests a la carte for $1 to $2 each, or select a group of tests like cholesterol screening for a discounted total. Generally, a full blood workup for us costs about $30. Even visiting the larger clinics and hospitals in the big cities is very affordable. The costs of operations, hospital stays, and physical therapy are less than half that of the same procedures back in the U.S.

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We had never checked too closely into the government offered Instituto Ecuatoriano de Seguridad Social (IESS) health plan for two reasons: first, we wanted to be able to choose our own doctors and facilities rather than accept the state-run options, and second—I have to admit—it just seemed like a bit of a pain. Waiting in line at a public services office is never a lot of fun, and it seems like there are always additional forms you need to complete, or other reasons why you must return two or more times before you have jumped all of the hurdles.

So when we started hearing rumblings of a new law that would make it mandatory to carry some form of insurance in Ecuador, it was a pleasant surprise to me when I took a new look at signing up for IESS.

The big change since I first looked into it three years ago is that you no longer have to go down to the office. The entire procedure can now be completed online.

Expats with a modest amount of Spanish language skills (or just Google Translate on their web browsers) can now go to the website to sign up for insurance, arrange for automatic debit payments, and even make medical appointments. I took a little test drive, and was able to sign up myself and Rita in about 15 minutes.

The fees involved for a married couple, at the time I write this, are $66 for the first person, and an additional $12.79 to extend coverage to the spouse. The total monthly charge then for two is $78.79. Of course, depending on how you choose to pay, there may be small additional fees involved, anywhere from 35 cents to a dollar or two.

The process was pretty simple. You just enter in your cedula (national identity card) number, and the system pulls up your name. Answer a few simple questions, choose some security answers (be sure to record your answers somewhere for later use—Ecuadorians are serious about online security), and if appropriate, add the cedula number for your spouse. You can then print out a Certificado de Afiliacion, which confirms your name, cedula, signup date, and cost of coverage. You now have 30 days to make the first payment, or you get dropped from the rolls and have to apply again. You can pay using your bank, Western Union, or even set up automatic payments on the IESS website if you have an Ecuadorian debit card. After three months of paying into the system, you are eligible to start using the IESS medical services.

So if you've been on the fence like me when it comes to signing up for healthcare in Ecuador, take notice; there is now an easier way to take care of your health insurance needs, quickly and efficiently, from the privacy and comfort of your home.

Commentary by Jim Santos, a coastal correspondent for International Living in Ecuador. Follow him on Twitter at @jimsantosblog.

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