Health Insurance in Ecuador
From the government IESS system at $80/month to premium international plans with global coverage — compare all your options in one place.
Important: IESS enrollment is mandatory for visa holders
All Ecuador visa holders must enroll in IESS (social security) within 30 days. Many expats use IESS as their base coverage and add a private plan for faster access to top hospitals. IESS costs approximately $80/month and covers pre-existing conditions.
At a Glance
Quick Comparison
| Provider | Type | Monthly Cost | Coverage | Rating | Pre-existing | Direct Billing | Visa OK |
|---|---|---|---|---|---|---|---|
IESS (Social Security) Budget-conscious expats who want visa compliance and basic coverage | Local | $80–$120 | Unlimited (within IESS network) | 3.2 | |||
BMI / Generali Global Health Expats wanting top-tier private hospital access with international standards | Int'l | $250–$600 | $1M–$5M | 4.5 | |||
Seguros Equinoccial Residents who want a trusted local insurer with multi-product convenience | Local | $100–$350 | $50,000–$500,000 | 3.8 | |||
Liberty Seguros (formerly Latina Seguros) Homeowners and drivers wanting a strong local insurer with international backing | Local | $90–$300 | $50,000–$300,000 | 3.6 | |||
Seguros Sucre Budget-conscious residents wanting basic coverage at the lowest price | Local | $70–$250 | $30,000–$200,000 | 3.0 | |||
Cigna Global US expats wanting seamless coverage between Ecuador and the US | Int'l | $300–$800 | $1M–Unlimited | 4.3 | |||
IMG (International Medical Group) Mid-budget expats wanting international coverage without premium pricing | Int'l | $150–$450 | $500K–$8M | 3.9 | |||
SafetyWing Nomad Insurance Digital nomads and young expats on a budget needing basic travel medical | Int'l | $45–$85 | $250,000 | 3.7 | |||
Pacific Prime Expats who want expert help comparing multiple international insurance options | Int'l | $200–$700 | Varies by plan selected | 4.0 |
Decision Framework
How to Choose Your Health Insurance
Budget-Friendly
$80–$150/mo
IESS alone or IESS + basic local plan
- IESS mandatory enrollment (~$80/mo)
- Covers all pre-existing conditions
- Longer wait times for specialists
- Add Seguros Sucre for extra coverage
Mid-Range
$200–$400/mo
IESS + local private or IMG/SafetyWing
- IESS for base + visa compliance
- Private plan for faster hospital access
- Seguros Equinoccial or IMG recommended
- Good balance of cost and coverage
Premium
$400–$800/mo
IESS + BMI/Generali or Cigna Global
- Direct billing at top private hospitals
- Global coverage for travel
- English-speaking support
- Best for retirees and families
Detailed Reviews
All Health Insurance Providers
Click any provider to see full pros, cons, hospital networks, and details.
IESS (Social Security)
Ecuador's national social security system. Voluntary enrollment available for foreign residents. Provides access to IESS hospitals and clinics nationwide. Required for visa renewals.
Monthly
$80–$120
Coverage Limit
Unlimited (within IESS network)
BMI / Generali Global Health
Premium international health insurance formerly known as BMI. Widely used by expats in Ecuador with strong hospital networks in Cuenca, Quito, and Guayaquil. Part of the Generali Group.
Monthly
$250–$600
Coverage Limit
$1M–$5M
Seguros Equinoccial
One of Ecuador's largest and most established insurance companies, now part of Zurich Insurance Group. Offers comprehensive health, auto, home, and life insurance products.
Monthly
$100–$350
Coverage Limit
$50,000–$500,000
Liberty Seguros (formerly Latina Seguros)
Part of Liberty Mutual Group. Strong in auto and property insurance, with growing health insurance products. Well-established in the Ecuadorian market.
Monthly
$90–$300
Coverage Limit
$50,000–$300,000
Seguros Sucre
State-owned insurance company of Ecuador. Offers very competitive rates on health, auto, and life insurance. Popular for SOAT (mandatory auto insurance).
Monthly
$70–$250
Coverage Limit
$30,000–$200,000
Cigna Global
Major US-based international health insurer. Offers comprehensive global health plans with strong coverage in Latin America. Well-suited for expats maintaining ties to the US.
Monthly
$300–$800
Coverage Limit
$1M–Unlimited
IMG (International Medical Group)
Indianapolis-based international insurance specialist. Popular for medium-term expat health plans and travel medical insurance. Good mid-range option between local and premium international.
Monthly
$150–$450
Coverage Limit
$500K–$8M
SafetyWing Nomad Insurance
Digital-first travel medical insurance designed for digital nomads and remote workers. Subscription-based model with no long-term commitment. Popular with younger expats.
Monthly
$45–$85
Coverage Limit
$250,000
Pacific Prime
Global insurance broker that compares and sells plans from multiple international insurers. Helpful for finding the right plan through a single advisor. Strong expat focus.
Monthly
$200–$700
Coverage Limit
Varies by plan selected
Common Questions