How does healthcare work for expats in Ecuador?

Ecuador offers a dual public-private healthcare system. As a resident, you can enroll in IESS (Instituto Ecuatoriano de Seguridad Social), the public system, for approximately $70–90/month depending on your visa category. IESS covers doctor visits, hospital stays, prescriptions, and many procedures with minimal co-pays. Most expats also use private healthcare, which is extremely affordable by international standards — a specialist visit costs $50–80, a blood panel $30–50, and a private hospital room $80–150/day. Major cities have excellent private hospitals. Ecuador does not have a public health insurance mandate for visa holders, but you need private insurance or IESS enrollment to access care efficiently.