Most expats are pleasantly surprised with the medical system in Cuenca, especially the quality of care. Medical costs are one-tenth of what they are in the States and the hospitals are state of the art. Eoin Bassett, editor of International Living, explains, “Ecuador has once again topped our Index as the number one retirement destination on the planet, and its low real estate and living costs were the key factors.” However, even with “bargain-basement prices” and low medical costs, there are a few tips to keep in mind as you negotiate your way through the medical system in Cuenca.
Doctor Appointments
Many of the doctors in Cuenca were trained in the States and know some English. If not, you may want to bring along a translator for ten dollars an hour to help you through the language barrier. Most medical offices work on a “show up” and “get in line basis.” Some offices give you preference if you call the first thing in the morning and request an appointment. Office hours are usually from 9:00 a.m. to 11:00 a.m. or 3:00 p.m. to 6:00 p.m. If you want one of the first appointments, it’s best to show up about 30 minutes before the office opens. The receptionist will take your name and give you a number which will be your “turn in line.” You will then give her $20-$25 cash for the office visit. Some specialists may be a little more expensive, but usually never more than $30.
When your name is called, just present your piece of paper to the nurse (or doctor). If you’re seeing the doctor for the first time, he will take your medical history and enter it into his personal files or computer system. Unlike in the States, you own your medical records and the doctor has to ask permission to see them. There are no copious medical forms to fill out and no medical confidentiality statements to sign.
An average visit will last about 30 minutes and if you need a follow-up visit (“controlo”), there’s no charge as long as you’re seeing the doctor for the same problem. Best of all, doctors in Cuenca still make house calls! Can you imagine that happening in the States?
Medical Insurance
About 75 percent of expats don’t have medical insurance and prefer to pay out of pocket. The other 25 percent either have international medical insurance or go with one of the medical insurance companies in Cuenca. And still others, who are Medicare age, return to the States for their medical care. One expat explained, “I realize the prices are ‘cheap’ in Cuenca, but what if I need a heart transplant?” Exactly! None of us knows what tomorrow will bring and unless you have a lot in savings, it’s best not to risk having no insurance at all.
If you’re 55 years and younger, the medical insurance policies are less expensive and go up incrementally with age and with the amount of insurance you purchase. For example, a couple can have a middle-of-the-road policy for approximately $85 a month which includes 70-90 percent reimbursement for medications, 25 percent off on office visits, and 80 percent reimbursement on hospitalization. Salud and Humana (NovaEcuador) are the major health insurance carriers in Cuenca.
An average day in the hospital with tests, doctor visits and a single suite will set you back about $200. The larger private hospitals, like Monte Sinai, Santa Ines and Hospital del Rio have a representative that will fill out the paperwork for you. When you’re released from the hospital, you’ll have the option of paying with cash or a credit card. After your claim is processed (approximately one month), you will receive a check in the mail or it will be delivered to your home by courier.
Cuenca works on a third-party system, so paperwork needs to be filled out in order to be reimbursed for medication, medical procedures or hospitalization. If you need a prescription, your doctor will fill out a simple form that you present to the pharmacy. Once they have you in the system, you will automatically receive the discounted price on your medication (usually a 70-90 percent discount depending on whether it’s trade or generic).
Hospitalization
If you happen to be employed in Cuenca and have your cédula (national identification card), you have all the rights and privileges of an Ecuadorian citizen. In that case, your workplace has the legal obligation to pay for your medical coverage (IESS) and Social Security. Many expats who teach English at one of the universities or language schools are pleasantly surprised that medical care is free through the national healthcare system (IESS).
Conclusion
If you’re contemplating Cuenca as your retirement destination, you’ll find that negotiating the medical system is simple, uncomplicated and personal. The doctors in Cuenca aren’t concerned about their pocketbooks; they genuinely care about their patients. There is little or no overhead as they don’t have the paper trail that has caused medical costs to escalate in North America. Negotiating the medical system in Cuenca is simple and one of the greatest perks of living in the “emerald” of South America.
Sources
International Living Retirement Index, News JunkyJournal.com
With the Right Choices Medical Care is Excellent in Ecuador, CuencaHighLife.com
The World’s Best Places to Retire, MoneyCentral.msn.com