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If you鈥檙e hospitalised in Ecuador and the British Consular Services are notified, we will try to contact you as soon as possible to see how we can help you. We will then aim to provide assistance according to your needs and how vulnerable you are.

To decide how to support you, we will consider factors such as your condition, whether you can speak on the phone, whether you are being supported by a tour operator or insurance company representative, or have relatives or friends with you.

Depending on how vulnerable you are, if you are alone and in hospital in Quito, Guayaquil or Cuenca, we will aim to visit you as soon as possible. We do not usually contact or visit people who have travelled specifically for medical treatment.

1. Going into hospital

There is a sole national healthcare system in Ecuador (鈥榮istema nacional de salud鈥�), managed by the Ministry of Health (MSP). This involves all public hospitals and health centres, which are complemented by the private sector (鈥榬ed p煤blica de salud (MSP 鈥� IESS and Police/Armed Forces) y complementaria - red privada).

Healthcare is widely available in Ecuador, but medical care outside Quito, Guayaquil and Cuenca may be limited, especially in small towns, but it is improving. Medical care in public hospitals is free. Private medical care is available, but can be expensive.

If travelling and/or living in Ecuador, it is highly advisable to obtain medical insurance.

For medical emergencies, whether involving residents or tourists, you should dial 911. Critical emergency admission is liaised by the National Police, Red Cross and Fire Brigade, through ECU911 (emergency response integrated system), available nationwide. The ECU911 emergency response integrated centre will identify the nearest available hospital and will activate the relevant liaison. Once a patient is stabilised (either in a public or private hospital/clinic) a transfer process (鈥榩roceso de referencia/derivaci贸n鈥�) will be activated. Likewise, and if applicable, a refund process (鈥榬ecuperaci贸n de costos鈥�) for patients with a private insurance.

You can download 鈥淓CU911鈥� free Smartphone Application to register for emergency assistance.

In an emergency, you are admitted to hospital through A&E (鈥楨mergencias鈥�).

When patients are admitted through the emergency room (A&E) of a private hospital, they must pay an admission guarantee fee. Please check the 鈥楶aying for your treatment鈥� for more information.

In order to be admitted to a private hospital a patient must:

• sign an admission-guarantee document (signed credit card voucher)
• undergo a medical evaluation
• given that not all foreign insurance companies are registered (under an agreement) in some private hospitals, patients may need to cover all their medical costs to then be reimbursed by the insurance company back in the UK. If so, patients are advised to keep all original bills and medical records
• if a specific insurance company has a set agreement with a local private hospital, in principle the payment of medical costs will be coordinated directly through the insurance company in the UK

Public centres/hospitals have been classified in levels of attention, from 1 to 4, starting with level 1 which is a preventative-promotional-healing care. Level 2 includes basic and general hospitals for outpatient and inpatient treatment, involving some mental health units (鈥榰nidad de salud mental鈥�). Level 3 are specialised hospitals for more complex treatment, including psychiatric treatment and drug/alcohol addiction rehabilitation (鈥榰nidad terap茅utica鈥�). Level 4 is more related to medical research.

The level of care provided in public hospitals can vary greatly. There can be periods due to budget constraints, when one can encounter issues accessing the required medication and specialised treatment.

Given that public hospitals in Ecuador have a policy of free of charge medical care; hospital admission can be very strict. However, where beds are available, admission for critical illnesses is a relatively straightforward procedure.

Critical emergency admission is liaised by the National Police, Red Cross and Fire Brigade, through ECU911 (emergency response integrated system), available nationwide. Once a patient is stabilised (either in a public or private hospital/clinic) a transfer process (鈥榩roceso de referencia鈥�) will be activated. Likewise, and if applicable, a refund process (鈥榬ecuperaci贸n de costos鈥�) for patients with a private insurance.

1.1 In order to receive non-emergency treatment under the public health system (MSP) a patient must:

• there are different (except for emergencies): by dialling 171 option 1 (toll free), by , through their , or through the 鈥楽aludEc鈥� telephone App.

• provide your local 鈥榗edula鈥� Ecuadorean identity card number (or passport number) to validate your personal information

• select 鈥楢gendar cita鈥� (schedule a medical appointment)

• select the required service and the available date and hour for the appointment

• you can also approach the nearest medical centre from your home to request for a medical appointment in person, through their 鈥榓dmisiones鈥� unit

• for the website medical appointment system, you will need first to register, either with your 鈥榗edula鈥� number or email address and create a password. You will need to provide your full name, home address and contact details. For easier reference, read the (only in Spanish)

• non critical emergencies will be managed through an external appointment system for further evaluation

If hospitalisation is required, for example a surgical procedure or other non-emergency in-patient care, this will be scheduled directly by the doctor. Admission is only possible where beds are available (except for critical emergencies). Sometimes MSP establishments may ask for a non-IESS affiliation certificate (鈥榗ertificado de no afiliaci贸n al IESS鈥�) to comply with their admission process

• if no emergency beds are available for critically ill patients, they are usually hospitalised in another available unit of the hospital or at another public hospital

• unidentified critically ill patients are admitted immediately to the emergency unit, where the social service department may get involved

Please note the 171 line does not have English speaking staff. For your convenience, the British Embassy Quito has put together a brief transcript in English of the standard questions asked during a 171 call, which can be viewed on聽our website. There may be short notice changes on the standard questions. Medical care at centres and/or hospitals run by IESS (Ecuadorean Social Insurance), under a social insurance scheme, is also free of charge for affiliated members and their children and spouses. In principle, all medication is provided without charge.

1.2 In order to receive non-emergency treatment under the IESS scheme a patient must:

• make a telephone appointment by dialling 140 (24/7 line, except for emergencies)

• or through an online appointment system (), by registering a user.

• approach the nearest or assigned medical centre

• show the Ecuadorean identity card (鈥榗edula鈥�)

• if hospitalisation is required, this will be scheduled directly by the doctor. Admission is only possible where beds are available (except for critical emergencies). If necessary, a transfer to another unit or hospital will be arranged, through a transfer formal request enclosing your full medical history

The IESS affiliation is accepted for the new public or private health insurance requirement for all foreign residents in Ecuador, which came into force in November 2017.

2. While you鈥檙e in hospital

On arrival you will have your vital signals taken and asked about your medical background (allergies, previous surgeries, etc.).

As a patient, you will need to bring your own towels, toiletries, nightwear, etc. Consider asking family or friends to bring them after you鈥檝e been admitted.

In hospital you will normally get 3 meals each day (breakfast, lunch and dinner) but meal times will vary according to your medical condition and the quantity/quality of the meals will vary greatly between hospitals.

If you are in a public hospital it can be helpful to have someone at hand to buy bottled water or extra food (the latter with specific dietary instructions).

Different wards/clinics/hospitals often have different visiting times and regulations.

All medical services align to informed consent, access to all information and personal data protection. Within the patient鈥檚 voluntary consent (鈥榗onsentimiento informado鈥�), the doctor will explain proposed treatment and the benefits and side effects/risks involved. This will be formalised by a signed consent form, directly by the patient, or in some cases by the next of kin.

Depending on the recommended treatment, and if this is not fully available at the public hospital, a transfer process (鈥榩roceso de referencia/derivaci贸n/contrareferencia鈥�) to another public or public hospital, with the same or higher level of attention, may need to be activated, without incurring into any extra costs.

2.1 Social workers

There are social workers (鈥榯rabajador(a) social鈥�) in most hospitals who can help you contact the British Embassy or your family. Ask your doctor, nurse or the ward administrative assistant if you would need to speak to a social worker.

3. Paying for your treatment

Public hospitals in Ecuador are free.

Medical centres and/or hospitals run by IESS (Ecuadorean Department for Social Insurance) are also free of charge for affiliated patients.

The cost of care in private hospitals varies depending on the standard of care and facilities available. The price of beds varies depending on the number of beds in a room. Some private hospitals offer a very high level of care.

Patients are admitted through the emergency room (A&E) of a private hospital, they must pay an admission guarantee fee, which is agreed upon entry to the hospital following a preliminary diagnosis.

If a patient arrives unaccompanied, and/or without a credit card, they will not be admitted. However, if the patient is in a critical condition, in principle private hospitals are obliged to assist them until they are stabilised. If they do not have sufficient funds to continue treatment in the private hospital, once they are stabilised they will be transferred to a public hospital, depending on availability.

The British Embassy in Ecuador cannot pay medical bills.

A 鈥渕andatory road accident insurance scheme鈥� called 鈥楽istema P煤blico para pago de Accidentes de Tr谩nsito鈥� (SPPAT), formerly known as SOAT, was introduced in 2008 and changed into a public insurance system in February 2015. It covers medical expenses; hospital transport of injured; disability compensation; death compensation and funeral expenses. This public insurance scheme therefore guarantees that every road accident victim is provided with immediate medical assistance either in a public or private hospital, without having to pay a deposit, in addition to the above compensation amounts.

4. Contact your insurance company

If you have travel insurance, you or a member of your family should contact your insurance company immediately.

We can only help you to liaise with your insurance company in exceptional circumstances, if:

• you are unable to call them yourself, and
• you have no one who can do this for you

You should also contact your GP in the UK, as your insurance company may want to speak to them as well.

Your insurance company may not accept your claim if you did not disclose a previous condition.

Remember to keep any receipts (including general expenses with travel, meals and accommodation for relatives accompanying you) and any medical reports. You may need them to make a claim for reimbursement of expenses on your return home.

5. Making a complaint

According to the Ecuadorean Constitution of 2008, all public and private hospitals/clinics are obliged to provide immediate emergency medical attention without demanding prior proof of funds. However, this is not always followed by private clinics and hospitals and prior payment guarantees have been demanded as a condition for treatment, in some cases even when medical insurance has been available. You should report any of these incidents to us so that we can raise it with the local authorities.

If you鈥檙e not happy with the care you鈥檙e receiving, you can make a complaint with the hospital鈥檚 customer services office or directly with the .

For more serious complaints, you should聽seek legal advice from an .

6. Before you leave hospital

When you鈥檙e discharged, you鈥檒l receive a letter in Spanish outlining your diagnosis and any medication prescribed (鈥楴ota/Informe de Alta鈥�).

Check with your airline if you need a Fit to Fly Certificate (鈥榗ertificado m茅dico de estar apto para volar鈥�). If you do, you must ask the treating doctor to provide one. They may not automatically give this to you.

7. Full medical report

If you want a full medical report (鈥榟istoria cl铆nica鈥�), you can request it from your treating doctor whilst you鈥檙e in hospital.

For medical insurance purposes, it can be requested from the hospital鈥檚 administration, as they will need the patient鈥檚 direct written consent to share the medical history with third parties (hard or digital copy). The medical history holder can request this by email (鈥榮olicitud del titular de la historia cl铆nica鈥�), by providing their full name/surname and the passport number.

8. Medical repatriation

If you have travel insurance, you should contact your insurance company as soon as you are hospitalised. This will give them time to check whether your policy covers your condition, and get your permission to access your medical records through your GP. Once they have validated your policy, they will liaise with your treating doctor to agree the best way for you to travel home. It may be some time before you are well enough to travel, and communication between hospital staff and the insurance company representatives is vital to assess and plan your repatriation.

If you do not have travel insurance and you wish to be medically repatriated, you (or your next-of-kin) may wish to consider paying for repatriation yourself. We cannot help with the cost of repatriation, and we recommend you contact a few medical repatriation companies to obtain an estimate of the cost.

View a聽list of medical repatriation companies.

9. Our contact details

British Consulate Quito

Telephone (593) (2) 3972 200

Use our contact form for consular enquiries: http://www.gov.uk/contact-consulate-quito

10. Further guidance

Find out more:

• In hospital abroad
• List of medical facilities in Ecuador
• List of medical practitioners in Ecuador
• MSP - Ministry of Public Health MSP鈥檚 Mental Health Helpline: 171 option 6
• IESS 鈥� Ecuadorean Social Insurance

11. Disclaimer

This information has been prepared by UK Government officials who are not legally or medically trained. It should therefore never be used as a substitute for professional medical or legal advice. It is intended to help British nationals overseas make their own informed decisions. Neither the UK Government nor any official of the Consulate accept liability for any loss or damage which you might suffer as a result of relying on the information supplied.