This article is part 2 of a 3 part series on healthcare providers in Ecuador.
Caution, there are many health care providers and insurance companies in Ecuador, but many of the lesser known ones have been known to try to find small exceptions in order to skip out on paying the larger bills of their clients. For example, if you got in a car accident, they may say you don’t qualify for coverage because the car was speeding at time of accident.
To avoid this, I would only recommend working with one of the most established health care insurers of Ecuador: BMI, Salud S.A., Grupo Generali, Cruz Blanca, or AIG.
In Ecuador, most health insurers have a maximum limit payout available per calendar year.
For example, as of the spring of 2010, for a male 18-31, the monthly premiums would be $35.77 for a maximum yearly payout benefit up to $15,800. For a female over 70, the monthly premiums for the same maximum yearly benefit would be $150.82 a month, for a male over 70, $211.15 per month (with Salud S.A.).
Now with the same company, Salud S.A., for yearly coverage up to $84,700, a male over 70 would pay $842 per month premiums and a female over 70 would pay $601.
The health insurance provider BMI offers interesting group rates, starting at $51.30 per month per person for groups from 5-24 people. The interesting thing about this coverage is they don’t have a yearly maximum benefit payout, instead a maximum per incident payout, which for the monthly premium mentioned would be $50,000 per incident.
Every health insurance provider in Ecuador has a list of affiliate clinics, where you will pay only a 10% deductible upon point of treatment. If treated elsewhere the deductible tends to be 20%. Some plans allow you to only pay the deductible, some require you to pay the full amount and then ask for a reimbursement.
With the reputable companies mentioned above, reimbursement is a harmless process that usually takes less than a day for small amounts, and less than 5 business days for large amounts. You will need to fill out a form, and have original copies of the prescription, receipts, bills, and other related documents.
One trick I have learned to ease the process of reimbursement is to work with one of the many insurance brokers in Ecuador.
For no extra fee, a good one will handle all your paperwork and be sure you get a reimbursement and treatment in a timely fashion. You could even call them when you have emergencies (and they would serve as a translator) and they will get someone over to you. For this, I would recommend both English and Spanish speaking Katty Mejer (her details are listed at the end of this report).
Now, if you are over 60 in Ecuador and looking for a new health insurance policy, things get a little sticky. (But that is why you bought this report, right?)
Yes, all the companies mentioned above will cover you for life if you get in before the age of 60, but if you are already over the age of 60, you only have one good option in Ecuador.
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