We've been part of the IESS System (Ecuador's National Social Security and Health Care) for the past five years and during that time our premiums have not gone up. For a couple we pay $80.03 monthly, which is all we pay -- no co-pays, no deductibles, and you cannot be denied based on age or pre-existing conditions. It even includes dental care!
All that is changing as of July 2017. New rates are as follows: 17.6% for the holder of the pension and 3.41% for each dependent, so for a couple the new rates will be 21.01%. Many expats were upset to learn of the new rate change last week. However, Ecuadorians have always been paying this amount for years -- half paid by their employer and the other half paid by the employee. There is no discrimination; we're only asked to pay our fair share.
For the past five years, we've been paying the rate based on Ecuador's minimum wage (as were all expats), which is $375 per month and if you're on a pensioner's visa, you are required to have a minimum of $800 per month and $100 per dependent.
This is just the starting point. There are 13 different visas that you can receive, including: investor's visa (25K in the bank or 30K in real estate); professional visa; pensioner's visa, etc. Don't worry, they have records on everyone's visa, but they're starting with the pensioner's visas first because the majority of expats are here on their Social Security. But if you have 25K in the bank or have a professional visa, don't think you're going to escape the new rates. The Ministry of Foreign Affairs has all your information tucked away!
You will need to go to the IESS Building on Hermano Miguel and Gran Colombia (fifth floor) and make an appointment with Diana Calle. Bring your cedula, the letter you used to receive your pensioner's visa, your CLAVE for IESS (and password), IESS readout, and your last three months of bank statements showing your pension income. If you have a RUC number, business or you're working in Ecuador, your rates may be different.
To set up your appointment, email Diana Calle at firstname.lastname@example.org and she'll be happy to help you out. If your Spanish isn't up to par, don't worry...she speaks excellent English.
Any way you look at it, IESS is a great deal. Where else are you going to go in the world with the quality of care we receive with just one low monthly payment? I guess if you make one million dollars a month, your rate won't be that low, but hopefully that's the exception and not the rule.
Until next time...hasta luego,
Connie & Mark