Cotacachi Healthcare: What Is Available?

January, 2019

What kind of healthcare can be found in Cotacachi?

Many people thinking about becoming expats are concerned about the availability of medical care in Ecuador.  In larger cities such as Quito, Guayaquil, Cuenca, Manta, and Ibarra you can find up to date medical facilities comparable to what you might find in the US.  Because Cotacachi is conveniently located between Ibarra and Otavalo and about 2 hours from Quito, you can find high quality medical care here.  It is also interesting to note that although Cotacachi is a small community there are a surprising number of complementary or holistic practitioners here.

Cotacachi Health Chapters sponsors a website http://www.cotacachihealthchapters.com/  where you can find more information about medical resources in the area in addition to some useful documents to help you plan for medical care in the region.

Important point about emergency care:

Extensive emergency medical services are not available in Cotacachi.  Depending on the nature of the emergency excellent care is available in Ibarra, which is about 40 minutes away by car; but for specialized care, such as cardiology, it may be necessary to be transported to Quito.  People who have serious medical conditions who need regular ongoing care or who may have the need for frequent emergency visits may find this area to be challenging.  Larger cities such as Quito, Cuenca, Manta and Guayaquil would be better choices.  It is also important to learn more about the medications available in Ecuador if you are taking very specialized medications or receiving experimental medications.  Not all US drugs or their equivalents are available in Ecuador.

Allopathic medical services are offered in Cotacachi, Ibarra, and Otavalo.  Here is a brief summary.

Hospitals:  Cotacachi has a small public hospital where basic medical services are available.  They are able to stabilize or triage seriously ill patients and then have them transferred to a hospital in Ibarra or Quito.  Cotacachi also has a small IESS (the social security system in Ecuador) medical clinic for people who are enrolled in this health insurance program.

In Ibarra there are small hospitals/clinics that are considered to be very good.  All have outpatient services for diagnostics and treatment. Here is a partial list.

In Quito there are private hospitals as well as the hospitals that are part of the socialized medical system called IESS, IESS website.   There are hospitals that specialize in cancer care, heart care, respiratory and other specialties.  These facilities offer a wide variety of care comparable to what you find in any major city.

Hospice Care.  I know of one hospice in Quito that will provide visits to patients in Cotacachi.  They also provide hospice care at their facility in Quito. Hospice San Camilo, Quito.   Email: info@hospicesancamilo.com

Routine office visits with allopathic doctors.

Most doctors operate on a walk in basis so no appointments are necessary.  However, that also means that you have to be prepared to wait to be seen.

  • Cotacachi: Dr. Luz Marina Vega Conejo is an allopathic medical doctor in Cotacachi who speaks limited English.  She will make house calls and is available for emergency calls.
  • Otavalo: In Otavalo there are also several medical providers.  One is an allopathic physician from Germany, Dr. Jakob Nieben who speaks English, German and Spanish.
  • Ibarra: There are many doctors who practice in clinics or private offices, most speak only Spanish.

Optometrists.  There is an optometrist in Cotacachi, Golden Vision Optica, Ernesto y Paulina Proaño.  There are also several in Ibarra and Otavalo.

Dermatologists can be found in Otavalo and Ibarra.

Dentists and Oral Surgeons can be found in Cotacachi, Otavalo and Ibarra.

Pharmacies: There are multiple pharmacies (farmacias) in Cotacachi, as well as in Ibarra and Otavalo where you can get many medications (but not all) that you would find in the US.  Most medication is less expensive than you would pay in the US.

Here is a sample of the alternative or complementary providers you can find in Cotacachi.

  • Naturopath, Dr. Gloria Gilbere, here is her website: http://www.gloriagilbere.com/.  She has office hours by appointment and also gives free health talks each month.
  • Chinese Medicine/Acupuncture, Dr. Santiago Liang, he has a clinic where he offers a variety of treatments including acupuncture, massage, and chiropractic.
  • Reflexology treatments are available at the Circle on the Square Treatment Center provided by Julie Powell, she speaks English and also offers other treatment modalities.
  • Cranial Sacral Therapy treatments are available with Jamara Gruber also at the Circle on the Square Therapy Center.
  • Aroma Therapy:  Young Living Essential Oils are available. Green Harmony Oils which can be ordered by email order through Prana pranaev@aol.com
  • Equine Assisted Therapy: Healing People Through Equine-Assisted Therapy,  Therapist Christina Ring
  • Tai Chi and Yoga Classes at Ananda Centro Holistico, you can find them on Facebook.
  • Qi gong classes, Circle on the Square Treatment center
  • Reiki and Hands-On Healing Work
  • Massage Therapists: there are several in Cotacachi, Otavalo and Ibarra.
  • Traditional Indigenous Medicine

In Ibarra you will find these complimentary/alternative providers among others:

  • Iridologist, Martha Orbe, also at Quiro Spa
  • Chiropractor,Dr. Cosme Orbe at Quiro Spa
  • Herbalist, Steven Orbe also at Quiro Spa
  • Traditional Indigenous Medicine including shamanic healing with San Pedro & Ayahuasca.

Organic and natural health products in Cotacachi

  • Gluten free bread, organic cheese, yogurt, and milk and organic seeds, nuts, essential oils, and more. Prana Energia Vital,  Xavier Solórzano Nellie Solórzano by email: pranaev@aol.com
  • Vitamins, supplements, herbal remedies, natural skin care, organic honey and more. Productos Naturales, Tienda Naturaleza, Cris Cevallos, Address:  Simon Bolivar between 10 de Agosto y Garcia Moreno
  • Organic produce, herbal medicine, essential oils and more: Mama LLakta on Parque Ornamental on Simon Bolivar.
  • Every Thursday there is an organic market featuring a wide variety of organic vegetables, seeds, pasta, breads and other products at San Francisco Park and at the Solid Rock Plaza.

How expats communicate with medical providers who don’t speak English.

While there are some English speaking medical providers in the area, most are Spanish speaking.  Expats find that they can communicate best with medical providers by hiring a translator/facilitator, link to Cotacachi Health Chapters.  It is also possible to use computer translation programs that most providers have in their offices.  There are also medical translations available in apps that can be used on cell phones.

Cost of medical care.

Several years ago blogs were stating that medical care is free in Ecuador.  That is no longer accurate.  Expats are now required to have medical insurance if they are residents.  The cost of office visits varies by the kind of service. Most providers accept only cash for office visits. Charges range from $15 for an office visit to $40 or more.  Medical procedures cost far less than in the US.  For example, the cost of a heart bypass surgery with hospital stay was $9,000 in 2018 at a private hospital in Quito.  A recent article in CuencaHighLife noted that a young man who fractured his neck had a hospital bill of $35,000 in Cuenca.    It is common for clinics and hospitals to ask for payments in advance of services by credit card or cash, even if the patient has medical insurance.  If the insurance company has a relationship with the facility the out of pocket expenses may be negotiable.

Health insurance companies in Ecuador.

There are private and government insurance options available.  The government based program is called IESS. The cost of monthly premiums varies starting at around $70 for one person.  People who have IESS insurance must receive care at the clinics and hospitals that are part of the program unless IESS has an agreement with a private hospital.  There are also private Ecuadorian and South American health insurance companies.  The cost of premiums varies.  There is a wide variety of plans and companies as you can see below.  For example, for a private insurance plan that covers catastrophic care the premium for one person is about $1500 per year with a $5,000 deductible.

The Ecuadorian Government published a list of approved medical insurance companies, (I have removed the links that do not currently work).

Insurance brokers are available in Ibarra to help you make a choice about medical plans.  The agent we have used is at Nova Insurance,  you can find contact information on the website for the broker:   http://www.novaseguroslatam.com/ 

Some expats have US based insurance companies.  In most cases, according to my understanding, it is necessary to pay out of pocket for care and then request a reimbursement from the US insurance company.