The elderly phase of life demands respect, care, and specialized attention. For expatriates who have spent years in the United States and across the globe and have chosen Ecuador as their new home, ensuring quality care is a priority. At Bluebox Asesores, we understand the importance of safeguarding your health and well-being, especially at a stage where care and medical attention are fundamental. Moreover, within our insurance method, we have incorporated personalized advice in case you have doubts about procedures suggested by your physician. Unfortunately, in Ecuador, there isn’t a legal entity that regulates the costs of surgeries and medical procedures in general. Hence, medical professionals are free to set their price lists and apply them as they deem fit. This is why we always recommend seeking a second medical opinion.

Ecuador offers a unique healthcare system, and adapting to this change can be challenging. At Bluebox Asesores, we comprehend the differences and provide support to ensure you feel safe and supported in transitioning to this healthcare system. We provide informative data about clinics, pharmacies, and clinical laboratories within your health plan. With this information, you can access all the services offered by your plan through a minimal cost known as a COPAY. This term refers to the partial value you are responsible for in your medical care and access to medicine, blood tests, imaging, and others. This value can vary from 10% to 30%, depending on the contracted plan and its contractual conditions. In a medical appointment, the maximum amount you will pay is $15. Regarding medical appointments, they can always be taken under copayment as long as the chosen doctor is within the network. If the doctor works externally, this is not an issue; in this case, you only need to process your medical expenses through the reimbursement process, which in Ecuador is managed by the client, and at BBA, you have our guidance from start to finish.

Now, once you know that you have access to a list within your contract’s network, we will analyze important points such as when to accept a procedure and when not to. When you visit a doctor in Ecuador, their initial step is to create a medical record where they collect all your medical history and that of your relatives up to third-degree consanguinity. At this point, everything you declare in your medical appointment must be included in your pre-existing conditions form of your health policy. This is because if any of these conditions are not declared and are evident in your medical record, the company will deny this diagnosis and its derivations indefinitely. This is the first point you should consider. Secondly, once you have provided all your information, if the doctor immediately suggests surgery for the ailment you are visiting for, it’s time to consider a second opinion. Or if they propose procedures that in Ecuador are not considered curative but rather experimental, it’s also time to seek different opinions. I mention this because there is a trend in the application of substances such as hyaluronic acid, botox, or corticosteroids that are not regulated in Ecuador. In the case of corticosteroids specifically, the company assesses them for certain conditions and covers them, but if the application is unnecessary for your diagnosis, it will not be covered. Another clear example is if a doctor directly offers you a product to be used, such as a common vial like SUPRAHYAL or SINVISC ONE, which has a market value of $322.15 and is sold by medical prescription. If your doctor offers the same product at a higher price, it’s a clear sign to seek a second opinion. In these cases, the insurance company will always ask for the invoice for the purchase of the medicine and will not cover it if your doctor bills both the application and the supply within their fees, as the insurance company considers it a contractual exclusion. Lastly, the price proposed by your doctor for a procedure should always be considered because each physician has their fee schedule, and you can always obtain a second opinion within your policy’s network.

Having a second medical opinion in Ecuador is vital. Don’t be swayed by slogans or only broker recommendations. During 2023, we handled six different cases that were not partially paid by insurance companies because the treating doctor increased their medical fees by 300% and used their medical title to treat conditions unrelated to their specialty. Remember that if you visit a specialist in Ecuador, they can only treat that specific condition they are specialized in and are not authorized to treat a diagnosis corresponding to a different medical specialty, which cannot be covered by any insurance company in the country.

Contracting a health policy with Bluebox Asesores not only means access to quality medical services but also an investment in your peace of mind. Being backed by robust coverage assures that you are protected against medical unforeseen circumstances, without financial worries.

In this new chapter of your life in Ecuador, your well-being is our priority. At Bluebox Asesores, we commit to being your partner in caring for your health, offering insurance solutions that adapt to your specific needs as an elderly expatriate.

Contact us today and discover how our health policy can provide you with the security and peace of mind you deserve while enjoying your life in Ecuador.

 

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