Voluntary membership rules for government healthcare program being reviewed, but expats will still be eligible

Ecuador’s Social Security administration, Instituto Ecuatoriano de Seguridad Social (IESS), is reviewing the terms of expanded voluntary membership in its health care program. A spokesman for the agency said, however, that any adjustments will not affect the eligibility of foreign residents.

The review is the result of concerns that the changes could put financial stress on the system, a concern that was shared by President Rafael Correa in his Jan. 11 national television program. IESS Director Fernando Cordero said the review could take several weeks.

On January 1, IESS announced that age and and pre-existing medical condition restrictions for voluntary membership in the program were being removed. Previously, those over 60 or with some pre-exisiting conditions were not eligible for membership.

Voluntary membership is for those who have not paid into the Social Security system as employees. The vast majority of voluntary members are Ecuadorians who have worked overseas and had not contributed to Social Security.

Cordero said that the changes that will be considered may require those making higher incomes to pay more than the current formula that is based on the Ecuador’s minimum wage of $340. There could also be limits, in some cases, on types and extent of treatment for certain conditions.

The Social Security spokesman said that suggestions that foreign residents might be excluded from the the program as a result of the review are not true. “Legal residents are treated the same as citizens in Ecuador and this will not change,” he said. He added that another suggestion that voluntary membership could cost hundreds of dollars a month, based on higher income, was also not true. "No formula for a cost adjustment for those making more than the minimum wage has been discussed, contrary to what you might have heard."

“We are just beginning the review and no final decisions have been made,” he added.