Originally published in CuencaHighLife
by Irene Gardner
As expats from North America and other foreign lands start their new lives in Cuenca, health insurance is just as necessary to have in Ecuador as it was “back home”, and as will be discussed in a future story, obtaining and maintaining your health insurance policy is, at this date, mandatory to not only receive your cedula and temporary residency visa, but also your permanent residency visa.
If you have been here for any length of time, you most likely have already learned that there are many health insurance options available in Cuenca. And, if you thought understanding health insurance policies and plans was difficult in your past life, wading through the myriad of health insurance company explanations of their various health insurance options (provided only in Spanish, of course) and under different insurance laws and regulations than the ones you left behind can be really daunting.
However, selecting the health insurance and type of policy that are best for your particular health situation (and your wallet), though challenging, is not impossible.
There are people here in Cuenca who speak English (if needed), are well-trained in the health and life insurance field, and who want to help you make the best choice for YOU.
Cuenca agents Ramiro Crespo and Daniela Cordero of Mega Brokers, which is headquartered and has a back-office of 50 people in Quito for processing claims, have made a concerted effort to understand the specific health insurance needs of the U.S. Expat community of Cuenca. Mega Brokers’ Cuenca office has taken on the name of Cuenca Expat Health Insurance. Per Ramiro, Mega Brokers “is a 20-year-old global health and life insurance brokerage company that works in South America with VUMI, Best Doctors, S.A., insurance companies that have been in business in South America for over 30 years, whose counterparts in the U.S. include United Health Care and Aetna.”, and, for international insurance, among others, Mega Brokers represents BUPA, whose counterpart in the U.S. insurance is Blue Cross/Blue Shield.
Daniela added, “Mega Brokers only contracts with the best insurance companies globally. We must work with the best, because Mega Brokers must maintain a good reputation to stay in business.”
Ramiro and Daniela, who both speak English, have worked diligently to develop a range of health insurance plan options, which include both local and international insurance coverage. Ramiro and Daniela take a personal interest in each of their clients, getting to know each person as an individual. They do not believe that “one size fits all” when it comes to health insurance coverage, and they will help you to choose the best option that suits you.
Daniela remarked, “To keep something in an Expat’s [health insurance] plan that is not needed only drives up the insurance cost for the client. That is why, for example, we do not offer medical coverage for pregnancy in our Expat plans.” She added, “We are so clear with our clients! We cannot create false expectations. We are very detailed in [our explanations about] what the insurance will cover.”
Mega Brokers does not claim to offer the least expensive health insurance option, but theirs is not a typical Ecuadorian insurance brokerage company. Ramiro and Daniela have developed insurance packages with deductibles of between $1,000 and $50,000 per year, which are not low deductibles, because their plans mostly cover catastrophic diseases. “We do not handle minor, out-of-pocket conditions,” commented Ramiro, adding, “We do not compete with other local companies.”
Having a Mega Brokers health insurance plan means there are no restrictions on which hospitals or doctors you can use. There is no “in network” or “out of network” restrictions or differences in the cost of coverage. And, according to Ramiro, “clients only need to bring us simple documents, such as doctor bills, for us to reduce the remaining deductible and, once the deductible is met, we file claims for them” for all medical costs up to the maximum value for the plan chosen by the client. Mega Brokers has plans available that range up to $1 million in coverage.
If you are one of the lucky healthy Expats, the choice of health insurance plans, range of deductibles, and other options are more plentiful. Daniela cautions, though, to ensure that “the level of deductible you choose is one that you can pay easily.” She sited an example of a person with a $5,000 deductible who suddenly finds that he needs a $7,000 surgery. That client would need to pay the $5,000 at the time of the surgery, with his insurance covering the balance of $2,000.
In addition to ensuring the health insurance coverage selected by a client is the best one for that client, Ramiro’s and Daniela’s goal is to provide superior service to U.S. Expats, helping them, if needed, to make their doctor appointments, referring them to the best doctors in Cuenca for their particular health issues, completing applications and forms for them, and filing claims on their behalf, so their clients do not have to concern themselves with administrative issues when they are already potentially stressed about a health concern.
Although Ramiro and Daniela want you to be their client, even if you choose another company, they believe it is important for you to have insurance, and they encourage anyone looking for health insurance to perform his/her “due diligence”—to ask questions, such as: Is the company approved by the Superintendent of Insurance Companies and on the list to operate an insurance company in Ecuador? Where are their offices located? How long has the company been operating in Ecuador? How many policy holders does the company have? What is the history and background of the company?
Ramiro and Daniela want to make obtaining, using and maintaining health insurance easy for their clients. Daniela said, “People come here to retire and take it easy. I want to help them to continue to have an easy life,” adding, “We want to and hope to create a bond of trust with our clients”, because they care about and consider their clients to be their friends.
The Mega Brokers Ecuador office is located at: Av. Remigio Tamaríz and Av. Solano, Edifício Office, 5th floor, Office 5-5. For more information, contact Ramiro and Daniela at:
email@example.com or 099-520-6384 or visit: cuencaexpathealthinsurance.com.