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South America

Ecuador Travel Insurance Guide

Ecuador requires comprehensive travel insurance with altitude and Galapagos coverage. US maintains Level 2 (Exercise Increased Caution) advisory with Level 3-4 warnings for specific regions due to crime and terrorism. Medical evacuation from Galapagos costs $60,000+. Altitude sickness risk in Quito (2,800m). Private hospitals require credit card guarantee before admission.

In this guide you'll find:
  • What there is to do in Ecuador Travel Insurance Guide
  • Cultural experiences & natural wonders
  • Seasonal attractions & adventure activities
  • Quick profiles of major cities
  • Hotel cost ranges
  • Visa & entry requirements
  • Healthcare costs & detailed insurance breakdown

Safety Ratings and Resources

US State DepartmentLevel 2: Exercise Increased Caution (Level 3-4 for specific regions)

There was no change to the advisory level.  The "terrorism” risk indicator was added.  Advisory summary was updated.  

Exercise increased caution in Ecuador due to risk of crime, terrorism, unrest, and kidnapping. Some areas have increased risk. Read the entire Travel Advisory. 

Do Not Travel to these areas due to terrorism and crime:

  • Guayaquil, south of Portete de Tarqui Avenue.
  • The cities of Huaquillas and Arenillas in the province of El Oro.
  • The cities of Quevedo, Quinsaloma, and Pueblo Viejo in the province of Los Rios.
  • The canton of Duran, in the province of Guayas.
  • Esmeraldas City and all areas north of Esmeraldas City in Esmeraldas province.
  • The area north of Esmeraldas City to the Colombian border and east to Carchi province.

Reconsider Travel to these areas due to terrorism and crime:

  • Guayaquil north of Portete de Tarqui Avenue.
  • El Oro province outside the cities of Huaquillas and Arenillas.
  • Los Rios province outside the cities of Quevedo, Quinsaloma, and Pueblo Viejo.
  • All areas south of Esmeraldas city in Esmeraldas province.
  • The provinces of Sucumbios, Manabi, Santa Elena, and Santo Domingo.

Advisory Summary

Crime and kidnapping

Crime is a widespread problem in Ecuador. Violent crime typically associated with narcotrafficking is common. It includes murder, assault, kidnapping, and armed robbery.  Areas with transnational criminal organizations see much higher rates of violent crime. U.S. citizens and LPRs have been victims of kidnapping and extortion.

Terrorism

There is risk of terrorist violence, including terrorist attacks and other activity in Ecuador. Visit the U.S. Department of State's country reports on terrorism to learn more. 

Demonstrations

  • Demonstrations happen across the country.
  • They are usually driven by political or economic reasons.
  • Demonstrators often block local roads and major highways without warning, disrupting access to important infrastructure.  

Local and U.S. Government Assistance

  • Most of Ecuador’s land is empty and remote, especially outside big towns and cities.
  • Local and U.S. government help may be very limited in remote areas. This may cause delays for U.S. citizens in remote areas.

Land Border Restrictions

  • Foreign citizens entering the country by land from Colombia or Peru must show a certificate of no criminal record. This certificate must be apostilled. You can find more information on the Ministry of Tourism’s webpage and at Ecuador.Travel.
  • The U.S. Embassy and Consulate General in Ecuador cannot help you get the necessary documents for crossing a land border.
  • U.S. citizens planning to enter Ecuador via a land border should check the State Department’s Office of Authentications webpage and Criminal Records Check webpage. These pages have information on getting a criminal record check and apostille from the United States.

Read the destination information page for additional information on traveling to Ecuador.

Risks in specific areas

Level 4: Do Not Travel

Do not travel to these areas for any reason due to terrorism and crime.

  • Guayaquil, south of Portete de Tarqui Avenue.
  • The cities of Huaquillas and Arenillas in the Province of El Oro.
  • The cities of Quevedo, Quinsaloma, and Pueblo Viejo in the province of Los Rios.
  • The canton of Duran, in the province of Guayas.
  • Esmeraldas city and all areas north of Esmeraldas city in Esmeraldas province.

Review our information on Crime Abroad and for Victims of Crime.

Terrorists, Transnational Criminal Groups, and Local Gangs

  • Terrorist and other criminal organizations often commit violent acts in these areas, including sudden attacks in public places, often without warning.
  • Violent crimes can involve murder, targeted assassinations, armed robberies, bombings, kidnappings, and assaults.
  • Violence in these areas has risen both in frequency and brutality recently, posing a security risk to U.S. citizens.
  • U.S. government employees working in Ecuador must get special permission to travel to these areas.  
  • The U.S. government has limited ability to provide emergency services to U.S. citizens in these areas.

Level 3: Reconsider Travel

Reconsider travel to these areas due to terrorism and crime:

  • Guayaquil, north of Portete de Tarqui Avenue.
  • El Oro province outside the cities of Huaquillas and Arenillas.
  • Los Rios province outside the cities of Quevedo, Quinsaloma, and Pueblo Viejo.
  • All areas south of Esmeraldas city in Esmeraldas province.
  • The provinces of Sucumbios, Manabi, Santa Elena, and Santo Domingo.

Review our information on Crime Abroad and for Victims of Crime.

Terrorist and other criminal organizations have engaged in violent activity in these areas. Recently, this violence has increased. U.S. government personnel must be very careful and stay alert when traveling in and around these areas. The U.S. government has limited ability to provide emergency services to U.S. citizens in these areas.

If you decide to travel to Ecuador:

  • Enroll in the Smart Traveler Enrollment Program (STEP) to get important updates and alerts from the U.S. embassy or consulate. Enrolling helps the U.S. embassy or consulate contact you or your emergency contact in an emergency. 
  • Review our information on Terrorism and Travel to High-Risk Areas.
  • Monitor local media for breaking news. Be prepared to adjust your plans.
  • Stay aware of your surroundings.
  • Establish a proof of life protocol with your loved ones. If you are taken hostage, your loved ones will know specific questions (and answers) to ask the hostage-takers to confirm that you are being held captive and alive.
  • Keep travel documents up to date and easily accessible.
  • Avoid demonstrations and crowds. 
  • Check local media for breaking news.
  • Review the Country Security Report for Ecuador.
  • Prepare a plan for emergency situations. Review the Traveler’s Checklist.
  • Visit the Centers for Disease Control and Prevention (CDC) website for the latest Travel Health Information for Ecuador.
  • We highly recommend that you buy insurance before you travel.  Check with your travel insurance provider about evacuation assistance, medical insurance, and trip cancellation coverage.
  • Review our information on U.S. Citizens Missing Abroad and for Victims of Crime.

Review Travel to High-Risk Areas

View US State Department Advisories →
Women's Travel SafetyRating: moderate

Political unrest and rising crime; urban robberies and assaults affect women, though Galápagos is more controlled.

View Women's Travel Safety Guide →
LGBTQ+ Travel SafetyRating: good

Constitutional protections for sexual orientation; anti-LGBTQ violence still occurs.

View LGBTQ+ Travel Safety Guide →

Visa & Entry Requirements

  • Valid passport required (must be valid for at least 6 months from entry date)
  • No visa required for US/UK/Canada/Australia citizens for stays up to 90 days
  • 90-day stay permitted within any 12-month period without visa
  • Tourist stamp issued upon arrival; for stays exceeding 90 days, advance visa required
  • If entering by land from Colombia or Peru, apostilled criminal record check required
  • Return ticket and proof of sufficient funds may be requested at entry

Additional visa information

  • US/UK/Canada/Australia citizens can stay visa-free for up to 90 days within any 12-month period
  • Tourist stamp issued upon arrival at Quito (UIO) or Guayaquil (GYE) airports
  • For stays exceeding 90 days, visa must be obtained in advance from Ecuadorian consulate
  • Passport must be valid for 6 months from entry (recommended 2+ years for flexibility)
  • If entering by land from Colombia or Peru, apostilled criminal record check from country of origin required
  • Ecuadorian visa and customs rules subject to change with little notice

Healthcare & Medical Information

Healthcare overview

Ecuador offers affordable healthcare compared to Western countries, with major cities like Quito and Guayaquil having good private facilities with English-speaking staff. A general practitioner visit costs $20-35 USD; specialists $40-80 USD; major procedures like knee replacement run $10,000-$15,000 (compared to $40,000+ in developed countries). However, private hospitals require an admission guarantee fee (signed credit card voucher) before admission; arrivals without credit cards may be denied unless in critical condition. Public hospitals offer free care but quality and wait times vary significantly. Outside major cities (Quito, Guayaquil, Cuenca), medical care is limited, especially in small towns. The Galapagos Islands have extremely limited medical facilities; serious conditions require medical evacuation to mainland Ecuador or the US. Galapagos evacuations cost $60,000+ with wait times up to 48 hours (no air ambulance based on islands). Altitude sickness is a significant risk in Quito (2,800m), Cuenca, and Andean regions above 2,500m - can be deadly and affects anyone regardless of fitness level. Comprehensive travel insurance with Galapagos evacuation coverage, altitude sickness treatment, and admission guarantee support is essential. Ensure policy covers adventure activities if planning hiking, rafting, or jungle tours.

Typical medical costs

  • General practitioner visit: $20-35 USD
  • Specialist consultation: $40-80 USD
  • Emergency room visit: $50-150 USD (private hospitals)
  • Hospital overnight stay: $200-500 USD per night
  • Major surgery (e.g., knee replacement): $10,000-$15,000 USD
  • Medical evacuation from Galapagos to mainland: $60,000+ USD (up to 48-hour wait)
  • Medical evacuation to United States: $75,000-$150,000 USD
  • Recommended minimum coverage: $100,000 medical, $250,000 evacuation, altitude coverage to 3,000m

Travel Insurance Recommendations

While travel insurance is not always required, it's recommended for international travel to protect against unexpected medical expenses, trip cancellations, and other travel-related issues.

Common travel issues to consider

  • Trip cancellations due to crime, civil unrest, and state of emergency declarations
  • Medical emergencies in Galapagos requiring expensive air evacuations ($60,000+)
  • Altitude sickness in Quito (2,800m) and Andean highlands
  • Violent crime including armed robbery, assault, and kidnapping (especially in Guayaquil)
  • Pickpocketing and theft in Quito's historic center, La Mariscal, and bus terminals
  • Gastrointestinal illnesses and food poisoning
  • Adventure activity injuries (hiking, rafting, jungle tours)
  • Transportation accidents and boat safety incidents in Galapagos

Recommended providers

Consider comparing policies from multiple providers to find coverage that matches your travel needs.

Emergency Contacts

Emergency Services (Police, Fire, Ambulance)

911

US Embassy Quito - Main Line

+593-2-398-5000

US Embassy Quito - After Hours Emergency

+593-2-398-5000 or +593-9-9788-3222

US Consulate Guayaquil - Main Line

+593-4-371-7000

US Consulate Guayaquil - After Hours Emergency

+593-4-371-7000

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