Health Insurance is now required for tourists entering Ecuador.
A new law was passed in August, 2017, and a new updated one on Nov. 9th, 2017, that makes health insurance for tourists, which covers your time in Ecuador, mandatory. They have not started requiring proof at the Ecuadorian airport yet. That was supposed to start happening on February 6, 2018, though they still have not started here on the Ecuadorian side. HOWEVER, there have been incidences of airlines requesting proof of insurance on the departure side. Since the law has gone into effect, even though Ecuadorian officials are not asking for it yet, some airlines at some airports have started asking for it already. It works like the rule about needing at least 6 months on your passport when coming to Ecuador. The airline that you fly on is responsible for checking and not letting you board your flight if you do not have it. (Rumors have it that the rule for needing insurance as a tourist will never be enforced. It's too difficult to enforce upon entrance to the country and public hospitals are not set up for receiving payments.)
Check with your insurance company to see if you are covered or can easily add international insurance. If so, bring that proof to the airport with you. It needs to cover all medical costs and cover the entire time of your stay.
If not, and you are only traveling short term, you can follow this link to an insurance company that we’ve found is very reasonable. You can choose medical insurance or trip insurance that includes medical insurance. They have a quick quote calculator, so you can see how much it will be without providing any identifying information.
For example, a family of 3, aged 49, 43, and 15 yrs., coming for a 1-week vacation, could buy the most basic health insurance for as low at $35, or trip insurance, with the trip valued at $2000 each, for $158 if you are a US resident, $321 if you are not a US resident. (That's total, not per person.)
We've scanned and included a PDF below that outlines these new regulations. It's from a page on the Ministerio de Relaciones Exteriores y Movilidad Humana's webiste: www.cancilleria.gov.ec. They gave it to us at the office here in Tena.
RESIDENTS, note that the November 9th update actually requires it for tourists coming on tourist visas, the usual 90 day one, and not on foreigners that already have a residency visa. This is a change from the original law that was passed in August. (I'm on this and I'll keep this page up to date as more things change. Promise!, Michelle)