How does healthcare work in El Salvador, and what travel insurance, health insurance or expat insurance do you need?

What is the quality of healthcare in El Salvador?

• The healthcare system in El Salvador consists of both public and private institutions. In general, the quality of the public healthcare system is considered to be substandard. However, many people cannot opt ​​for private healthcare due to the cost.
• Most Salvadorans are covered by the El Ministerio de Salud Pública y Asistencia Social (MSPAS) and El Instituto Salvadoreño del Seguro Social (ISSS).
• Most healthcare is provided in the larger cities.
• In recent years, El Salvador has taken positive steps in healthcare. For example, the country is now known for medical tourism in the areas of dental care and cosmetic surgery.
• Call 911 in the event of a medical emergency. Emergency care in hospitals is called “Emergencia”.

How does the public healthcare system work in El Salvador?

• The MSPAS provides free healthcare to residents of El Salvador. The system consists of three levels; from primary care in smaller health centers and secondary care in regional and national hospitals, to tertiary care in specialized hospitals.
• Foreigners with a valid visa can also use the free healthcare.
• In general, the quality of public care is not good. For example, the machines are often outdated, the staff is often not well trained and there is often a shortage of medicines.
• The health centers offer basic care such as visits to the general practitioner, dentists and internists. Care in these centers is free, but it comes with very long waiting times.
• The public health system has two regional hospitals (in addition to many smaller/departmental hospitals) that offer a higher quality of care than other hospitals. These are the Hospital San Juan de Dios in Santa Ana and in San Miguel.
• For the specialized hospitals (child care, gynecology, Covid etc.) a referral from the regional or departmental hospitals is required.
• There are also very local clinics that offer free care in rural areas. These clinics offer very limited care and are often only open a few days a week.
• Then there is also El Seguro Social (ISSS), the social health insurance system. This insurance is mandatory for everyone who works in the public sector or in a private company and offers access to certain healthcare institutions. A contribution is then made by the employee and the employer.

How does the private healthcare system work in El Salvador?

• The private sector consists of profit-making and non-profit institutions. The profit-making institutions are mainly found in the big cities, the non-profit institutions (generally NGOs and churches) in the countryside.
• The profit-making private sector generally has better facilities, but is also a lot more expensive. It is therefore mainly used by foreigners and wealthy locals.
• In the private sector, there is a greater chance that you can get by with English.

How is the family doctor or general practitioner arranged in El Salvador?

• The GP in El Salvador is locally called “medico de familia” or “medico general”. The GP provides the first layer of care.
• There are both public and private GPs in medical centres. Most expats opt for private GPs.
• It can be helpful to ask other foreigners for advice on finding a good GP.

How is the dental care and dentist arranged in El Salvador?

• Dental care in El Salvador is of good quality, especially in private clinics. The costs are also relatively low, which attracts many medical tourists to the country.
• In the public sector, waiting times are often long, which is why many locals also opt for private care.
• Simply call or e-mail a clinic and make an appointment. You can also get insight into the costs via the website or by phone.

How is pregnancy and maternity care arranged in El Salvador?

• Pregnancy care and deliveries can take place in both public and private institutions. Although public care is free, foreigners generally opt for private clinics because of the state of the public system.
• In public hospitals, the father is generally not allowed to be present at the birth.
• Both types of centers offer both prenatal- and postnatal care.
• The father can be present via private care. Better care is also provided, you can choose the doctor you want and, for example, a private room. Be aware that there are costs involved and that you will probably have to pay immediately upon leaving the hospital.
• Abortion is illegal.

How safe or unsafe is a trip or stay in El Salvador?

What should you pay attention to in terms of safety in El Salvador?

• El Salvador has historically had high crime rates, mainly due to the presence of violent gangs. Recent government measures have led to a significant decrease in the number of homicides and an improvement in the general safety situation. For example, the homicide rate has dropped from a peak of 106 per 100,000 inhabitants in 2015 to significantly lower figures in recent years. However, it is still a relatively dangerous country.
• Avoid low-income neighborhoods and remote areas, especially at night. Do not wear expensive jewelry or go out after dark in downtown San Salvador.
• Be careful at ATMs. You may be followed.
• The number for the police is 911.

What should you look out for in terms of diseases in El Salvador?

• Several insect-borne diseases are prevalent in El Salvador, including dengue, chikungunya, and zika. Protect yourself from insect bites by using insect repellent and wearing protective clothing. In addition, tuberculosis is common, especially in children. It is advisable to avoid contact with stray animals due to the risk of rabies.
• Check which vaccinations are mandatory or recommended before departure.

What should you pay attention to when it comes to traffic in El Salvador?

• The infrastructure in El Salvador is developing, but road conditions can vary. In urban areas, the roads are generally good, but in rural areas they can be less well maintained. It is important to be alert to unexpected road conditions and traffic behavior.
• People are generally not very careful when driving. Traffic accidents are common because traffic rules are not always strictly followed and people drive unpredictably. Many accidents are caused by distractions while driving, careless merging and speeding.
• It is not recommended to use public transport and to hail taxis on the street. If you are traveling by car, keep the windows and doors closed, even while driving.

What are the best insurance options for backpacking, traveling, doing an internship, studying, volunteering, or working in El Salvador?

• Is the trip to and your return sufficiently covered? Are you sufficiently covered before, during and after your activities? Which insurance best suits your trip and your activity?
• Insurance for backpacking and traveling in El Salvador
• Insurance for studying in El Salvador
• Insurance for internships in El Salvador
• Insurance for volunteering in El Salvador
• Insurance for digital nomads or paid work in El Salvador

What types of insurance should you get if you're planning to emigrate, work as an expat, or live in El Salvador?

• Health insurance is generally not mandatory for a stay in El Salvador and the public healthcare system offers free care. However, most expats opt for their own private insurance in order to be able to use private institutions (with shorter waiting times, better equipment, etc.) and to be covered for possible medical evacuations in situations where local care is insufficient.
• Make sure your insurance covers medical evacuation as well as coverage in neighboring countries.
• International health insurance for El Salvador
• International travel insurance for El Salvador
• International life insurance for El Salvador
• International income protection insurance for El Salvador