How healthcare works in Uruguay

The cost of living in Uruguay is not low but healthcare is good and affordable. Find out how the Uruguay healthcare system works and how to be eligible.
By Mark Teuten
healthcare in uruguay
Last updated on July 10, 2019
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The cost of living in Uruguay is not low but healthcare is good and affordable. Find out how the Uruguay healthcare system works and how to be eligible.

Last week I woke up feeling poorly and after deciding that I really didn’t want to head out to the closest emergency clinic–which is literally three blocks away from my house–I picked up the phone. Through the emergency service of my healthcare provider I was connected with a physician (yes, on the phone) who asked if I’d like an over-the-phone consultation or a house visit. Forty-five minutes a doctor was at my bedside. It turned out I had a seasonal virus and I was prescribed painkillers and bedrest. Unfortunately I had a relapse several days later (I had not bed-rested as much as I should–naughty, naughty) and just to make sure that the relapse was not serious I called the emergency again. It was a busy Sunday and this time, having gauged that I was not an urgent case, the doctor came by at the end of the day. Having grown up in the UK where housecalls are no longer available, at least in South Wales where my family lives, I was once again impressed by the public/private healthcare system here in Uruguay.

So how does private healthcare work in Uruguay? Mark Teuten shares some background and facts.

The Uruguayan healthcare system is known by its abbreviation Fonasa, the Spanish term “Fondo Nacional de Salud” (National Healthcare Fund). It was created by the Frente Amplio government in 2007 with the aim to entitle all employees and pensioners to health care outside of the public health system. The public system would still be free, but was to be reserved for those outside of these broad categories.

Latest government figures state that there are currently 2.5 million people registered with Fonasa – out of a total population of just over 3 million. This would mean only 500,000 people are left using the public system or having to pay the full amount for private health care.

Who is entitled to Uruguay private healthcare coverage under Fonasa?

The following:

  1. All legally registered employees who work at least 13 days a month or more than 104 hours per month.
  2. Anybody registered as a sole trader (“Unipersonal”) including the sub-category of “Monotributistas” for very small businesses. [Guru note: Self-employed expats fall into this category]
  3. All public employees.
  4. All those receiving a state pension in Uruguay.
  5. Coverage extends to all family members under the age of 18 and over 18 if they are registered as disabled.

What coverage am I entitled to as an expat?

You can choose between over 40 different institutions, which are a mix of:

  • Mutual health care providers e.g. CASMU. These are organisations owned by the affiliated members. By signing up to one of these you will be entitled to free health care. Note though that the “free” bit means access to the basic health care package and there will be extra to pay for better attention.
  • Private health care providers e.g. British Hospital. By signing up to one of these you will be entitled to a discount on their monthly fee. The discount is about 90%, but varies according to salary.
  • Private insurance companies e.g. Blue Cross and Blue Shield. These insurers use any one of the private health care providers depending on the particular medical problem. Likewise signing up with one of these will entitle you to a similar discount on the monthly fee.

How much do I have to pay?

There is a sliding scale of contributions payable by employees (employers also have to make a separate different contribution) depending on your family situation:

  • Single with no children – 4.5%.
  • Single with children – 6%.
  • Spouse/partner with no children – 6.5%
  • Spouse/partner with children – 8%

How do I get the coverage?

By informing your health care provider that you want the benefits of the Fonasa scheme. They will give you the necessary forms to fill out and process them. It normally takes two to three months for the deductions to kick in.

The consequences of the 2007 healthcare reform on private healthcare in Uruguay

According to government figures over a million people moved over from the public to the private system as a result of the scheme. Viewed solely in this way the scheme would be a massive success. Anecdotal evidence would suggest that some of the care provided by the mutual health care providers leaves a lot to be desired because they are being forced effectively to offer health care at a fee fixed by the government which does not cover their costs. So they tend to recover the difference by charging for other services outside the “basic package”. [Guru note: We have found that there are longer waiting times to see specialists than previously but the waiting times are manageable and any emergency is bumped to the top of the list, with for example, cancer patients getting treatment virtually immediately. Those charges outside the basic package are minimal eg 20 USD for a pap, 10 USD for a consultation.]

Anecdotal evidence would suggest that the public system has improved as well because it is having to attend to less people and in addition the government has spent more money on it to improve infrastructure etc. However the public system still leaves a lot to be desired and is not to be recommended except for emergencies. [Guru note: I visited a friend in a brand new public A&E hospital in Montevideo and the service provided was very good.].

Offsetting Uruguay’s relatively high social security and income taxes

The Fonasa scheme is a good way to get cheaper health care for all employees and their families and for those with their own company. In this way it can help to offset the relatively high social security and income tax payments already made by all tax payers in the country.

Mark Teuten is a British lawyer based in Montevideo since the 1990s. He has law degrees from both the UK and Uruguay. He can help you with your residency applications, setting up a registered company and other legal matters. Guru’Guay has recommended him to our readers who have praised his trustworthiness, clarity, prompt communication even over great distances and careful advice regarding courses of action.

UPDATE: This article was originally published on March 15, 2018.

Image by Yerson Retamal from Pixabay

Note: This article is for information purposes only and should not be relied upon as legal advice.

Thinking about living in Uruguay?

Personal recommendations are essential to getting good service when living in Uruguay, maybe more than in other countries. Guru’Guay only recommends specialists and companies we know personally and professionally and—crucially—have vetted.

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31 Responses

  1. Bonjour j ai 69 ans et ma femme 66 ans nous aimerions partir vivre a la retraite en Uruguay pays que nous adorons pouvez vous me conseiller une assurance pour la santé merci de votre réponse salutations Vincent

  2. We have a 23 year-old son with Down Syndrome who is very healthy and takes no medications. Would we be able to obtain health insurance for him, and would he be able to come to Uruguay as our dependent?

    1. Hi Melissa, thanks for writing. Your son could not be discriminated against due to his condition, so I cannot foresee a problem. Of course it would make sense to check with your residency expert or the mutualista of your choice in advance of a move. Best wishes — Karen

  3. We are an older couple in very good health. By the time the borders are open and we could plan a trio to Uruguay, we will be 74 or 75 years old. Will we be able to acquire health insurance and at what cost? We are beginning to be concerned that our age will make it impossible to move abroad becasue of the insurance situation.

  4. I would like to join a mutualista and I am a legal permanent resident here in Uruguay. Since I pay property and school taxes does it allow me to join the fonesa group? The CAMEC sounds great, but I happen to live in Santa Lucia del Este which is closer to Piriapolis than Montevideo.
    Alejandra

  5. What happens if you are older than 70??? Private hospitals and mutualistas have an age limit. What would be the solution for this? Thanks

  6. Hi there

    My wife and i have recently moved to Uruguay but have not yet got our documents in order for the Cedula. We are currently on a tourist visa. Do you know if we can apply for private health cover without it?

    1. Hi Shayne, you can apply for private coverage with just your passport. Welcome to Uruguay! — Karen

  7. Are you aware of any studies / resources comparing the various mutualistas, eg costs, benefits, quality of service, locations, etc.?

    Thank you. Btw, I enjoy your website and your two books.

    1. Hi Robertson, this kind of comparative market study is not a thing in this part of the world. If we were funded it’s something that we could totally do and it would make a lot of sense. So glad to hear you are enjoying the Guru’Guay Guidebooks to Montevideo and The Guru’Guay Guide to Uruguay: Beaches, Ranches & Wine Country. All the best, Karen
      PS If you are not receiving my monthly newsletter which comes out the last weekend of the month yet, you can sign up for it using the link in our website footer. I share stuff I don’t write about elsewhere. 

  8. My true (and good) story as an expat living in Uruguay with a membership in La Espanola health mutualista:
    My breast cancer was grade 2B and required a lumpectomy and the removal of some lymph nodes in the adjacent armpit, six months of chemo, and two and a half months of radiation. Unfortunately, the chemotherapy and other medications to attack the cancer damaged my heart and caused left ventricular dysfunction. Therefore this accounting also includes treatment and testing for my newly acquired heart condition. The total period of this accounting includes 16 months of monthly premiums at approximately $60 per month, all costs for surgery and hospital visits (which equaled $0), all doctor co-pays (approximately $7 each), all Imaging and tests, and all medications. (My monthly premium was based on being a temporary resident aged 54 years old when I signed up.)

    Drumroll: $2,500, or $1,550 dollars after subtracting out the monthly premium.

    I am now doing well and walk 3 miles a day to bring my heart function back up to normal and lose weight. Funny story, after signing up for my health care plan I went to my first appointment because I needed a mammogram for my immigration process. That was when they found the cancer, the very first appointment I ever had with them!

    1. Hi Laura, I’m so delighted that you are back to walking 3 miles a day! That is so amazing that the cancer was caught in your very first appointment. Talk about serendipity. Thank you so much for sharing your story for us all. It is illuminating. — Karen

  9. Hi Karen,
    We would be very grateful for guidance enrolling in a top of the line health care association in Uruguay. We intend to retire in Uruguay (we own a house now in Playa Verde but are there only 2-3 weeks out of the year at this point). I am presently 68 years old and my wife is 59. We have now have Blue Cross Blue Shield in the US but when we spoke to the BCBS representative here in the US they said they had no affiliation with BCBS in Uruguay. We have also heard that there are age limits on certain health care associations in Uruguay. We would like to know if there is a healthcare association that is capable of servicing the Playa Verde (Piriapolis) area well and would enroll us notwithstanding our age. Do you have any advice for us?
    Thank you so much!
    Monk and Mara Topping
    PS – We very much appreciate your books! They a very important contribution!

    1. Hi Monk and Mara, thanks so much for your kind words about the Guru’Guay Guides! It’s a pleasure to add to people’s experience here in Uruguay. How lucky that you are living in Playa Verde! I love it. Regarding a good healthcare association in the area, my own experience of coverage has been with the Mautone in Piriapolis which is affiliated to my association, COSEM. You could contact them. If you struggle with Spanish, I’d definitely recommend you seek the assistance of one of our recommended relocation specialists.

  10. i am a Canadian citizen who spent 4 months last year in Uruguay and will be doing so again this year (Nov. – Feb.) and hopefully repeating that for many years to come as I really love it there. So i am not technically an expat, just a tourist, I guess. I am 72 years old and in excellent health, but at my age I hesitate to travel with no medical coverage.

    I have been told that a person can get health coverage from the government of Uruguay on a private basis, but don’t know any details. As i would much rather see my dollars go to support the system in Uruguay than to some private American insurance corporation (for ridiculously overpriced travel medical insurance), i was hoping you could give me some info about this or direct me to some other sources.

    thanx so much for this.

    1. Hi Rose, lucky you to be spending four months a year in Uruguay! It would be health insurance with a private health provider here, not the government. I guess it would depend on what paperwork they ask you for. Perhaps Mark the author can answer, or else I’m sure our other residency expert, Laura Canepa at Mobility LC will have the answer.

    2. Hi Rose,
      You can get free medical assistance via the public system for emergencies. For anything else you will have to pay a private healthcare provider. There are many schemes available and obviously the cost is a lot less than in the US (e.g. Medicina Personalizda, Asociación Española, Hospital Evangelica, Hospital Americano). Note that some schemes though have a cut off date at 60 years old.

  11. I want to comment about my experience during a hospital stay at CAMEC, my mutualista. I had a stroke on Aug. 19th., and was hospitalized with right side paralysis and speech impediment. I was released on Aug. 27th.

    When I suffered the stroke at 1130 pm, a friend called CAMEC, and in six or seven minutes, a full-fledged MD arrived at my house, followed immediately by an ambulance with two paramedics. After the MD took my vitals I was taken to the CAMEC hospital. Within thirty minutes an EKG and cranial CT scan were conducted.

    The care was excellent, with experienced qualified staff. I was reeally impressed with the meals I was served. Each morning, I was offered my choice of two entrees for both lunch and dinner. Every morning I was served with delicious coffee with maralade and crackers. Around 4 pm I was given fresh fruit yogurt.

    Lunch and dinner always comprised of soup. salad, entree, an at least one vegetable, followed by a mouthwatering dessert, typically chocolate mousse topped with freshly shipped cream.

    I received dailly physical therapy by a highly qualified professional with a very encouraging bedside manner.

    Now, for the most amazing part. Cost for the MD and ambulance ride, ER visit, EKG, and CT scan was around US $48.00. During my hospital stay, another cranial CT scan and ultrasound of my heart and neck veins blood flow were performed.

    I had twice-daily MD visits including specialists of all types such as neurusurgeons, cardialogists. and Internal Medicice.

    Total cost of my hospital stay was $0.00. Monthly premium is $48.00.

    1. Hi Edie, thanks so much for sharing more detail. Your description is so graphic – and I still can’t believe that there are places anywhere in the the world where the hospital food is described as ‘mouthwatering’!! Hope that you continue to do well – Karen

  12. What happens if you are not under any of the 5 categories listed for FONASA? A fully retired expat. Then, I assume the private insurers do not have to take you (at least not after a certain age). What do you do then? Just pay privately for everything and hope for the best? Thank you for clarifying.

    1. We are fully retired expats. We enrolled in Española being 62 and 68 at the time. Still there four years later.
      I had been told (by someone who, I discovered later, had no idea of what’s what and who’s who in Uruguay LOL) that Española had an age limit.
      Before we enrolled I asked about the age limit and the four employees present looked at me like I’d had a little too much of the locally-legal weed LOL
      Our monthly payment and copays are pretty much like Eddie Cohen’s ones. My diabetes medication is under $3/month.
      From what I understand private care companies like, for instance the British Hospital, have a 60 yo (?) age limit. Can’t say it for sure though because we never even dreamed of going that route.

      1. Christine, thank you so much for taking the time to share your experience. You did make me laugh – sometimes limiting factors that we might take for granted elsewhere (like age or pre-existing conditions) just don’t exist in Uruguay. Diabetes medication at under three dollars is just amazing. That’s less than a standard prescription in my home country of the UK. In appreciation, Karen

        PS. For those unfamiliar with Uruguay, the Española is a mid-level ‘mutualista’, whereas the British Hospital is much more top of the range.

    2. Hi Cesar, both Eddie and Christine are retired expats, so their cases are directly relevant to your question.

  13. I went to the ER a few weeks ago.

    ER visit: US $ 10.00
    Electrolyte blood analysis: US $7.11.
    Cerebral CT Scan: US $23.29
    Total: US $40.40

    Doctors still make house calls, and the cost is only US $20.57.

    If you call an ambulance, it arrives with a full-fledged MD, not an EMT.

    My mutualista is CAMEC. I pay around US $53.50 per month. For that, I get totally free hospital stays and all costs are free, including hospital stay, surgery, medications, doctor care, and nursing care. When you check out, regardless of what was done or how long you were hospitalized, you pay nothing.

    An office visit in the clinic is around US $8.00, and the monthly cost for my cancer medication is around US $0.15. The same medication in the US is around $500.00.

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