🏥 Healthcare System in El Salvador: Complete Guide
El Salvador has a dual healthcare system composed of a public sector and a private sector. This guide helps you understand the available options, costs, and how to access care.
📊 System Overview
The Salvadoran healthcare system is divided into three levels:
- MINSAL (Ministry of Health): Free, serves ~70% of the population
- ISSS (Social Security): Payroll contributions, ~25% (formal workers)
- Private: Direct payment or insurance, ~5-20%
2026 Health Budget: $1,325 million USD. Health spending: ~7.2% of GDP.
🏛️ Public Sector - MINSAL
The Ministry of Health manages the national public network with 30 public hospitals, 372 health units (primary care clinics), and community family health teams (ECOS).
Free services: Consultations, emergencies, maternity, vaccinations, prevention.
Main MINSAL Hospitals
- Hospital Nacional El Salvador (San Salvador): National reference, Telemedicine - Budget $144.4M
- Hospital Benjamín Bloom (San Salvador): Pediatrics - Budget $63.4M
- Hospital Zacamil (North San Salvador): Maternity, Emergency - Budget $53.1M
- Hospital San Juan de Dios (San Miguel): General medicine - Budget $50.3M
- Hospital San Juan de Dios (Santa Ana): General medicine
- Hospital Rosales (San Salvador): Historic hospital (1902), Internal medicine
- Hospital de la Mujer (San Salvador): Gynecology, Obstetrics - Budget $31.8M
- Hospital San Rafael (Santa Tecla): Emergency - Budget $27.1M
Limitations: Long wait times (3-6 months for specialists), medicine shortages, aging infrastructure.
🏛️ ISSS (Social Security)
Social Security covers formal sector workers and their families.
Infrastructure: 11 hospitals, 71 health units, own pharmacy network.
Contributions: Employee ~3% of salary, Employer ~7.5%. Self-employed can register voluntarily.
Services: General and specialized consultations, emergencies, surgery, maternity, rehabilitation, dental, medications.
🏨 Private Sector
The private sector offers higher quality care but at higher costs.
Infrastructure: ~30 private hospitals, ~116 private clinics, concentrated in San Salvador, Santa Ana and San Miguel.
Main Private Hospitals
- Hospital de Diagnóstico: Reference for expats, English-speaking staff, imaging, oncology
- Hospital Centro de Emergencias: Specialized 24/7 emergencies
- Centro Médico Escalón: Multi-specialties
- Hospital de la Mujer: Maternity, Gynecology
- Hospital Centro Ginecológico: Gynecology, Obstetrics
Advantages: Short wait times, modern equipment, internationally trained staff, English-speaking doctors.
💰 Costs - International Comparison
Salvadoran Private Sector vs Other Countries
- GP consultation: $30-50 (vs $150-300 USA, $50-150 Canada/Europe)
- Specialist consultation: $50-100 (vs $250-500 USA, $100-300 Canada/Europe)
- MRI: $300-600 (vs $1,200-3,000 USA, $500-1,000 Canada/Europe)
- Dental implant: $800-1,500 (vs $3,000-6,000 USA, $2,500-6,000 Canada, $2,000-4,500 Europe)
- Cosmetic surgery: $2,000-4,000 (vs $8,000-15,000 USA)
Estimated Savings
- 🇸🇻 vs 🇺🇸 United States: 60-80% cheaper
- 🇸🇻 vs 🇨🇦 Canada (private): 50-70% cheaper
- 🇸🇻 vs 🇪🇺 Western Europe: 40-60% cheaper
🌍 For Expats and Tourists
Access to Care
- Tourists: Public emergencies and private hospitals (direct payment)
- Legal residents: Access to public MINSAL system
- Formal employees: Access to ISSS through contributions
- Mandatory insurance for residency applications
Recommendations
- Get international insurance ($150-500/month)
- Have an emergency fund of $2,000-5,000
- Choose private for serious emergencies
- Hospital de Diagnóstico: Recommended by US Embassy
📞 Useful Numbers
- National emergencies: 911
- Medical emergencies: 132
- Hospital Rosales: 2222-5866
- Hospital Bloom: 2133-3100
- Hospital Zacamil: 2272-2000
- Hospital de Diagnóstico: 2505-5700
- Centro Médico Escalón: 2555-1200
🔄 Recent Developments (2024-2025)
- April 2025: $120M World Bank loan for primary care
- Telemedicine Program: $86.8M allocated to Hospital El Salvador
- New projects: Hospital zona Norte (Nejapa), Hospital Rosales renovation
⚠️ Practical Tips
- Bring your essential medications
- Check your vaccinations (Hepatitis A/B, Typhoid)
- Many medications sold over-the-counter at pharmacies
- Private hospitals often require payment or proof of insurance before treatment