Humana

What Humana does

Humana S.A. (legal name: Medicina para el Ecuador, MEDIECUADOR HUMANA S.A.) is an Ecuadorian prepaid medicine and health insurance provider founded in 1994 and headquartered in Quito. The company sells subscription-based prepaid health plans directly to individuals and families, SMEs (Plan Humana Business, Plan Pyme), and large enterprises (Plan Corporativo), with coverage tiers ranging from $15,000 to $500,000 and a flagship specialized portfolio that includes Plan Renacer (lifelong $500,000 oncology coverage) and Plan Proteger (up to $500,000 for major medical expenses or accidents), plus a dental plan (Plan Prosonrisas). Revenue is generated primarily through recurring annual premiums, supplemented by copayments collected at the point of service within the network (e.g., $15 in Red Preferida Practihumana and $25 in Red Preferida Metrohumana).

The company's core technology stack centers on the MiHumana mobile application (iOS and Android), the Humana Express online reimbursement platform, a four-step online quote-and-purchase system (Cotizador), telemedicine service provided in partnership with Metrored, and a pharmacy home delivery service integrated with Medicity, Farmacias Económicas, and Fybeca. Underlying these services is a proprietary provider network — Red de Prestadores Humana — comprising 1,247 physicians, 227 hospitals and clinics, and 798 medical centers across Ecuador, structured as a preferred network (Red Preferida), an ambulatory network (Red CAM), and a reimbursement network.

Humana is a subsidiary of Grupo Conclina C.A., Ecuador's largest medical services conglomerate, which also owns Hospital Metropolitano (flagship tertiary and quaternary hospital), Metrored (ambulatory services network with locations in Quito and Guayaquil), and Fundación Metrofraternidad (social responsibility foundation). The company serves more than 200,000 members nationwide, operates physical offices in Quito, Guayaquil, and Cuenca, and distributes through a dedicated broker portal, a WhatsApp Business customer service line, and direct digital channels. The 200,000+ member scale, 29-year operating history, and 62% market share among the three largest prepaid medicine entities in Pichincha province establish Humana as one of the leading prepaid health platforms in Ecuador.

Name

Humana

Legal name

Medicina para el Ecuador, MEDIECUADOR HUMANA S.A.

Website

https://humana.med.ec

Company type

Private

Founded year

1994

Operating status

Operating

Headcount range

251–500 employees

Short description

Humana S.A., founded in 1994 in Quito, Ecuador, is a prepaid medicine provider serving more than 200,000 individual, family, and corporate members through seven named health plans, a 1,247-physician nationwide provider network, and a digital platform (MiHumana app, Humana Express) integrated with Hospital Metropolitano within the Conclina group.

Ownership category

akta.pro rank

Product category

Prepaid Health Insurance

NAICS

Direct Life, Health, and Medical Insurance Carriers (52411)

SIC

Hospital & Medical Service Plans (6324)

akta.pro primary industry

Group HMO Plans (FSAIAFAK)

akta.pro secondary industries

Self-Funded Employer POS (ASO/TPA-Administered) (HLAEAOAH), Individual Health Insurance Administration (TPA/ASO) (FSAIAEAK)

Keywords

• Prepaid health plans
• Health insurance Ecuador
• Corporate health benefits
• Medical provider network
• Prepaid medicine

Headquarters

HQ city

Quito

HQ country

Ecuador

HQ region

Latin America

Offices4 records

Markets served

GTM type

B2B and B2C

Offering type

Services

Cost components

Operations, Personnel, Marketing or Sales, Technology or R&D, Infrastructure

Revenue model

1. Prepaid Health Plan Premiums: Annual subscription-based premiums for prepaid medicine and health insurance plans, with various coverage tiers ranging from $15,000 to $500,000 maximum coverage. Revenue generated through recurring annual fees from individuals, families, and corporate clients.
2. Copayments: Fixed copay payments collected at point of service for consultations and treatments within the CAM network. Red Preferida Practihumana has $15 copay; Red Preferida Metrohumana has $25 copay.

Pricing tiers

Go-to-market motion2 records

Distribution channels5 records

Marketing channels5 records

Core offering

Humana S.A. is a prepaid medicine and health insurance provider in Ecuador selling individual, family, and corporate health plans (Plan Individual y Familiar, Plan Renacer, Plan Proteger, Plan Prosonrisas, Plan Corporativo, Plan Humana Business, Plan Pyme) ranging from $15,000 to $500,000 in annual coverage. It supports these plans with a digital ecosystem including the MiHumana mobile app, Humana Express online reimbursement, teleconsultation, pharmacy home delivery, home doctor visits, and ground ambulance service. Members access care through Humana's nationwide provider network (1,247 doctors, 227 hospitals/clinics, 798 medical centers) and the integrated Conclina group infrastructure including Hospital Metropolitano and Metrored.

Product overview

Humana S.A. is a prepaid medicine and health insurance provider in Ecuador offering a portfolio of individual, family, and corporate health plans under the Conclina C.A. group. The core product line includes seven named prepaid medicine plans: Plan Individual y Familiar (coverage $15K–$150K annually), Plan Renacer (lifelong $500K oncology coverage), Plan Proteger (up to $500K for serious illness/accident), Plan Prosonrisas (dental plan), Plan Corporativo (large enterprise), Plan Humana Business (SME), and Plan Pyme (SME). These plans are supported by a digital ecosystem centered on the MiHumana App (iOS/Android), which provides plan management, reimbursements (Humana Express), teleconsultations, pharmacy delivery, and appointment scheduling. The provider network (Red de Prestadores Humana) spans 1,247 doctors, 227 hospitals/clinics, and 798 medical centers nationwide. Metrored serves as the group's own ambulatory network in Quito and Guayaquil. Supporting services include home doctor visits, ground ambulance, telemedicine, pharmacy home delivery via Medicity and Farmacias Económicas/Fybeca, and the Humana Direct virtual office. A broker portal enables insurance agents to manage client accounts.

Differentiator

Problem solved

Functional benefit

Brands

• MiHumana: Digital portal and mobile application for affiliates to manage their health plans, including reimbursement requests, appointments, and document downloads.
• Medihumana
• Humana Express
• Humana Direct
• Plan Renacer
• Plan Proteger
• Plan Prosonrisas
• Plan Humana Business
• Plan Pyme
• Plan Corporativo

Products and services

• Plan Individual y Familiar Individual and family prepaid medicine plan offering annual coverage from $15,000 to $150,000 for individuals and families in Ecuador, including benefits such as robotic surgery, consultations starting from $4, home doctor visits, teleconsultations, 90% coverage on the affiliated network, laboratory exams, maternity coverage, medicines, travel assistance, life insurance, and funeral assistance.
• Plan Renacer Specialized oncology prepaid medicine plan providing lifelong coverage of up to $500,000 for cancer diagnosis and treatment, backed by Hospital Metropolitano within the Conclina group.
• Plan Proteger Comprehensive prepaid medicine plan offering up to $500,000 in coverage for major medical expenses arising from serious illness or accidents (gastos médicos mayores) for individuals and families.
• Plan Prosonrisas Dental prepaid plan covering odontological evaluations, consultations, diagnostics, teeth whitening, X-rays, and dental cleanings.
• Plan Corporativo Corporate prepaid medicine plan for large enterprises offering hospitalization and physician fee coverage via pre-authorized credit or reimbursement, customized to corporate headcount.
• Plan Humana Business SME-targeted prepaid medicine plan designed for small and medium businesses to provide wellness and quality of life benefits to their workforce.
• Plan Pyme SME prepaid medicine plan providing comprehensive coverage for the human capital of small and medium enterprises (Pyme) in Ecuador.
• Humana Express Online reimbursement service enabling members to submit and process medical expense reimbursements fully digitally, with faster turnaround and bank transfer payment, eliminating the need for in-person paperwork.
• MiHumana Mobile App Mobile application for iOS and Android allowing Humana affiliates to manage their health plans, schedule medical appointments, request medication refills with direct pharmacy coverage via Medicity and Farmacias Económicas/Fybeca, submit and track reimbursements, access the provider network, and download plan documents.
• Portal del Bróker Dedicated broker portal platform enabling insurance brokers and agents to quote, sell, and manage Humana plans for their clients, accessed at portalbroker.humana.med.ec.
• Metrored Ambulatory Network Ambulatory medical services network subsidiary of Conclina group with physical locations in Quito and Guayaquil, providing in-person consultations, diagnostic services, and telemedicine covered at 100% for Humana members.
• Humana Direct (Virtual Office) Virtual office service providing an online self-service channel allowing Humana members to manage their plans without visiting a physical branch.

Quantifiable outcome

• 200,000+ members nationwide
• +3 more outcomes

Named customers1 record

Segments3 records

Ideal customer profiles2 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration9 records

Feature5 records

Partnerships

Nine partnerships are on record, tiered core, major and minor.

• Grupo Conclina C.A.coreStrategic or Co-development PartnerHumana S.A. is a subsidiary of Conclina C.A., the most important medical services group in Ecuador. Conclina also owns Hospital Metropolitano, Metrored, and Fundación Metrofraternidad, forming an integrated healthcare ecosystem.
• Hospital MetropolitanocoreStrategic or Co-development PartnerFlagship tertiary/quaternary care hospital within the Conclina group network, serving as the primary hospital for complex procedures and surgeries including robotic surgery for Humana members.
• MetroredcoreTechnology or IntegrationNetwork of outpatient medical services with locations in Quito and Guayaquil. Humana members can schedule appointments through the app and access services with copay-based payments. Telemedicine consultations with Metrored are covered at 100%.
• Fundación MetrofraternidadcoreStrategic or Co-development PartnerSocial responsibility foundation providing complex medical surgeries and care to children and adolescents from low-income families. Humana and its members participate in social outreach programs.
• MedicitymajorTechnology or IntegrationPharmacy partner enabling direct coverage for medications ordered through the MiHumana app, eliminating reimbursement paperwork for members.
• Farmacias EconómicasmajorTechnology or IntegrationPharmacy network partner for direct medication coverage through app-based ordering with no reimbursement required.
• FybecamajorTechnology or IntegrationPharmacy partner integrated into the medicine home delivery service with direct coverage application for Humana members.
• PlaceToPaymajorTechnology or IntegrationSecure online payment gateway partner for processing credit and debit card payments for plan purchases and premiums.
• Jardines del ValleminorStrategic or Co-development PartnerFuneral assistance partner providing burial coverage for policyholders and dependents included in Humana plans.

Scale indicators9 records

Recent moves6 records

Expansion highlights6 records

Regional players

• Sura: Major Latin American insurance and asset management group offering health insurance and prepaid medicine products across multiple Andean and Central American markets. Comparable to Humana on prepaid health offerings, with regional scale advantage.
• Auna: Latin American integrated healthcare platform combining prepaid health plans with owned hospitals and clinics, primarily in Peru and Colombia. Comparable to Humana on the integrated prepaid-plus-provider model, though operating in different geographies.
• Pacífico Seguros: Major Peruvian health insurer offering prepaid health plans and corporate medical coverage through affiliated provider networks. Comparable to Humana on prepaid health plan model and employer-sponsored coverage, though concentrated in Peru.

Direct peers

• Saludsa: One of the largest prepaid medicine and health insurance companies in Ecuador, offering individual, family, and corporate plans with a nationwide provider network. Direct head-to-head competitor to Humana in the Ecuadorian prepaid medicine market.
• Confiamed: Ecuadorian prepaid medicine company offering individual and corporate health plans with affiliated provider networks. Competes directly with Humana for individual and corporate prepaid health plan members in Ecuador.
• Ecuasanitas: Ecuadorian prepaid medicine operator providing individual, family, and corporate health coverage through an affiliated network of doctors, clinics, and hospitals. Directly comparable to Humana on business model and target market.
• BMI del Ecuador: Ecuadorian prepaid medicine operator offering individual and corporate health plans with affiliated provider networks. Direct competitor to Humana in the Ecuador prepaid medicine market, similar size and customer segments.

Broad incumbents

• Mapfre: Large Spanish-headquartered multinational insurer with significant Latin American health insurance operations. Comparable to Humana on health insurance product offering, though operates at far broader scale and across multiple lines of business.
• Keralty (Sanitas): Global health group operating Sanitas prepaid medicine and health insurance across Latin America (Colombia, Ecuador, Brazil, etc.) with vertically integrated provider networks. Closely comparable integrated model to Humana/Conclina, with broader geographic footprint.
• Bupa: Global health insurance and healthcare group operating in Latin America, including Ecuador. Comparable to Humana on international private health insurance product structure and individual/corporate target segments.

Market position

Strengths4 records

Weaknesses4 records

Competitive moat6 records

Key risks5 records

Key highlights7 records

Customer concentration

• Facebookfacebook.com/HumanaEc
• Instagraminstagram.com/humanaec

Revenue estimate

Valuation estimate

Number of profiles

Subsidiaries1 record

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Humana