When once is living in a new country, it is always important that you live in that country according to their rules. As Dorothy said in the Wizard of Oz, “You’re not in Kansas anymore!” What she meant by that is that what was the norm in the United States, or wherever you are from, may not be the norm of the country where you are now living.
Here in Ecuador, for example, the immigration rules changed and instead of being able to get a Permanent Residency Visa, you now get a Temporary Residency Visa, which is good for two years. At the end of that time, or right before your Temporary Residency Visa expires, you can apply for a Permanent Residency Visa. As of yet, with the Temporary Residency Visa a Cedula, or Ecuadorian ID, has not been issued. They plan on having one, but so far nothing.
Another change that has occurred is that not only will those who are living here be required to have Health Insurance, but all travelers/visitors to Ecuador will be required to either have Traveler’s Health Insurance or Health Insurance that will be able to be used in Ecuador should the need arise. You will have to have an insurance card or ID and a letter stating that the insurance you have can be used in Ecuador. We have Tricare Overseas, which is a U.S. Government Health Insurance that is available for all U.S. Military personnel or retired/disabled former Military and their families. While you can print out a copy of the benefits letter from their website, because it does not specifically say it can be used in Ecuador, it may not recognized. Additionally, a Certified copy of the benefits letter is required and it could be required to be apostilized like documents that are used to get your Residency Visa.
Getting in touch with personnel at TriCare who would listen to what you needed and not just read script, proved to be difficult so we began researching insurance available here in Ecuador and found that there are many. One needs to do their homework and research the companies to find out which will work for your particular needs. There was one we looked into that is based in the U.S. and offers so-called International Health Insurance. When asked if they provide an insurance card and benefits letter, they kind of danced around without giving any kind of clear answer. The one thing they were sure of was that you needed to either pay $12,000 up front or you could pay in 2 payments. Needless to say we walked away from that one rather quickly.
There are companies who will issue insurance based on your income and your premiums are based on a percentage of that income. So you could be paying anywhere from $150 a month to well over $500 a month. After much research, we found a company that offered 3-4 plans, were not based on your income and there are no deductible requirements. We have the option of either using their doctors and hospitals/clinics, referred to as “in network” or using doctors, hospitals or clinics of our choice. If we go out of network, we pay the bill, then submit the claim to the insurance company and 2-3 weeks later, we are reimbursed and our medical services will end up costing us nothing. If needed, they even offer pet insurance!
We decided to use this company and selected their $20,000 policy. The $20,000 is a cap on medical they will pay per year and will cost us $200 each per month. If after a year we find we don’t need that much of a cap, then we can reduce it to the $15000 policy, $150/month per person, or if we need more can go to the next level. All our prescriptions will be covered and, if needed, can even have the physician visit our home. Nice to know that there are doctor’s who still believe in house calls.
Unlike the U.S., for example, where a visit to a doctor’s office can be expensive, my primary doctor charged $223 per visit, here in Ecuador the cost is nowhere near that. I had to see a doctor for what I thought was walking pneumonia and the visit was $30. Because he felt I didn’t need an antibiotic and prescribed some light medication to help with the cough, my prescription was $5. Here in Ecuador, most doctor’s make their own appointments, have a small office without staff, and thus do not have the overhead you find in the U.S.
Dentists here are not as expensive either. We had our teeth cleaned to check out one dental agency and the cost was $35 for a deep cleaning. I couldn’t believe it, my dentist in the U.S. charged $175 to clean my teeth and I have an upper denture and a full lower permanent implant!
In summary, it is important to be able to change with the requirements of whatever country you are going to call home. It will do you no good to say, “we don’t do it that way back (fill in the blank of where you are from).” You could be told to go back where you came from.
Since my last posting, we have been notified that our belongings will be shipped on the 28th of September and should arrive in Guayaquil on October 5th. I will be posting on the experience of dealing with Custom’s once we have completed our business with them. We will be going to Guayaquil the day before the ship is due to arrive and will meet with Customs to go over our inventory of what is in our container the next day. The shipment had been postponed due to Hurricane Irma hitting the U.S. Additionally, the settlement on our home will, hopefully, be held on September 28th as that too was postponed due to Hurricane Irma. The house had to be re-inspected to make sure there were no damages since parts of Florida had been declared a disaster area. We will be glad when the new owners take over so we won’t have the mortgage and homeowners insurance to content with any longer. In Florida, Homeowners insurance is very expensive and there aren’t a lot of company’s that will insure. Some areas require hurricane insurance, flood insurance, and more.
Until the next time my friends, wishing you all the best that life has to offer. Take care and God bless.
Terri at the Drake’s Nest
Book signing at Blue Phoenix Book store in Alpena, MI on 9-3-2011