Medical Tourism: Escape The USA Healthcare Scam!

Healthcare and Health Insurance in the United States is a huge headache that can rightfully cause you a lot of distress. We know people who work jobs they hate or even delay retirement simply because they need health insurance. It doesn’t have to be that way!

Before we moved to Ecuador, JP had two surgeries on his back that ended up costing almost $1,000,000. After that, our health insurance premiums skyrocketed. It’s a familiar story, but we found a happy ending, going outside the States for our healthcare needs. 

We’ve compiled a list of the top 10 countries that have better health care at a fraction of the cost. Now you can plan your next medical procedure along with the trip of a lifetime! 

What is Medical Tourism? 

The concept of medical tourism may sound a little out there, but it’s becoming increasingly popular, and for good reason! In many of these locations, you can pay for a month long medical tourism trip and still spend less than you would to get the same procedure in the United States. 

Medical tourism companies can help you get connected with doctors and ensure you have everything you need, including the proper visas. Another option is to apply for permanent residency, allowing you to stay there and pay a lot less for your healthcare. Global health insurance is also available, and if you exclude the United States from the list of places you get treatment, it can be extremely affordable. 

Let’s jump in and look at our favorite places to get medical care! 

10. France

France is known for its high quality – but low cost – healthcare.  Every year, CEO world puts out a ranking of the top healthcare systems in the world, and this year France ranked number seven! 

There is even a specific healthcare system for foreigners called Protection Universelle Maladie (PUMA). It allows access to state healthcare after only three months of residence. If staying in France for three months isn’t quite what you’re looking for, you can also turn towards private or global health insurance to help cover the costs. 

If France sounds like the perfect place to get your medical problems dealt with, you’re not alone. Medical tourism is incredibly popular in the area. You can enjoy all the romance and beauty that is in France while getting the care you need. 

9. Spain 

If you’ve ever dreamed of living where they filmed spaghetti westerns or where delicious Spanish wine is made, you might want to consider medical tourism in Spain. CEO World ranked Spain number 8 on its list of healthcare systems. 

This country features both a public and private healthcare system. If you’re looking to use the public system, you’ll need to contribute income tax and social security, but there are extremely affordable options for private insurance. In fact, some of the prices are as low as what we pay in Ecuador! 

Spain is incredibly popular for medical tourists because of its beauty and culture, as well as the long-term options for visas. 

8. Czech Republic

Ranked number 14 by CEO World, we love the Czech Republic because of its excellent health care, multiple options for visas, and low cost of living.  They are known far and wide for their excellent universal healthcare. 

If you’re looking to become a permanent resident in the Czech Republic, you are required to get private health insurance. There are lots of English-speaking practitioners, and medical tourism is popular, so they will be familiar with your situation and know how to deal with it. 

One of the unique offerings in the Czech Republic is its spa designed specifically for cancer survivors

7. Portugal 

With their state-of-the-art facilities and significantly less expensive procedures, Portugal is very popular among medical tourists. CEO World ranked its healthcare number 22, and treatment there can cost between 50-30% of what it costs in the US. 

Public health insurance is available for both citizens and residents, so if you go there as an expat, you’ll have no trouble using their system. It’s almost free, paid for with taxes and social security. 

6. South Korea

South Korea was ranked number 1 by CEO World! It’s known for being safe and affordable, as well as having lots of things to do and see while visiting. That, combined with their available one-year medical visa, makes South Korea a very popular destination for medical tourism

We have heard from lots of friends that it’s a joy to live in South Korea as a foreigner, so this is one destination you won’t want to write off. 

5. Thailand

An excellent option for medical tourism, Thailand is ranked number 13 by CEO World. Thai hospitals are some of the best in the world, and the procedures cost a mere 10-20% of what you would pay in the US! 

Thailand is a popular destination for expats because of its exciting culture and low cost of living, so you may want to consider a longer-term visa. You never know if you might fall in love with the country! 

4. Malaysia

Even though CEO World ranked Malaysia number 34, the only ranking lower than the United States, we’ve done our research and believe that it’s a strong choice for your procedures. While the pandemic hit this healthcare system hard, they are back on track to returning as one of the top healthcare systems in the world. 

They’ve been putting a lot of effort into their medical tourism, which isn’t a surprise because their hospitals are top-notch and provide care for as little as 20% of the cost in the United States. Malaysia does have public healthcare that expats can access, but you’ll end up paying higher rates, so private health insurance is a great option – and not too expensive. 

You aren’t required to have health insurance in Malaysia at all, so if you want, you can pay out of pocket for procedures. 

3. Argentina 

Argentina is one of the best countries for healthcare in South America. CEO World rated it number 27 out of all the healthcare systems in the world. They have private health insurance that’s extremely affordable and just recently started to include medical marijuana. 

The healthcare costs are 60-70% cheaper than those in the States. There’s so much to experience in Argentina over your stay, and with a one-year medical visa available, you’ll have more than enough time to enjoy this country fully.  

2. Mexico 

A long-time favorite of medical tourists from America, Mexico is easy to get into and offers high-quality procedures at a fraction of the cost. Ranked number 29 by CEO World, Mexico’s healthcare system is 3–4 times less expensive than the US.

There are even hospitals all along the border that cater specifically to medical tourists! Many doctors got their training in the US, so they speak fluent English. There are both private and public insurance options, so no matter what, you’ll be able to find an option that works for you. 

1. Ecuador

It should come as no surprise that our favorite place to get healthcare outside the US is Ecuador! Ranked number 25 by CEO World, it came in five better than the States.  

Our costs here are so low we’re always shocked when we go to the doctor to get anything done. We have health insurance that covers both of us for only $192 a month (with JP’s pre-existing condition).

We haven’t had any major procedures done since coming to Ecuador, but we know people who have had cancer treatments, shoulder injuries, and heart surgeries that they were very happy with. In general, healthcare will cost a mere 25% of the cost in the States, and many doctors speak English. 

You will deal directly with the doctor right away; you won’t have to spend weeks or months just interacting with nurses or admin staff. So many people come here for dental tourism as well, and it is significantly cheaper even with travel. 

Bottom Line

Healthcare can be such a complicated and stressful thing to deal with. We hope that by making you aware of the options, we’ve opened your eyes to the whole world of possibilities available to you with medical tourism. Happy healthy travels!

Watch Our Video About Medical Tourism


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10 Reasons Ecuadorians Leave (And Why it Shouldn’t Deter You)

Immigrating to a new country takes a lot of time and thought, so of course, you want to be sure that the place you’re moving to is just right. Many would-be expats interested in starting a new life in Ecuador look at the immigration statistics and see that lots of Ecuadorians are leaving their country. This can be troubling.

We know that the cost of living in Ecuador is low, the weather is great, and the culture is beautiful. So the question remains, why are Ecuadorians leaving, and should it deter you from settling down in the country? 

We’re going to take you through some of the most common reasons people leave Ecuador, and hopefully, you’ll see that it’s not as foreign as you might expect. 

10. Better Education for Their Children

The public education system in Ecuador is indeed lacking. However, that doesn’t mean there aren’t any good schools here. There are many thriving international and private schools, but these can be more expensive.

While wealthier Ecuadorian families may send their children to these specialized private schools, many middle- and working-class Ecuadorians cannot afford the tuition. So, for these parents, finding a better educational opportunity for their children is one of the main reasons they leave Ecuador.

9. Studying Abroad

Many Ecuadorian students choose to leave the country for their higher education. This is because they want to be exposed to new cultures and ideas, and they feel that they can get a better education elsewhere.

You’ll find many doctors, engineers, architects, and even musicians who went abroad to get more specialized training in other countries. While some of these students stay in the countries their schools are in, many of them return to Ecuador to start up their businesses and practices.

8. Visiting Family in Other Countries

This is a big one. Because so many Ecuadorians have family members living in other countries (the U.S., Spain, Italy, Argentina, etc.), they often choose to leave Ecuador for extended visits with loved ones. This is especially common among the older generations of Ecuadorians who have children and grandchildren living abroad.

7. Healthcare

There is a misconception, even among Ecuadorians themselves, that their healthcare system is not up to par with developed countries. Much like with schooling, while the public healthcare system can struggle with funding and doctors, the private system is fantastic. 

Private healthcare here is easy to navigate, affordable, and has exceptionally well-educated professionals working within it. While experimental treatments are often more easily accessible in places like the United States, regular everyday healthcare in Ecuador shines. 

The doctors are not as quick to prescribe drugs when lifestyle changes will do the job, and you can have access to prescription medications that might not be available in the United States.

6. Concerns About Corruption

Many people in Ecuador are concerned about corruption and political instability within their country and believe that it will be better somewhere else. However, there is corruption all over the world.

Living in a different country can protect you from these concerns because you don’t have the historical baggage that comes from being born and raised in a country and knowing the ins and outs of every issue. 

In fact, when people we talk to describe corruption within the government, it’s often similar to how lobbying operates in the United States.

5. Increase in Crime

Unfortunately, over the past few years, Ecuador has seen an increase in crime. This is likely due to a variety of reasons, including the current economic situation and political instability. While petty crime such as pickpocketing and bag-snatching is common, there have also been reports of more serious crimes such as home invasions and robberies. There’s also been an increase in drug cartel and gang activity which is worrisome to Ecuadorians. 

 Of course, this isn’t to say that crime doesn’t happen in other countries – it does. But for many Ecuadorians, the increase in crime is one of the main reasons they’ve decided to leave.

4. A Desire to Experience Other Cultures

For some Ecuadorians, living in their home country can feel a bit like being in a bubble. Sure, there are different cultures within the country, but many people never get the chance to experience life outside of Ecuador. 

Additionally, travel can be expensive and time-consuming from Ecuador. So, for some people, leaving the country is simply a way to open up their world and learn about new cultures.

3. A New Adventure

This is similar to wanting to experience a new culture; however, some people have been bit by the adventure bug. If it’s cycling, skiing, or rock climbing, some Ecuadorians leave to get closer to their ideal adventure locations. 

These people may not move abroad, but they certainly spend quite a bit of time abroad, sometimes taking several months off from work to experience the world. While this is a foreign concept to many Americans, it’s common practice in Europe, and in many other parts of the world

2. Learn a New Language or Improve Their English

While some people might leave Ecuador to learn a new language, others do it to improve their English. In a globalized economy, being bilingual or trilingual is seen as an asset. 

Many Ecuadorians who want to work in international companies or pursue careers in fields like medicine or law know that they must brush up on their English before being competitive in the job market.

1. Better Economic Opportunities

While the cost of living in Ecuador is quite low, that can also translate to lower wages. For many Ecuadorians, leaving the country is a great way to find work that will allow them to send large amounts of money back home.

There are also quite a few entrepreneurs in Ecuador, and they will leave to make money that they can use to build a business when they return.

The Great Return

In recent years we’ve seen a big increase in people moving back to Ecuador after spending time abroad. Many of them move home for the same reasons that you would want to settle down in Ecuador. There’s a lower cost of living, the culture is rich and exciting, and the people are kind. 

There is also the added bonus of returning to families and having less discrimination than they may receive as an immigrant. 

There are lots of misconceptions about all Ecuadorians being illegal immigrants, but in reality, there are many more people who can legally move to other countries. 

Conclusion

To sum it up, Ecuadorians leave Ecuador and move back to Ecuador for the same reasons everyone leaves their home country or moves back to it. People are the same everywhere, so the fact that many Equadorians are becoming expats should not prevent you from living the dream along the equator.

Watch Why Ecuadorians are Leaving Ecuador


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48 Hours In Cuenca Ecuador: The BEST Itinerary to Experience the Gem of Ecuador

We were so excited to be able to return to one of the most beautiful and vibrant cities in the world, Cuenca Ecuador. There’s so much to do, and we were able to pack a lot into 2 days.

If you’re lucky enough to be visiting Cuenca for a few days and want to make the most of your time, here’s an out-of-this-world itinerary to experience the breadth of the city in just 48 hours!

Day One

Birding in Parque Paraíso

Thousands of bird enthusiasts flock to Ecuador every year to experience the unique and thriving bird population. With over 1650 species of birds (including 132 types of hummingbirds) we have the highest density of birds in the world!

Our guide Carlos was so knowledgeable, and with his help, we were able to spot over 20 different species of bird in just 2 hours. Even if you aren’t usually interested in bird watching, seeing so many hummingbirds and waterfowl in one place was an invigorating experience that you won’t want to miss!

Tipping Your Hat at El Museo del Sombrero de Paja Toquilla

This museum is one of the most popular tourist attractions in Cuenca, and it’s clear why. Not only were we able to learn all about the history of the Panama hat, but we were able to get our own custom hats to take on the rest of our adventures!

Although the straw hats are named for Panama, they were worn by the indigenous people of Ecuador for hundreds of years before making their way north in the early 1800s. Popular during the California gold rush, Panama hats gained international fame when President Theodore Roosevelt wore one on his visit to the construction site of the Panama Canal.

While the history and behind-the-scenes tour is fascinating, one of the most memorable parts of this museum is the store. There’s a plethora of unique, handmade Panama hats for you to explore, and what’s more, they’re all completely customizable.

If you want a hat resized, fitted with a new band, or made completely from scratch, they’re able to provide whatever alterations you desire. It’s a bit like the Willy Wonka factory of hats!

While you wait for your hat to be made perfect, you can enjoy the café upstairs, complete with one of the most incredible views in the city.

Visit Diverse Markets like Casa Yangoe

If you know us, you know how much we love organic produce. That’s why we couldn’t miss the new market right near the hat museum. Casa Yangoe featured fresh fruits and vegetables, sourdough bread, handmade indigenous clothing, and of course Ecuadorian chocolate.

Explore Culinary Delights at Restaurants like LaMaria Cocina Libre

We consider Cuenca to be the culinary capital of Ecuador, so if you’re only visiting for a short time, tasting the local food is a must. LaMaria was an excellent choice for us because it was born as a tribute to the women who worked to protect Ecuadorian culinary traditions.

The menu featured a variety of gourmet traditional dishes including veggie ceviche, avocado, corn tacos, and more.

Experience the Wild Side at Prohibido Centro Cultural

With so many museums to choose from in Cuenca, it’s fun to get a bit off the beaten path and explore something more macabre. Prohibido Centro Cultural is an extreme art gallery that showcases the dark side of the city’s artistic imagination.

Eduardo Moscoso was constantly at odds with the more conservative town leadership of Cuenca before founding this museum. It feels a little like a haunted house, with depictions of demons, skulls, and destruction. The museum is small but packs quite the punch.

Cleanse Your Artistic Pallet At La Lira

If darker art isn’t your thing, right next door is a more traditional art gallery. La Lira features different artists every couple of months, so it always has something new to see. They also host poetry and book readings along with live music performances.

Walk Along History in the El Vado Neighborhood

This might just be the most significant point of interest in Cuenca because without it the city might not exist at all. El Vado was the first neighborhood created by the Spanish in 1557. The original residents had to wade across the Tomebamba river to enter the city, leading to the name El Vado, which translates to “the ford.”

The area also features a beautiful Palo Ensebado sculpture depicting a traditional game involving climbing a pole to get prizes. This is a great way to see the vibrant culture year-round.

Day Two

Be Transported to the Incan Empire at Pumapungo

This free museum holds stunning artifacts from the ancient Inca Empire. Clay pots, ancient tools, art, and even shrunken heads abound!

While the inside of the museum is, of course, a joy, our favorite thing to do is walk around the grounds. They feature ruins from the 1400s, and if you’re lucky you might spot some llamas on the hills.

Let Your Cares Wash Away At Piedra de Agua

Just 15 minutes from El Centro is THE best spa in South and Central America. Piedra de Agua won the title just this year after opening in 2008. Enjoy thermal pools, mud baths, and delicious food and refreshments surrounded by breathtaking nature.

The hot water used at this spa comes from a spring that’s 4000 meters deep. They have food to cater to any dietary restrictions, so long as you call ahead and let them know.

We were able to enjoy the cave experience in a romantic underground area just for us. With various spa treatments and Champagne flowing, it was a one-of-a-kind experience that we will not soon forget.

Beyond the 48

There’s truly so much to do in Cuenca, this guide only scratched the surface. We have other guides to fill out your itinerary if you have more time.

From the New Cathedral to San Francisco Plaza, there’s always more beauty and culture to take in. And of course, you can’t miss the world-famous Cuenca flower market.

We recommend budgeting a full week to take in all this amazing city has to offer.

Conclusion

While two days may not feel like a lot of time to experience the culture and beauty of one of Ecuador’s oldest cities, if you know what you’re looking for you’re sure to experience something unique and exciting.

From breathtaking views to shrunken heads to underground spas, there’s an adventure around every corner. We know once your time is done, you’ll be jumping at the chance to spend another 48 hours in Cuenca!

Watch the 48 Hours In Cuenca Video


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This newsletter covers things we don’t share ANYWHERE ELSE! You’ll get all sorts of timely information about Ecuador and global expat news that might affect your travel or move decisions.

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Cuenca Ecuador ExpatsWe've assembled a supportive community of current and future expats who are eager to share their experiences, answer questions and offer encouragement as you embark on your move abroad.

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Ecuador Temporary Resident Visas

UPDATED FEBRUARY 2, 2023

There are several different types of Ecuador Temporary Resident Visas: Professional, Investor, Pensioners, Rentista/Digital Nomad, Dependent, etc. The qualifications and requirements vary for each type of visa so you’ll need to select the best option for your specific circumstances.

You can apply for an Ecuador permanent residency visa after 21 months of your temporary residency providing you haven’t left the country for more than 90 days during that period. The permanent visa requirements are identical to the temporary visa requirements. The only difference is that the temporary visa is valid for 2 years while the permanent visa never expires.

If you would like to discuss your visa options with Maite and her team at GringoVisas, please submit our Visa Agent referral form and we’ll send an immediate email introduction.

Several substantial changes were made to the Ecuador visa laws in March 2022. The new visa laws ONLY apply to NEW temporary visa applicants. If you are currently living in Ecuador with a temporary residency visa that was issued prior to March 2022, you can apply for a permanent residency visa at your 21-month mark under the old visa laws and income requirements as long as you haven’t been outside Ecuador for more than 90 days during your temporary visa period. If you have questions or special circumstances, please check with a qualified visa agent.

General Requirements for Ecuador Temporary Resident Visas

There are a few general requirements for all Ecuador Temporary Resident Visas. You can read the detailed list on the government website here; however, here are the main things you’ll want to consider:

Ecuador Temporary Resident Visas

Passport Expiration

If your passport will expire during the 2-year visa period, we recommend renewing your passport before applying for the visa.

Ecuador no longer attaches physical visas to your passport. Instead, they issue electronic visas that are attached to your passport number.

When you renew your passport, you’ll get a different number which means your visa will need to be electronically transferred to the new passport. This requires a $100 fee and an additional trip the visa office to sign paperwork.

There’s no harm in renewing your passport early and doing so will save you a lot of inconvenience.

Health Insurance

Health insurance is required for the pensioner visa and to get a cédula for all types of visas (not the 90 day tourist visa). You will need health insurance from a private Ecuadorian health insurance company. We’re happy to introduce you to our recommended Ecuadorian health insurance brokers here…

If you have foreign health insurance that will cover you in Ecuador, the contract needs to state specifically that you will be covered in Ecuador. You may need to request a special contract from your insurance company that specifically states “Ecuador” in the coverage area.

Income Requirements

Each type of visa has different income requirements detailed below.

For the pensioner visa, you must prove monthly income based on statements from Social Security, a pension or other retirement accounts.

For all other visa types, you must prove income based on bank statements from the previous 3 to 12 months, depending on the type of visa and the ministry official.

Self-deposits are allowed because they don’t verify the source of funds. That means you can deposit money into your own account from another account, or someone else like your spouse can deposit money into your account to meet the minimum income requirements.

It’s best to use an account that is only in the primary visa holder’s name rather than a joint account. If you have a joint account that you’re planning to use for the visa application, the Ecuadorian ministry will only consider 50% of the deposits as income for the primary visa applicant. Therefore, you would need to deposit twice the minimum income to meet the visa requirements.

You cannot combine income sources from your spouse or any other source. All the income must be in the primary visa holders income statements and/or bank statements.

Fingerprints & Background Checks

You’ll need to provide a State Police Report for your home state and a Federal FBI background check with your application.

Ideally, your background checks will be squeaky clean, but if you have a minor offense with a reasonable explanation, or if it happened a long time ago, it may not affect your application process. The ministry official has the final say, but a visa agent can help you navigate the process and advocate for your approval.

These reports must be less than 6 months old when you file your visa application. If they are more than 6 months old, you will need to request them again and pay for the new reports, so plan carefully.

Marriage License & Birth Certificates

For dependent visas, you’ll need a marriage license for a spouse or birth certificates for children. The documents need to be less than 6 months old when you send them for apostille; therefore, you will likely need to order new certified copies.

You can register your marriage license in Ecuador at a Registro Civil office so it will always be on file and you won’t need to go through this process again when you apply for permanent residency. Ask your visa agent for help with this.

Apostilles, Translations and Notarizations

ALL documents must have an apostille if you’re moving from a country that is part of the Hague Convention. If you’re from Canada, ALL documents must be legalized at the Ecuadorian consulate or embassy.

Additionally, ALL documents must be less than 6 months old to qualify for an apostille and to be accepted by the Ecuadorian Immigration Ministry when you submit your visa application. That means you need to plan the timing of your documentation very carefully.

Once all documents have an apostille, they need to be sent to Ecuador to be translated by a certified Ecuadorian translator and then notarized by an Ecuadorian notary.

A visa agent can help you navigate this complicated and time-sensitive process.

Ecuador Temporary Resident Visa Ministry Fees

Ecuador Temporary Resident Visas have two primary fees. The temporary resident visa application fee is $50 per person and is non-refundable. If your visa application is approved, the temporary resident visa fee is $400 per person.

Permanent Residency Consideration

The temporary visas no longer have travel restrictions, which means you can be outside Ecuador as much as you want during your 2-year Ecuador temporary residency.

HOWEVER, if you plan to apply for permanent residency after 21 months, YOU CANNOT BE OUTSIDE ECUADOR FOR MORE THAN 90 DAYS DURING THE 21-MONTH PERIOD!

In other words, you can be outside Ecuador for a total of 90 non-consecutive days during the 21 months leading up to the application date of your permanent residency visa. If you are outside Ecuador for more than 90 days during that period, you will need to apply for another temporary residency visa rather than a permanent visa.

Ecuador Temporary Resident Visa Types

All temporary residency visas in Ecuador are good for 2 years from the date of issue. You are allowed to apply for permanent residency after living in Ecuador for 21 months as long as you haven’t been outside Ecuador for more than 90 days during that period.

You can review all of the visas types and their specific requirements on the Ministry of Foreign Affairs and Human Mobility website. The Ecuadorian government websites are all in Spanish, so here is a helpful article showing you How To Translate Websites to English from Spanish (or any other language).

Professional Visa

The Ecuador Professional Visa has the following requirements:

  • Monthly income of at least USD $450 (there is no additional income requirements for dependents)
  • An undergraduate or graduate degree from a university approved by Senescyt, which is the entity in charge of recognizing foreign higher-level degrees
  • A notarized diploma with an apostille
  • A notarized transcript with an apostille
  • A notarized letter with an apostille signed by a university official stating the diploma and transcript are valid, and that at least 80% of the classes were taken in-person (not online)
  • A notarized letter with an apostille signed by a university official stating the field of study and level of education according to the International Standard Classification of Education (ISCED) of Unesco

My temporary (and now permanent) visa is a Professional Visa, which means I still work, have regular income from outside Ecuador, and a degree from an approved university. Senescyt no longer publishes an “approved university” list. Most universities are now accepted, but they still go through the same approval process that they always have.

Amelia has a degree from The University of Phoenix, but that university is not accepted by Ecuador because the majority of classes are taken online. To qualify as an approved university, more than 80% of classes must be taken in a classroom setting and not online.

I went to the University of Kansas (Rock Chalk Jayhawk) for both my bachelors and masters degrees. When I graduated in the 90’s, online courses weren’t a thing yet, so I took all my classes in-person. This means Amelia is here on a dependent visa that’s attached to my professional visa.

We had to get an official diploma and transcript from KU for my most advanced degree (Masters). We also had to get a notarized letter from a university official stating my degree was valid and that the classes were taken in-person. Then we sent all the documents to the GringoVisas office in Connecticut so they could get the apostille before mailing them to Ecuador.

Investor Visa

For the Ecuador Investor Visa, you must show $450/month in income  and you must invest $45,000 in either a CD or property. There is no additional investment requirement nor additional income requirements for dependents.

Certificate of Deposit (CD): You can invest $45,000 in an Ecuadorian COOP CD for at least 2 years, the duration of your Ecuador Temporary Resident Visa.

The interest rates on the CD’s will shock you if you’re coming from the US where banks no longer pay meaningful interest. As of this writing, the interest rate on a 2 year CD in Ecuador is roughly 8.0% annually! That’s around $283/month in interest on your $45,000 CD!!!

You can leave the interest in the account so it compounds, but you are allowed by law to withdraw the interest income from your CD without invalidating your visa. However, you need to be careful when signing the paperwork with a COOP like JEP because they will default the application to prevent withdrawal of the earned interest until the CD end date. Be specific with them and tell them that you want to withdraw the interest every month, 3 months, or each year, whichever you prefer.

Bank deposits are only insured up to $32,000 so that means at least $10,500 of your investment will not be insured. You are not allowed to split the investment into different accounts or different banks to make up the difference, either. The entire investment must be in one CD.

Property: You can purchase property to qualify for an Investor Visa in Ecuador. The only requirement is that the property be assessed by the municipality for more than $45,000.

The ministry will issue a visa lien against your property and if you wish to sell it you will have to forfeit your visa and request a lien release.  (You can apply for a different type of visa or convert to a permanent visa before selling the property.)

The assessment value may be substantially lower than the purchase price. You can request a new assessment if the registered value is less than $45,000.

You are not allowed to transfer the investment without reapplying for the visa. So, for instance, you cannot use your CD to buy property. The investment must remain the same for the entire duration of the Temporary Resident Visa and cannot be changed or transferred.

Pensioners Visa

In order to get a Pensioners Visa, you need to show income for the remainder of your life of at least $1,350/month + $250/month/dependent.

Your income can be from Social Security, a pension, retirement accounts, annuities, etc. If you’re using Social Security for your income requirement, you’ll need an annual statement from the Social Security Administration (SSA) that’s signed by an SSA official and has an apostille at the federal (not state) level.

Rentista (or Digital Nomad) Visa

The Rentista Visa has been updated to function more as a Digital Nomad Visa as of March 2022. There are now two ways to qualify for this visa.

Digital Nomad Visa: If you are a digital nomad or work remotely for a company abroad or as a freelancer, you need to show an income of $1,350/month + $250/month/dependent, or a yearly income of $16,200 + $3,000/year/dependent (based on bank statements) for the previous 3 to 12 months.

Additionally, you need to prove you work for a real corporation or LLC by providing the legal business documents. If you are a freelancer, you need to have your own legal LLC.

You may also need proof of your work contract or employment that states you will continue to earn an income after you move to Ecuador for at least 2 years.

Rentista Visa: If you own a rental property outright in your home country, you may be able to use that as the support for your visa.

You are required to have a tenant with a 2-year lease agreement for at least $1,350/month in rent + $250/month/dependent. You will need to provide the deed of ownership for the property and the 2-year rental agreement.

Work Visa

For the work visa you must be sponsored by an Ecuadorian company. The company has to pay into the IESS and you need a 2-year work contract.  This visa can now be converted into a permanent resident visa provided you don’t leave the country for more than 90 days during the first 21 months.

Dependent Visa

A Dependent Visa must be attached to a valid Temporary Resident Visa and can be used for your spouse, children, parents, grandparents, brothers, sisters, or any blood relative. The primary Temporary Visa must be issued before the Dependent Visa application can be filed.

Ecuador Temporary Resident Visas

With the Pensioner visa the primary visa holder must show an additional income of $250/month/dependent and the additional income can come from any source. For the Rentista/Digital Nomad visa, you have the option of showing at least $3,000/year/dependent in lieu of the $250/month/dependent.

There are no other special requirements for the dependent visa. The dependent visa holder has all the same benefits and requirements as the primary visa holder.

Amelia is here on a dependent visa attached to my professional visa. Since our visas were issued prior to the visa law updates back in February 2021 (not 2022), we are stuck under the old rules. That means as long as we stay married, she can maintain her dependent visa, but if I die or we get divorced, she will need to get her own visa and start the entire process over from the beginning. That’s the major downside to the Dependent Visa in Ecuador prior to February 2021.

However, for visas issued AFTER February 2021, dependent visa holders no longer lose their visa if the primary visa holder dies. If you get divorced, you may or may not lose your visa, depending on the circumstances.

If you leave your spouse, you will likely lose your visa. If your spouse leaves you, he/she must file for divorce in Ecuador and you must contest it. If you sign the divorce agreement, you have voluntarily agreed to the divorce and will lose your visa. If the primary visa holder leaves you for a justifiable and provable reason (e.g. abuse, infidelity, etc.), you may still lose your visa even if you contest the divorce. The laws are complicated so speak to a qualified attorney before signing anything!

Other Temporary Residency Visas

The other types of Ecuador temporary resident visas are the volunteer visa, student visa and industrial investor visa.

These are only temporary visa options and cannot be converted to permanent resident visas at the end of the 2-year term. If your goal is to become a permanent resident of Ecuador, it’s best to get one of the other visa types.

These types of visas aren’t popular with expats because they don’t lead to permanent residency, so we’re not going to cover them in this article.

90-Day Tourist Visa

The 90-day Ecuador tourist visa is easy to get. Just come to Ecuador and it gets issued at passport control. It’s only valid for 3 months, but you can apply for a 3 month extension once every 12 months.

The extension application has a fee that has increased from $100 when we moved here to $142. You’ll need to apply at the end of your 90-day tourist visa.

Ecuador Temporary Resident Visa Process

There are lots of steps involved with getting your Ecuador Temporary Resident Visa, and it usually takes 3 to 6 months.

It can take 2 to 3 months just to get the background checks done in the US, sent for the apostille and mailed to Ecuador for translation and notarization so keep that in mind when you’re planning your travel.

Step 1: Fingerprints

The first step in the process of getting your Ecuador Temporary Resident Visa is getting your fingerprints taken. We had ours taken in Cuenca Ecuador on our exploratory trip in 2017, but you can also have them taken back in the US at a local police station.

Step 2: Background Check

Once we had our fingerprint forms, our visa agent requested the background checks from the FBI Identity History Summary Checks website.

Step 3: Visa Specific Requirements

Professional Visa

You need to request a notarized diploma, transcript and the official university letter stating your documents are real and classes were taken in-person (not online).

Dependent Visa

If you’re applying for a dependent visa, you’ll need to get a certified copy of your marriage license, and birth certificates for your children and other relatives. Again, all these documents must be less than 6 months old to get an apostille so you may need to order new certified copies.

Investor Visa

For the investor visa, you’ll need to invest in a CD at an Ecuadorian COOP for at least 2 years, or purchase property that you intend to keep for the duration of the temporary resident visa. You can wire funds directly to an Ecuadorian bank from a US bank.

You will need to open the CD in a COOP such as JEP because banks like Banco Guayaquil require an Ecuador government ID (cédula) to open an account. You can open an account at a COOP with just your passport and your investor visa application.

Pensioner Visa

You need to request a letter from the SSA stating your monthly income and you’ll need to provide monthly income statements.

Step 4: Request an Appointment with the Ministry

You can go to any of the ministry offices in Ecuador to submit your application, but some have longer waits than others. Your visa agent will know which office is best at the time.

Step 5: Fill Out and Notarize the Visa Application Form

The visa application form is in Spanish and must be filled out in Spanish. Once it’s filled out, you’ll need to go to a notary to have it notarized. You need to sign the application in front of the notary after showing him or her your identification.

 Ecuador Temporary Resident Visas

Step 6: Submit Your Application

Once you have your completed visa application form and all the other required documentation with apostilles as needed, go to the ministry office on the date of your appointment to submit your application. You’ll need your passport as identification.

This process is different if your visa will be issued in your home country. Your visa agent will help with that process.

Step 7: Wait

We submitted my Ecuador temporary resident visa application at the end of October when we first arrived in Ecuador, but didn’t receive it until the end of January. It took 3 months to get approved and printed.

Due to the constantly changing laws and delays when we applied for our temporary resident visas, we were here in Ecuador for several months beyond our 3-month tourist visa without our temporary resident visa. Since the application was in-process, we technically weren’t illegal aliens, but it sure felt like we were! Thankfully we didn’t need to leave the country during that small window or it might have been difficult to get back in.

Step 8: Get Your Visa from the Ministry

Once your visa is approved, the government issues an electronic visa that is digitally attached to your passport number. They no longer attach a physical visa sticker to your passport. Again, if your passport is about to expire, we recommend renewing it first before applying for your Ecuador temporary resident visas.

Step 9: Get a Cédula

After we received our temporary resident visas, we took them to the government office in Cuenca to get our cédula, which is our official government issued identification card. It looks like a driver’s license, only it doesn’t allow us to drive.

It took about an hour to get the cédula and the cost was $5. You are not required to get a cédula; however, your expat life in Ecuador will be much easier and you’ll have more banking options available to you if you have one. You will need a cédula to apply for the public IESS health insurance.

Hopefully, you found this lengthy article about the Ecuador Temporary Resident Visas helpful. If you see others asking about this complex process on social media, please share it with them. And if you spot any inaccuracies or outdated rules, please let us know so we can keep this up-to-date.

HUGE thanks to Maité from Gringo Visas for not only helping us with both our Temporary and Permanent Resident Visas, but for taking the time to answer a bunch of questions for this article about the new visa requirements in Ecuador.


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Our Ecuador Healthcare Experience

Before our recent hospital visit, we did not have in-depth personal experience with the Ecuador healthcare system. We know Ecuador has one of the best healthcare services globally, so we expected something nice. Pleasantly, our expectations were exceeded. The quality was so great that their affordable cost was almost shocking.

I met the doctor for a series of medical checkups and blood tests. Actually, I met four doctors and had three medical procedures and several lab tests.

I have a family history of colon and prostate cancer, so I need to check in with a doctor regularly. The tests are scheduled every 5 years, but I was already 2 years overdue for this one due to the COVID pandemic. I finally got tested and while the news is not exactly great, we are optimistic.

There are many good things to take away from our experience with Ecuador’s healthcare, and we will walk you through them in this article.

Ecuador Health Insurance Brokers

Ecuador’s health insurance system differs from the United States so we had many questions, which were answered by our private insurance broker, Maurice Miranda.

As we found out from Maurice, there is a remarkable difference between insurance brokers in Ecuador and those in the United States. He was very interested in getting us the right doctor and was heavily involved in scheduling appointments.

First Appointment

Our first appointment was at a private health institution. The facilities were impressive and looked much better than the few public hospitals we had formerly visited.

We didn’t know we were supposed to make payments at a machine before we could meet the doctor. Different systems clearly. Thankfully, our kind Doctor didn’t have any problem with our manners (Pun intended) and accepted direct payment from us.

Our doctor was amazing. She spoke and understood fluent English, missing only a few words, which was not a big deal as we understood the small Spanish inputs she used as substitutes.

She ran some vital checks and discovered my blood pressure was quite off the roof, which we all agreed was due to me being nervous. I was over two years past my checkup schedule, so I was a little anxious.

After the blood pressure check, I was expecting to fill out my family health history and information in a 14-page book, just like in the US, but that wasn’t the case. It was easier. Ecuador doctors use computers to collect all necessary info about your medical and family history. They ask the questions and you answer. I prefer this pattern as I really communicated and connected with my doctor. I expressed how I felt about my genetic vulnerability to prostate cancer and the toll of dealing with an over 50-year-old prostate which made urinating difficult.

Our doctor was great, empathetic, and very caring. She listened to my concerns and gave me a prescription to help in the bathroom. She ordered some bloodwork, a Colonoscopy and a Sonogram to ensure I didn’t have any other more obvious problem with my prostate.

She spent about 45 minutes to an hour with us. The total fee for the appointment was $15. We have private insurance with Confiamed this fee was our copay.
Our doctor directed us to get the bloodwork out of the way as soon as possible.

Bloodwork Test

The doctors in charge of the bloodwork asked all the necessary questions regarding our diet. My wife and I generally maintain a whole-foods plant-based diet to keep my cholesterol at a safe level, so our diet was good.

They ran lots of tests, including checks on cholesterol levels, triglycerides, blood sugar, nutrient levels, PSA, parasites, and many other conditions.

The bloodwork was very comprehensive, as the specialists didn’t want to miss anything. About 5 to 6 blood vials were extracted, and I bet I looked a lighter shade of white when we left the hospital.

The entire cost was $188 for about 2 pages worth of tests, which was very affordable for a privately funded hospital. Our insurance covered 90% of the cost, so we paid $18.

The bloodwork results were out in no time, and the major concern was my high PSA and a low Free PSA, both bad. The good news was that the parasite test came out negative. The Sonogram test was next on the list.

Sonogram

It took us three days to get an appointment for the Sonogram. The doctor ran some tests and checked my prostate, bladder, kidneys, gallbladder, pancreas, and liver to see if anything was out of place. This check was as comprehensive as my bloodwork, and I think the doctor wanted to get a holistic view of my system because I complained of abdominal pain.

The Sonogram result was not very comforting. My prostate was 2.5 times larger than normal, which was worrying. The cost for the Sonogram was $80, with insurance responsible for 90% of that.

Now, it would be nice to mention something special about Ecuador’s healthcare. Every patient gets a unique medical record. So once I complete a test, the result is uploaded to my medical record.

A new doctor handling my case can just check my record and know the step forward. It is so easy and seamless.

Colonoscopy

The Colonoscopy test was the next on our list. When we went to make the appointment, they had openings the next day, but I wanted more time to prepare, physically and mentally.

On the day of the exam, my appointment was at 11:30AM and we were on our way home at 12:45PM. The result was excellent—no evidence of swollen tissues and no sign of cancer or polyps.

The only thing I didn’t appreciate was that the anesthetic made me sick. They used Propofol, which I’ve had several times without issues. But this time it caused a reaction.

Amelia got really scared when I passed out in the taxi on the way home. When I woke up, we were on our way back to the hospital, but I told her I just wanted to go home and go to bed.

The entire cost for the colonoscopy was $305 and insurance covers 90%.

Return to Our First Doctor for Result Review

We returned to our doctor after completing the three tests she recommended. She reviewed the results and was very comforting all through our one-hour session. Her major concern was about the situation with my prostate. She referred us to a urologist for better insight so we knew what we were dealing with. The fee was a $15 Copay.

The Urologist

The urologist didn’t speak English so it was more difficult to communicate with him. He was concerned about my family history of prostate cancer and made it clear that my PSA numbers and larger-than-normal prostate hinted that I might have a problem.

He called the imaging center right then to get the name of the doctor who runs the MRI. After the call, he recommended I schedule the MRI ASAP. We spent about 10 minutes with the him for a $15 Copay.

Contrast MRI

After leaving the Urologist’s office, we messaged Maurice about the new development, and he scheduled an appointment the next day for a Contrast MRI. That’s right: the very next day!

A Doctor conducted the MRI, and she did the IV for the contrast. All necessary protocols were followed, highlighting how advanced the Ecuador health system is. I wore the noise-canceling headphones which the doctor spoke through when I was in the MRI.

The MRI was not the most comfortable place, and it felt like it wasn’t designed for an adult. My shoulders got cramped, and my arms were asleep for most of the time. Apart from that, everything was good.

The MRI results were out in 3 days. Another surprise. In the US, getting an MRI result could take weeks and even months.

The total cost for the MRI was $320 before insurance, which is quite affordable. The insurance handles 80% of the charge.

The Result and Meeting the Oncologist

The MRI result was a one-page report written in Spanish. I translated the words into English and could make sense of them to understand there were two spots on my prostate. That was clearly not good. It seemed like one of the two spots was likely cancer.

I messaged Maurice again and asked him to find me an English-speaking Oncologist, and he quickly set an appointment for the next day. Good luck finding such quick service in the US.

We met with the Oncologist for over an hour, and he explained the results and concerns. There were two spots in my prostate. One looked normal, while the other was likely cancer, but it was still very small to confirm.

The Oncologist explained that if it was cancer, it could be treated since it was spotted early. He ordered another PSA test with strict preparation specifications for the best reading. He also requested I get another Contrast MRI in 3 months for a better evaluation of the spots in my prostate.

The entire cost was $50 before insurance. We couldn’t get a Copay benefit since he is out-of-network. The insurance company will reimburse 80%.

The Revelation

It is never great to hear you probably have cancer, but we’re optimistic and happy we spotted it early. If it is cancer, it’s still small and treatable, and stats show that the survival rate at this stage is very high.

We’re still hopeful that the two spots are NOT cancer. We’ll know more after the next PSA test and MRI, but for now, we will definitely continue to live our best lives.

Total Costs

  • 3 Dr visit copays: $45
  • Oncologist out of network: $50
  • Bloodwork: $188
  • Sonogram: $80
  • Colonoscopy: $305
  • Contrast MRI: $320

Total cost before insurance: $988

Insurance Cost: $192/month for both – $15 copay, $100 annual deductible, 90% covered in-network, 80% covered out-of-network.

Insurance Reimbursements

  • $573 in-network – 90% back or $515
  • $370 out-of-network – 80% back or $296
  • $811 – $100 deductible = $711 back

Total out-of-pocket cost: $277

So insurance saved us from spending an outright $988, and instead, we only payed $277.

Clearly, in the US, we would have spent thousands of dollars even if we had insurance. Ecuador is significantly cheaper despite also having state of the art facilities.

Insurance Reimbursement Process

If you live in Ecuador, you will need private insurance to apply for your visa. However, the process may be a bit confusing, so a huge thanks to our insurance broker, Maurice, for helping us! We couldn’t have done it without him!

Documents You Need

  • Insurance Claim Form – Signed and stamped by the Doctor
  • Pedidos – Orders for the procedures
  • Facturas – Receipts with the RUC (hospital tax ID)
  • Resultados – All of the results and images from the procedures

You also need a bank account with the account holder’s name on it for your insurance claim reinbursement. I Had to open a new bank account in my name to get the reimbursement.

Our Take On Ecuador Health Care System

CEO World currently ranks the country’s health system at number 25, and we personally agree with this number due to the quality of service we received.

The country’s use of medical technology is impressive. We noticed that every institution we visited made a deliberate effort to make every medical session efficient and effective. For example, I did not have to write out my family history. I instead spoke about them while the attending doctor typed them. This option was more effective from a patient perspective, because I could easily relate with the doctor who clearly seemed to understand me.

The availability of a digital medical record was also very impressive. The results of every test I took gets updated on my medical record, and the new doctor only needs to check the record to know my health status. It was seamless and fast and saved me the pain of having to keep repeating the same information every time.

Another important part of our experience was the affordability of the tests. Everything was very affordable, and we are talking about the prices even before insurance. The entire cost before insurance was below the $1000 mark. In the United States, we would have doled out a few thousand dollars to get the same treatment.

Our verdict on the Ecuador healthcare system based on personal experience is that it is superb. We are even happier we moved to Ecuador following this experience!


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Streets of Loja Ecuador Video

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Loja Ecuador is a popular small city nestled in the Andes Mountains in Southern Ecuador. The people are very friendly and the city is very clean. You’ll notice a blend of colonial, art deco and 60s utilitarian architecture, lots of murals and churches. It’s growing in popularity with expats, but it’s still relatively undiscovered by foreigners.

You may also enjoy our Vilcabamba Ecuador Drone Video


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Vilcabamba Ecuador 4K Drone Video

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Vilcabamba Ecuador is one of the most popular cities in Ecuador for expats and vacationing Ecuadorians. It’s a beautiful town nestled in a valley in the Andes Mountains.

If you’re considering a visit or move to Vilcabamba, we talked about the pros & cons in this video on our other channel @Amelia And JP:
HIGHEST CONCENTRATION OF EXPATS IN ECUADOR! (Vilcabamba Ecuador Pros & Cons)


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Loja Ecuador 4K Drone Video

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Loja Ecuador is located in the southern Andes mountain region of the country. It’s about a 4 hour drive north to Cuenca, and 45 minutes south to Vilcabamba. The Loja Province airport is located in Catamayo, which is 45 minutes west of the city of Loja.

Watch more videos about Loja over on @Amelia And JP :
THIS CITY IS NOT WHAT WE EXPECTED!
IS THIS CITY RIGHT FOR YOU? (Loja Ecuador Pros & Cons Video)


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Gualaceo Ecuador 4K Drone Video

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Gualaceo Ecuador is less than an hour east of Cuenca Ecuador, which makes it a great day trip. It’s known for handcrafted textiles, shoes and the macanas worn by the indigenous people in the area.

Watch our full tour video over on @Amelia And JP here:
3 FAMOUS VILLAGES (3 different reasons)

Drone used: DJI Mavic Air 2

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Chordeleg Ecuador 4K Drone Video

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Chordeleg Ecuador is less than an hour east of Cuenca Ecuador, which makes it a great day trip. It’s known for handcrafted filigree jewelry, and the whole town is full of jewelry stores.

Watch our full tour video over on @Amelia And JP here:
3 FAMOUS VILLAGES (3 different reasons)

Drone used: DJI Mavic Air 2

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