Medical Questions about Living in Ecuador

I am planning to move to Cuenca in a few years.  One aspect could be a deal breaker.  I take a medication that costs $1100/month w/o insurance.  The generic is$600 w/o insurance. With insurance, the copay is $100/month.

I need to understand how much medical insurance will cost in EC and what will be my copay on this medication.

From what I have learned so far, medical insurance will cost 17.6% of my monthly income and I think that medications which are issued from hospital pharmacies are free.

These are some of the questions I hope to learn during my visit of Oct 17 - 22 (next month).
If you have any info on these points, I would love to hear from you.

I would like to meet with one or more expats to hear your stories and will buy you lunch or dinner.

Thanks in advance,

Joe Gaglio

Is the IESS really 17.6% of income? 
That would be almost 20% of my pension! Then add my husban to that!

Someone please let me know if that is accurate.

Thanks,
Robin

I for sure am no expert on Ecuador, however when getting a visa to Ecuador I would only prove enough income to qualify for the visa. If you have a pension and SS both, I wouldn't necessarily be verifying income of both if not needed. Only provide what is required. You could also look at other travel insurance pricing and compare.

It seems every country has its drawbacks. In Colombia being a tax resident comes with the obligation to pay Colombian taxes on top of paying your US  taxes. Thus I am looking at traveling 1/2 the year outside Colombia. Medical in Colombia (EPS) is very reasonable (For my wife and myself at the current exchange rate $36 USD a month) however it has its own drawbacks in being a tax resident @ 183 days in a 365 day period. If you are not tied to Ecuador in some way you may want to look at all country options and see what restrictions or obligations and benefits other countries like Peru, Chile, Uruguay and others may offer. Countries like Panama used to offer a good benefit package to retirees to lure them to the country. I do not know if those are still in place, but for sure look at all options before tying yourself to a retirement destination.

NHLFAN :



It seems every country has its drawbacks. In Colombia being a tax resident comes with the obligation to pay Colombian taxes on top of paying your US  taxes.

Any income taxes paid in Colombia can be taken as a credit against US taxes as a foreign tax credit.  In many cases it is dollar for dollar, so whatever income taxes are paid in Colombia would reduce U S taxes by the same amount.  So you would pay the sametotal amount, just to two governments instead of one.

I am not worried about taxes. With only Social Security there are no Federal taxes.

It is Ecuador that I am planning to move to, not Columbia.  Any help on Ecuador?

To help you budget, you can search online for medicine in Ecuador. To get a price estimate, go to
fybeca.com
and search for the medication in Spanish

Individual Expats in Ecuador who subscribed to IESS health coverage were paying just over $80 a month.  Couples paid only slightly higher, maybe eight or ten percent more as a couple.

The Ecuadorian government attempted to peg a new rate, possibly  approaching 20 percent, to Expats, based on their (declared) income.

The effort was hampered by the bureaucrats' inability to implement it .. and the fact that Expats were not exactly champing at the bit to declare every dollar of their worldwide income.

It is my understanding that the payment change plan was scrapped two month ago.

Check with your local IESS provider for the current actual policy.  Expats have been understandably confused.

About a month ago, I stopped into an IESS facility in Quito and asked if my IESS policy (paid on Banco auto-debit monthly) was still active .. and the reception desk checked and told me it was active.

IESS doesn't have my worldwide income data (I have an investor's visa based on ownership of my condo) so i presume the price of my coverage is the same or similar to before.

cccmedia

The 17.6% (plus another 3.41% for a dependent) based on your actual income is under constitutional challenge at this time. The current mode of thinking, is claim the lowest income amount allowable and pay that, which comes to $67.94 for an individual, $81.10 for primary and one dependent. (Of course, as a Canadian, this still seems pricey to me, but better than some other options.) Lawyers have successfully challenged the percentage on an individual basis and we are all waiting to see how the constitutional challenge comes out. Of course, this could take years. There are also private insurance options that might be more appealing. The upside of IESS is there's no co-pay, as I understand it. As to specific medications, that is beyond my scope of experience. Generally speaking, most medications here are less expensive than in the US and Canada. I've heard up to 90% less expensive, but that was a word of mouth story, so I can't vouch for its validity.

mugtech :
NHLFAN :



It seems every country has its drawbacks. In Colombia being a tax resident comes with the obligation to pay Colombian taxes on top of paying your US  taxes.

Any income taxes paid in Colombia can be taken as a credit against US taxes as a foreign tax credit.  In many cases it is dollar for dollar, so whatever income taxes are paid in Colombia would reduce U S taxes by the same amount.  So you would pay the sametotal amount, just to two governments instead of one.

I actually think you have it backward. You pay your US taxes and that can be deducted from your Colombian tax. But Colombia starts taxing at a lower limit and taxes at a higher rate. For instance if you had $2000 a month SS, (72,000,000 COP a year) as a couple you wouldn't owe any US tax with the standard  deduction for a couple filing jointly. But in Colombia you would be in the 28% tax bracket. If you happen to have a pension on top of that, your easily be in the 33% tax bracket in Colombia. It's quite worth wild to have a second location to spend 1/2 the year unless your looking at a small SS check as your only income.

Had no idea the Colombian taxes were so high at such a low income.  In that case, being a snow bird would make more sense.  Agree if you only have SSA income and little other taxable income you will owe nothing in the US.  Even $1,000 a month pension/IRA plus $2,000 a month SSA results in no federal taxes for a married filing joint return.

mugtech :

Had no idea the Colombian taxes were so high at such a low income.  In that case, being a snow bird would make more sense.  Agree if you only have SSA income and little other taxable income you will owe nothing in the US.  Even $1,000 a month pension/IRA plus $2,000 a month SSA results in no federal taxes for a married filing joint return.

This isn't comprehensive tax law for Colombia, but it gives a brief description of the income tax rate about 1/2 way down the page. https://en.wikipedia.org/wiki/Taxation_in_Colombia
I believe Colombia is really shooting themselves in the foot by taxing expats retirement income. Funds they would spend for 6 months of the year will be infused into another countries economy.

PEI Red :

The 17.6% (plus another 3.41% for a dependent) based on your actual income is under constitutional challenge at this time. The current mode of thinking, is claim the lowest income amount allowable and pay that, which comes to $67.94 for an individual, $81.10 for primary and one dependent. (Of course, as a Canadian, this still seems pricey to me, but better than some other options.) Lawyers have successfully challenged the percentage on an individual basis and we are all waiting to see how the constitutional challenge comes out. Of course, this could take years. There are also private insurance options that might be more appealing. The upside of IESS is there's no co-pay, as I understand it. As to specific medications, that is beyond my scope of experience. Generally speaking, most medications here are less expensive than in the US and Canada. I've heard up to 90% less expensive, but that was a word of mouth story, so I can't vouch for its validity.

Yeah word of mouth is utterly useless. The "90%", can be for one particular type of medicine for instance. I think following Lebowski's advice is the way to go and to find out exactly what the price is for the OP specific type of medication, brand too if it's important.

As for the 17.6% - Living in the developing world can be unsettling because laws change so often. The fact of the matter is that we don't know. They may enforce it if they find a way of doing do. I wouldn't be surprised if they do it, after seeing some of the latest austerity measures that were passed just this past month alone.

Mr. Media,

I went to the link you posted to find out how much our IESS would be.  I chatted with and kind lady but could not get real information.  I looked for information or a chart on the website but did not find it.

I guess that Joel and I will wait and see what the government does.  Certainly, I hope the increase will be scrapped!

Thanks everyone for the information!

Robin

Here are some interesting numbers:

There are 3.6 million people enrolled in IESS

60,000 are foreigners

21,000 of those foreigners are Venezuelans


Source: El Comercio

Gracias.  IESS is located one block from the hotel where I will being staying in Cuenca.  I will go to them and get a full understanding of my options.

Hi,
Would you ask if they have a chart or web location to find out what it costs now?  I have a pension and a spouse and we want to sign up for IESS.  It is hard to find a place or person who can give me the cost.
Thanks for any help.
Robin

Robin,

I looked up IESS and it is one block from my hotel.  I will go there and get as much info as I can and pass it on to you.

Joe Gaglio

Joe,

Thank you very much.  Anything you find out will be helpful.

Have a great day!

Robin

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