The Wandering Librarian

As we started telling friends, family, coworkers, and acquaintances about our plans to retire and expatriate, we were constantly asked “but what will you do for health insurance?!”  And, unlike many unanswered questions at this time, we do have the semblance of a plan.  It is multistep and will require several moving pieces, but it seems like it will work just fine.

Employer Coverage

The plan obviously starts with our employer based coverage.  As an employee of a state run university system, we have a high deductible health plan in place and a well funded Health Savings Account (HSA).  That HSA will hopefully stay intact in the background racking up tax free earnings over the years for later down the road, but we can always cash out any money needed for any health related expenses at any point in the future.

The In Between

Now that I have retired, we planned to stay in the United States for about four to six weeks.  While that is a short time, we recognize that anything can happen.  The last time we had a one day lapse in health insurance, my daughter fell and busted her lip open at daycare.  Thank goodness for low cost care at a Federally Qualified Health Center!

Because I am retiring mid-year and have a relatively low income as a librarian, we will be eligible for subsidized care for the remainder of our stay in the United States.  We are now enrolled in a Bronze Level plan purchased on the exchange. Our portion of the premium is only about $150. Thanks, American taxpayers! 

Now, if this was not a good option for us because of a higher income, we could also participate in COBRA in the meantime between employment and expatriating.

Getting to Ecuador

Once we leave the United States, we will utilize travel insurance to cover our trip and medical treatments in that time frame.  This is a common method that North American expats use when going from their home country to Ecuador.  For the low cost of $280, I insured my trip and my health for three months.  To find reliable health coverage which will meet your needs, you can visit https://www.insuremytrip.com/

Settling In

Once we arrive in Cuenca, we will be enrolled in a private health insurance program that should kick in after 90 days. Because most medical care is relatively affordable, we are opting for a major medical policy which will cover our expenses when we exceed a $5,000 deductible. However, that is very unlikely to happen unless we have a catastrophic illness such as cancer, or we are in a really bad accident.

Ecuador does allow permanent residents to participate in their public health system for a very minimal cost, but the care is less state of the art and requires long wait times.  Instead, we have budgeted $100 a month for our major medical policy.  How is it so inexpensive? Good quality care in the private system is relatively inexpensive compared with the United States.  A visit to a primary care doctor is approximately $30 total and a specialist is $50.

The entire process will be daunting, but nothing in comparison to the amount of effort that is going into getting our visas.  Legal immigration is immensely complicated, challenging, and expensive.  Just something to keep in mind before you decide to run off to another country!