Living in Ecuador

"I just spent 5 weeks just a couple kilometers north of Crucita. Beaches and climate were some of the best I have experienced. Crucita is more crowded but if you get north of the new marina (under construction) its almost deserted as far as you can see. I jogged north about a mile and was the same as far as I went. Some condos on the beach in that area but they are mostly empty and even on weekends not a lot of activity. I liked it so much I am going back the end of the year," wrote a member in Crucita.

"There is an expat community in Vilcabamba. Its membership varies in variety and number. People arrive people depart. Some are in the town, visible every day, some come in only on market Sunday, some might go months without setting foot in the town. Come for a visit. Stay more than a couple of days to get the feel of the town. Have a taxi give you the tour. You'll have a better idea of the place and options for living there. Look at San Pedro and Malacatos as well, two towns near Vilcabamba. These are worthwhile places to look at," commented one expat who made the move to Vilcabamba.

"1. Learn some basic spanish before coming here. 2. Have a source of income to sustain you, don't expect to work to survive. 3. Keep an open mind and expect things to be very different from home. 4. Come for 3 to 4 weeks to see if you will like the country and city before making permanent immigration plans. 5. Have great patience and don't expect the people to act in a manner to which you are accustomed. Things here take time. 6. Remember you are a guest in their country so be respective of their customs, If you don't know what is expected-- ASK. Don't demand anything. They wll be nice if you are. 7. Always check your passport for visas and date stamps. They have been known to make errors on dates--quite often! 8. Be flexible, things are not under your control. Have Fun," remarked one expat living in Bahia de Caracruz, Ecuador.

"I started in Vilcabamba yet very quickly moved over the hill to a beautiful little town called Malacatos. It's much cheaper, safer and very peaceful and tranquil here. I drive 35 minutes twice a month to Loja for a big shop and if I need anything specifically Americanized then I can drive 17 minutes to Vilcabamba. I've never loved the cities and really enjoy mountain living so am very grateful that I chose to move here. I spent the past few years struggling to survive in the US in an expensive, tiny apartment and here in Malacatos I live in a big, beautiful home with land. I feel like a millionaire here," wrote one member in Malacatos.

"I have a close friend who is going to move here. He loved his visit here a couple of months ago. I told him that the culture is very different form the US but that is true anywhere in the world. The only way to learn is through immersion into the life here. I took a job consulting for the municipio, another side task of teaching the local kids in our barrio English and I applied to teach at the local University. The more active I am, the faster I get what is going on here. Ibarra is no Quito; it is like most other towns in Ecuador, just a little larger at 150,000 people. My Spanish is constantly improving. Our farm is becoming more productive, our list of freinds is growing. But it all takes lots of time and personal investment of yourself," remarked one expat who made the move to Ibarra.

"There are now two expat groups which meet in Cuenca each Friday night at 5 p.m. One is at Zoes and the other at the Ecualyptus. From here you can meet and greet other expats and then extend you network," remarked one expat who made the move to Cuenca.

"Here you meet others through shopping for food, necessities for the home, and dining out. There is a Rotary International group here but they only speak spanish. If you have a talent, such as painting, you can set up in one of the parks and meet people. There are a dozen expats here that speak english and most are very helpful for newcomers. Also there are about 30 to 80 boats from all over the world at the marina, depending on the month, and most "boaties" speak English and are helpul. The marina owner, an American, also runs a restaurant there and he and his Columbian wife speak english," explained one expat living in Bahia de Caracruz, Ecuador.

"Expats living in Ecuador often join local clubs, attend cultural events, and join social media networks centered around activities they love. Expatriates may also join online communities specific to the country where they live, such as Ecuador Expats Online, which is a popular forum. Furthermore, connecting with other local English-speaking expats through local churches, booksellers, and language classrooms can provide an excellent way to meet people from all over the world. Finally, expats may join outdoor activities such as hiking, diving, and mountaineering, which not only provide an opportunity meet each other, but also Experience the beauty of Ecuador," said one expat in Ecuador.

"Weekly expat Fridays at 5, currently held at Sakura Restaurant on 3 de Noviembre in front of the Tomebamba River at the bottom of the Escalinata," said one expat who made the move to Cuenca.

"Use your skills to get some form of employment. Consult, teach, help with a multitude of civic type organizations. Immerse yourself into the life," explained one expat living in Ibarra, Ecuador.

"Cuenca has a lot going for it as far as the arts. There are always free concerts that you can attend in the city. Art festivals, Choirs, Orchestras you name it. This is a very family oriented society and life revolves around the family. My local business colleagues are always spending time with their families on the weekends and we should learn from them. They have a wonderful network of family around them. Religious events are a time for parades, church and other activities," said one expat in Cuenca.

"Salinas is a really nice place. Is like being in Guayaquil, but with a beach nearby, You will find supermarkets, banks, schools, hospitals and many more things than other ecuadorian beach. And a big plus is that is near Guayaquil (the biggest city in Ecuador and main commercial city of the country)," said one expat who made the move to Salinas.

"Living in Ecuador as an expat or digital nomad can be an incredibly rewarding experience. With its picturesque landscapes and vibrant culture, it's no wonder that more and more expats are choosing to make Ecuador their home. Many expats and digital nomads choose to settle in the larger cities such as Guayaquil, Quito, and Cuenca which offer all the amenities of a larger city with a more relaxed atmosphere. Ecuador's cost of living, coupled with its relaxed visa requirements make it an ideal choice for those who want to live abroad. Furthermore, the country is remarkably diverse with its own unique cultures, landscapes, and people, making it an excellent choice for those who want to explore and experience something different. With its temperate climate, stunning nature, and friendly people, Ecuador is a great choice for expats and digital nomads looking to live and work abroad," explained one expat living in Ecuador.

"Ibarra is the capitol of Imbabura and as such has many lawyers in the area but it is primarily agricultural with a lot of commerce going on. It is the largest of the cities in this province and offers a lot of night life, greater restaurant selection and a pretty progressive city leadership," mentioned one in Ibarra.

"Yes, there is some crime in Ecuador. Though it is not as prevalent as in some other Latin American countries, crime does occur, including theft, pickpocketing, assault and mugging. Additionally, there is organized crime related to international drug trafficking. Violent crime tends to be concentrated in some of the larger cities and tourists should exercise caution when travelling in certain areas," commented one expat who made the move to Ecuador.

"You make yourself a victim if 1. You come here wearing expensive clothes and jewelry and waving the latest iPhone. 2. You buy a fancy house and show it off. 3. You refuse to integrate into the community, respectfully. You want to be one of us not one of them. 4. You don't learn Spanish. Automatically you are a gringo. 5. We bought clothing and phones, cheap, hear and so dress like the locals. 6. We buy carefully, not flashing big bills and try to spread our purchases around some to patronize many of the locals, not just one or two. But not big purchases.... 7. I don't carry a purse on the street, I put bills in my pocket, separated so I can just pull out one fiver instead of a wad. I leave my fancy cell phone at home. You need to use some sense. Try not to act like a rich space alien landing in their town and wandering around in a spacesuit," remarked one expat living in Ecuador.

"Not a lot of crime in Cuenca but people need to us common since living here as they would in any city," wrote one member in Cuenca.

"I believe that the people here are warm and accepting. I certainly have not come across any hostilities to expats. They are very eager to be of helping nature," said one expat in Cuenca.

"Yes, there is a lot of diversity in Ecuador. Ethnic groups, languages, backgrounds, and cultures all exist in the country in a variety of forms. Ecuador is home to people of African and Indigenous descent, as well as those of European and Middle Eastern descent. Additionally, a wide range of religious beliefs and practices can be found in the country. Generally, Ecuadorians are very accepting of diversity and are known to embrace it as part of the national culture," said one expat who made the move to Ecuador.

"The majority of people here are Catholic. There are a large number of Evangelical Prostestant Churches. Also many Mormons are here helping the poor. They are very tolerant of all religious followers here, as long as you don't tell them their religion is wrong," explained one expat living in Bahia de Caracruz, Ecuador.

"Ibarra is considered pretty diverse as far as Ecuador is concerned. The largest group is Mestiza at 75% with an equal amount of Afro, Indegena and Blanca...all at about 8%. There is lots of commerce here and it is surprising to me how quickly people here adapt to the internet and other technologies so readily. I forget that the US was once technology illterate," mentioned one in Ibarra.

"The Graded American School in Ecuador (GASE) is an excellent bilingual international school located in Quito. It offers a quality, comprehensive American-style education to international students of all ages, from Pre-K through 12th grade. The school offers rigorous academic programs and diverse extracurricular activities to make learning fun and engaging. GASE is accredited by the Southern Association of Colleges and Schools in the United States and by the National Ministry of Education in Ecuador. The Canadian Academy in Quito is another popular option for international education in Ecuador. It is an internationally accredited bilingual school with a stringent academic program that emphasizes critical thinking, creativity and 21st-century learning. CISCO certified courses in computer engineering and digital media are among some of the unique features of this school. The Academy also offers an array of extracurricular activities that emphasize teamwork and community participation. The Anglo-American School of Quito offers an international curriculum that offers a unique blend of Ecuadorian and British educational styles. It is accredited by the National Council for the Evaluation of Educational Quality in Ecuador, making it the first international school in the country to receive this prestigious accreditation. The school has programs ranging from Pre-K through 12th grade, with a curriculum that incorporates innovative technology such as robotics, coding, and 3D printing. Finally, The Paradise Private School in Guayaquil offers a bilingual, transnational and multicultural education. It is an IB World School, meaning it offers a holistic certification in its schooling system, ensuring that graduates are well-prepared to meet the challenges of an ever-changing global environment. Additionally, Paradise Private School has a strong focus on student leadership development and provides a range of extracurricular activities," remarked one parent with kids at in .

"I would highly suggest taking a look at all options in Quito. This school has made a rapid change to being an elitist, local school where students of powerful local families are given preferential treatment and their parents are allowed to dictate what is done at the school. Discipline is non-existent. The curriculum is constantly "being worked on" and the school is all about how it appears, not substance. Bullying by local, wealthy is prevalent and the school takes no action. The answer is to make the target and their family the problem and wait for them to leave while the bully is allowed to continue for years to come," explained one expat living in Quito, Ecuador.

"Highly recommend this wonderful school. They tailor their program to meet the needs of the individual child," said one parent with children at Colegio Menor San Francisco de Quito (CMSFQ) in Cumbaya.

"You must come to the campus to see. It is a nice little campus in the upscale community of Cumbaya. Tuition runs about $6,000 per semester and $1500 for the summer semester. They do offer financing through the University as well as scholarships to top performing students. Class sizes are small and there are a wide variety of programs of study available. It is a nice option to the expensive US colleges," commented one expat when asked about Universidad San Francisco de Quito (USFQ) in Cumbaya.

"The cost of living in Ecuador varies and depends on what city or region you are located in. Generally speaking, daily expenses can be kept low if you are living outside of the major cities. Groceries, transportation, and rent are generally much cheaper than in other countries. However, prices for imported goods, luxury items, and eating out in restaurants can be more expensive," commented one expat who made the move to Ecuador.

"I have meet folks who live on $1200/mo including rent. Our lifestyle is more like $1200-1500 and we own our place. That includes eating out, 2 grocery runs/month, beer deliveries and biweekly massages for two," remarked one expat living in Manglaralto, Ecuador.

"I've lived here for five-plus years now, on the flanks of Volcan in Cotacachi where my Ecuadorian wife and I have built a home on 1000 sq. meters of property. The cost of living, which I estimate at about 10 – 15% of costs in Canada makes it possible for us to live well on my meager pension and maintain my investment portfolio for travel and splurges. I am a numbers guy by nature and keep a running spreadsheet of daily expenses, which since we are not even close to rich is necessary to try to control rampant spending. I'll make a list of the basics (more or less Fixed expenses): Phone: $30 for one unlimited cell phone with data. Internet: $22/month for good service of 30MBS fiberoptic. Electricity: Average of $25/month. Water, good clean potable water: amazing but true, $1 (one dollar/month.) Full medical coverage including most prescription drugs, through IESS, Ecuadorian medicare: $90/month for the two of us. Property tax: For whatever reason it has never exceeded $3/year. When we paid rent, before we built, it was $125/month for a two-bedroom apartment.. Our two-bedroom 2.5 bath home with big patio and carport cost around $35k to build, with me working along a team of five 'albaniles" masons who I paid $100/week for five long days of hard work, no coffee breaks, usually no lunch break as they eat while they worked and worked like demons with no pushing. The work ethic here is astounding. Food is divided into two catagories. Groceries (supermarket and local markets): Around $250/month for what we prepare at home and we eat extremely well. Dining out, a couple of times a week we have a (usually shared) meal out. About $80/month or less. The two of us can almost always eat very well for under $6 for both. No added tax, no tips. What you see on the menu is what you pay. Period. We spend hardly anything on alcohol so that's not relevant since we might have a drink once or twice a month and never out. We have a car, which are extremely expensive to buy but not too bad to maintain. Mechanics are good, lots of competition, and often work for an hour or more for $10. Or they say forget it if the job is easy, or they ask for a couple of bucks (for a cola). Nobody that I know who drives has automobile insurance. Or homeowners insurance for that matter. I've never figured out what the 'bomberos' firemen do all day. Reminds me of the old ads for the Maytag repairmen. Everything is built of concrete, cement blocks or bricks. Tile surfaces and concrete floors and ceilings. Food in the markets, fresh, wonderful fruit and vegetables are 10% to 20% of what they cost in the north, for me British Columbia, Canada. I find myself getting pissy if avocados cost more than 3/$. Mangos 2 or 3/$. Lettuce is $0.50 head, as are broccoli and fresh greenbeans. Vine-ripe tomatoes are usually$0.10/each. bananas $0.02/each, Onions and bell peppers are often 6-10/$. Eggs are high now, at $3.50-$4/for a flat (cubeta) of 30. usually in the fresh produce world prices are given in a how many for a dollar. Fresh meat is sold by the pound. Beef is about $1.50-2.00/lb. Pork is $2-2.50/lb for any cut. whole chicken costs about $1.25/lb, and pieces (legs and thighs, or breasts are around $150/lb. I could go on, but you get the idea. Come find out for yourself," remarked one expat living in Cotacachi.

"If you live like the Ecuadorians live, it is very cheap as the basic salary per month is $425. Costs go up the more you live like an expat and the closer you get to approximating your same lifestyle in the USA or Canada. General rule of thumb is if the locals use it, there will be an inexpensive option. If not, it is expensive. If you can find it, Campbells Chicken soup in red and white label is about $3. Apple pie filling (can of fruit) is $11. Note that basic salary here is $425 per month. Utilities like electric (appox $20-25 per month, water $10 per month, gas is propane tanks, they bring a replacement tank into your house for $3.25 and take away the empty. Cell service about $25, internet about $35-40. Total utilities about $100 per month. Diesel is $1.70 per gallon. Gym memberships are often pricier than US, same with dry cleaning and laundry service," said one expat living in Ecuador.

"Prices are and product availability and servicing is changing rapidly. Though many things have always been cheaper (food and lodging) technological products were very dear 10+ years ago, they are not now. I bought a new computer yesterday and the price (with a bit of shopping) was 5% more expensive for the same thing on Amazon.com. us. I double-checked, all specifications. That being said, if you are looking for a city and country cheaper than Cuenca, there are plenty. They simply will be far less fun," mentioned one expat inCuenca.

"There is a wide variety of housing available on the Coast. In my little stretch of beach, expats can purchase a home in a gated community starting at just $125K and going up to $285K for an amazing 3 bedroom home with a pool. Rentals are anywhere from $600 and up depending upon amenities. Taxis and food are inexpensive and good," commented one expat who moved to Rio Chico, Ecuador.

"A couple can live here on $1200-$1300 a month which includes for example 3 bedroom 2 bath modern apartment. A single person can live under $1000 a month," remarked one expat living in Vilcabamba.

"There are miles of gorgeous beaches, what more can anyone want? Surfing is possible year round here as is scuba and snorkeling. Golf is a couple of hours north outside Manta," mentioned one expat inRio Chico.

"Of course, there is soccer! But I'm finding out from the youth that they are playing basketball and enjoy that very much also, as well as volleyball. They have a Water Slide and Fun place for the young people to go a few miles outside of Catamayo, and there are neighborhood volleyball matches for many ages, bingo, outdoor music concerts in the parks, and artists show their paintings occasionally. No golf clubs, that we know around here, sorry... But I am sure there would be in Cuenca and Quito," commented one expat who moved to Catamayo and Loja, Ecuador.

"The beaches are the main attraction in this area. You can participate in a friendly game of soccer, beach comb for shells, go fishing, paragliding or relax in a hammock on the beach," remarked one expat living in San Jacinto.

"In Ecuador, residents enjoy a variety of recreational facilities, such as beaches, parks, and outdoor activities. The country's long coastline provides plenty of opportunities for swimming, surfing, and other water sports. There are also many national parks and reserves, offering hiking, camping, and bird watching. For those who prefer indoor activities, there are plenty of museums, galleries, and theaters. Shopping malls, movie theaters, and bowling alleys are also popular recreational spots," commented one expat.

" Do not come to Cuenca looking for beach weather; mostly it is cooler here. We are now in the Spring-Summer season now. It goes to 70's during the day, but down to 50 at night. Now it is 58. No snow, and you're not scraping ice off your window, but the weather is mild spring," remarked one expat in Ecuador.

"The best climate in the world. We have dry and rainy season only. The temperatures are 24-26 C (80s F) during the day and 14-15 C (57-60 F) at night all year round. Not too much humidity because we are in the mountains on 1600m (5250 feet) elevation," wrote one expat living in Vilcabamba.

"There are about 30 restaurant in a town of 5.500 people. Many choices and types of food, from local Ecuadorian to Turkish and American/European foods," wrote one expat living in Vilcabamba.

"Seafood is the main course here on the coast of Manabi, there are other restaurants serving grilled pork, chicken, steak with sides of rice, salad and plantains. Chinese cuisine is available as well. There is one pub located in San Jacinto and three in the next village located ten minutes away via bus/taxi or a 25 minute walk on the beach," commented one expat who moved to San Jacinto.

"Good prices for eating out! Variety in both Catamayo and Loja. We can eat a very healthy, good meal for $5.00 in Catamayo. We have not participated in nightlife much just to go out to eat at different restaurants where sometimes you might have someone serenade you at your table," said one expat.

"One of the most popular restaurants in Ecuador is La Choza de Laurel, located in Quito. This restaurant is known for its traditional Ecuadorian cuisine, such as ceviche, empanadas, and llapingachos. The restaurant also offers a variety of seafood dishes, as well as a selection of international dishes. The atmosphere is cozy and inviting, and the staff is friendly and attentive. Another popular restaurant in Ecuador is El Pobre Diablo, located in Cuenca. This restaurant is known for its traditional Ecuadorian dishes, such as ceviche, tamales, and seco de chivo. The restaurant also offers a variety of international dishes, such as Italian and Mexican cuisine. The atmosphere is relaxed and inviting, and the staff is friendly and attentive. Finally, La Casa de la Abuela is a popular restaurant in Quito. This restaurant is known for its traditional Ecuadorian dishes, such as ceviche, tamales, and seco de chivo. The restaurant also offers a variety of international dishes, such as Italian and Mexican cuisine. The atmosphere is cozy and inviting, and the staff is friendly and attentive," commented one expat living in Ecuador.

"No nightlife and as I stated previously, anything from local mom and pop restaurants to more foreign type. All very affordable though either way you choose," remarked one expat living in San Clemente.

"We have organic market on Saturday and general market on Sunday. You can get fresh produce, meat and dairy. During the week many local shops offer fresh fruit, veggies, meat and other products, very plentiful. In Loja there is a supermarket called Supermaxi for more commercial and international products," mentioned an expat living in Vilcabamba.

"It appears that most of the people like to shop on the special marketing days where people come from miles around to show their wares. As I mentioned, Tia has some good buys (specials) and SuperMaxi is great up in Loja," said an expat in Catamayo and Loja.

"While you will quickly adjust to shopping here, and find the supermercados very similar in layout and product to what you're used to, don't be afraid to go to the central markets to buy your fresh produce, poultry, fish, liver, veggies, etc. and test your haggling skills," remarked one expat in Machala.

"People living in Ecuador typically buy groceries and do other shopping at local markets, supermarkets, and department stores. Many people also shop at small, family-owned stores and street vendors. Additionally, online shopping is becoming increasingly popular in Ecuador," wrote one expat living in Ecuador.

"Local people shop at the local mom and pop stores. Expats travel to Bahia de Caraquez 45 minutes away or to Portoviejo 45 minutes away. There are big modern grocery stores there that have just about everything one would be used to back home. The prices are not bad either. There is also a large weekly vegetable market in Charapoto 10 minutes away every Sunday. In addition, there are trucks loaded with fruits and veggies that drive around town just about every day," commented one expat who moved to San Clemente.

"You can stay for 90 days with a valid passport (minimum 6 month validity from the expiration date). I refer everyone to attorney Floridalva Zambrano, Portoviejo office, for Visa/Residency information and assistance. The immigration laws change frequently," said one expat living in San Jacinto.

"That is a tough one! We made some mistakes, but the best way if one would choose to live in the area where we are to go to Cuenca. We know an ex-pat that told us after we had some serious problems, that we should have been able to get everything done there instead of traveling to Machala or Quito.," mentioned one expat inCatamayo and Loja.

"The latest residency visas are a two year temporary deal that can then be exchanged for a permanent one. Rules for qualifying stayed the same as when I came 3 years ago, but the temporary visa was a new idea instituted in 2017. The requirements of background checks and proof of ability to support yourself are pretty straightforward. Canadians have had good luck at getting visas before they arrive but most expats I know have used an expediting service or lawyer since the actual rules can change," commented one expat who moved to Rio Chico, Ecuador.

"In Ecuador, foreign nationals must obtain a visa prior to entering the country for any purpose. US citizens are eligible for a tourist visa that is valid for 90 days. This visa can be extended at the Migración y Naturalización service office. To obtain a tourist visa, applicants must complete an online form and provide a valid passport, return flight ticket and proof of financial support. Those wishing to obtain residency must first obtain an authorization of residence from the Foreign Ministry. This must be done through an Ecuadorian consulate abroad before entering the country. To request an authorization, applicants need to provide a valid passport and birth certificate as well as documents detailing their purpose in the country and economic resources. After entering Ecuador with the authorization of residence, the applicant must then register with the Migration and Naturalization Service office and present additional required documents. The applicant must also undergo a background check by the authenticity of documents committee and sign declarations of nationality, residence, and other required documents. Once the residency application is approved, a residency card will be issued," remarked one expat living in Ecuador.

"Also, they may tell you to submit documents electronically but you WILL need them in paper versions. Visas are now electronic but Immigration requested a paper copy of my visa (and their ministry issued it!) which was NOT listed as one of the documents needed. You actually rarely use your visa once you obtain a cedula (ID card) based on the visa, not even for reentry to Ecuador once you have a resident visa. USA passport and cedula are all needed, except for at times, covid vaccine card. I took a photo of my cedula side by side with covid vaccine card and use the photo when needed. Bring extra original documents like birth certificates and marriage licenses and background checks, at least 3 originals of each and apostilled. Your background checks will be good until you return to USA, obviously you are not committing crimes there while you are living here. Expensive and difficult to get more documents while you are here sent from USA," commented one expat.

"The cost of medical care if much cheaper than the United States. I had back surgery for $8,000 and I only had to pay $1,000 deductible," mentioned an expat living in Quito.

"I would pay out of pocket if it were still available, because doctors are cheap. With my cheap insurance, I will still have to pay out of pocket and maybe get reimbursement if I'm lucky. Insurance here is a government sponsored racket, as whenever government requires something the drops and prices go up, that's why governments do it. If it were a service people actually wanted it wouldn't be required," said an expat in Cuenca.

"I relocated to Ecuador April 2022. On May 2nd 2022 I woke up with slight left hand arm pain. As the day progresses I became nauseated and dizzy. On the 3rd of May I had a buddy take me to a local clinic. They were impressive and within an hour diagnosed me with onset of heart issue and suggested I see cardiologist. Being as I was here only 3 weeks in Ecuador I personally decided to return to Houston Texas immediately and flew back. On the 4th of May I was admitted to Memorial Herman Hospital Woodlands Texas. I received a Quintuple Bypass (CABG) Graft the following day. I recuperated 7 weeks and returned to Ecuador. I fly back to Houston every 6 months and see my Cardiologist for exams and stress test. I've talked to expats who've had good results from Cardiologist in Ecuador and one even had a double bypass surgery in private hospital and is quite happy. I personally carry no private insurance. I'm okay with their health personal they diagnosed my health issues very impressively. Would I go through major health surgery in Ecuador. No. Not unless it was life threatening. But that's just me. ," remarked one expat in Ecuador.

"Healthcare and health insurance in Ecuador can be expensive, depending on the type of coverage and services needed. Generally, public healthcare is available at a lower cost than private healthcare, but the quality of care may not be as high. Private health insurance can be expensive, but it can provide access to higher quality care and more specialized services. Additionally, many employers offer health insurance plans to their employees, which can help to reduce the cost of healthcare," wrote one expat living in Ecuador.

"We tried private insurance here. Even though we got to the two years when prior conditions must be accepted by Ecuadorian law, we cancelled it. We come from a country where medical coverage is universal. We found the private insurance process deeply humiliating and we are not trained to tolerate it. The Cuenca medical services are great, superior to most in the world. It is a world medical/dental tourism destination. It is cheap.. though no serious illness is costless. We have the resources to pay as we go and like most developed world expats, at the very worst, we can return from where we came and get our coverage back in 3-4 months. If Ecuador decides to stopping letting expats in who cannot prove they have insurance, we pay 90$ a month in IESS premiums That is not to say that hospitals are not without payment annoyances in Ecuador. If you do not pay before leaving, they will not unhook you from their stuff. And it is hard to go downstairs and pay at Accounting when you are in bed undressed with tubes still running into you. Ecuadorian credit cards will not cover (without tedious special arrangements) amounts over $1000 and even then, the hospital won't believe it. Happily, Ecuador may not be a credit/debit card place but it is a cash one. Unlike the developed countries, banks here have gobs of the stuff on hand. My wife and I get an estimate and the non-hospitalized one has the cash on hand. (shrug)," commented one expat who moved to Cuenca.