Should You Retire in Ecuador?

Retirement accounts have taken a hit yet again as we enter the NEXT Great Recession (or worse). You may have never thought about living abroad before, especially this late in life. However, it may now be a serious consideration and you might be wondering if you should retire in Ecuador.

Benefits of Retiring in Ecuador

For the past 10 years, Ecuador has been near the top of the list of best places to retire abroad, and for good reason. Ecuador has a lot of benefits for retired expats:

Low Cost of Living

If your retirement accounts have taken a hit like ours have, finding a place to retire that has a low cost of living is likely at the top of your list.

Ecuador converted its currency to the US Dollar back in 2000, which helped bring unprecedented economic stability to this small South American country. For the past several years, Ecuador’s inflation rate has been among the lowest in the world, hovering around zero percent.

Change may be a hassle in the States, but here in Ecuador, you’ll be able to put those pennies, nickels, dimes, quarters and even half dollars to good use!

The cost of electronics is generally higher, so it’s best to bring those things with you. But housing, food and transportation are generally 1/3 the cost compared to the United States.

Bottom line is your American earned retirement dollars will go a lot further in Ecuador than in the United States.

Low Healthcare and Medication Cost

One of the things that continues to shock us is the high quality, yet highly affordable healthcare and medication. If you’re from Canada or Europe you might not feel the same way since you have Universal Healthcare, but as an American, we’re in heaven!

The cost of healthcare and medication in Ecuador is about 1/5th to 1/10th the cost compared to the United States.

My neurosurgeon back in Denver charged nearly $300 for an office visit and since we had a $12,000 deductible, that came completely out of our own pocket. Plus, we typically saw the Physician’s Assistant, not the neurosurgeon.

In Cuenca, my neurosurgeon charges $35 for an office visit and my appointment is with him, not his PA. He takes his time with me, too. My appointments generally last 30 to 45 minutes.

Our general practitioner also charges $35 for an office visit. My physical therapist charges $20 for an hour compared to $100 back in Denver. I paid $350 for a 3D printed dental crown (my mom just paid $1,400 for a traditional crown back in Kansas City).

We don’t take any medications so we don’t have a lot of experience buying them. However, we’ve been told they run about 1/10th the cost compared to the States.

If a large amount of your budget is spent on healthcare, retiring in Ecuador could save you a fortune!

For more about healthcare, check out this article: Our Ecuador Healthcare Experience.

Easy to See Your Doctors & Dentists

Another shocking difference between Ecuador and the US and Canadian healthcare systems is how easy it is to see a doctor or a dentist. We don’t need to wait weeks or months for an appointment; we can often see them the same day or the next day.

The first time I went to see our general practitioner, I asked him for a referral to an English-speaking neurosurgeon for my ongoing spinal issues. He picked up his mobile phone and called the neurosurgeon while I was sitting there. He asked if I would like to go see him the same day. It was 4PM! I said tomorrow would be just fine.

According to CEOWORLD Magazine, in 2019 Ecuador had the best healthcare system in the Americas south of Canada. They looked at Overall Healthcare, Infrastructure, Professionals, Cost, Medicine Availability and Government Readiness. Ecuador ranks 25th among the 89 countries they evaluated, barely losing to Canada (23rd) and beating the US (30th). The top 9 countries are in Asia and Europe, and number 10 is Australia.

If you’re tired of waiting months to see your doctor or dentist back home, retiring in Ecuador may be just what the doctor ordered. Sorry. I had to go there.

IESS Covers Pre-existing Conditions

Once you have your temporary resident visa and your cedula (a government issued ID card similar to a driver’s license), you can go on Ecuador’s public health insurance plan. It’s called IESS (Instituto Ecuatoriano de Seguridad Social). It’s their version of social security and universal healthcare rolled into one.

While private health insurance is available and affordable in Ecuador (we have Confiamed for $156/month for both of us), it doesn’t cover pre-existing conditions until you’ve been paying into the plan for 2 years. After that, they offer pretty low coverage amounts. Our plan only pays up to $7,500 per incident, which isn’t much if I need another surgery on my back. They also don’t cover medication expenses related to diabetes, heart disease, cancer, etc. if you had the condition prior to signing up for the plan.

With IESS, all your pre-existing conditions are covered on the first day. The monthly premium is around $75/person and you have no out-of-pocket after that. No copays, no medication costs, no nada. Everything is covered.

You do have to go to IESS hospitals and doctors, so that limits your options a bit, and we’ve heard mixed reviews about the experiences other expats have had, but if you can’t afford healthcare back in the US or your pre-existing condition isn’t covered, retiring in Ecuador or another country with Universal Healthcare may be your best option.

Affordable Transportation

We don’t own a car and have no plans to own one. That saves us a LOT of money! But that also means we need other forms of affordable and reliable transportation.

Car ownership in Ecuador for anyone but the wealthy is a relatively new thing. Most average people didn’t own a car just a decade ago. Now it’s common to see older people learning how to drive, and driving schools are everywhere.

Because most people still don’t drive themselves, Ecuador has been built around public transportation. Buses and taxis are very affordable and easy to find. Quito has a new world class tram system and Cuenca’s Tranvia will hopefully be operational soon.

The major cities also have mobile apps like Cuenca’s AzuTaxi that allow you to call taxis to your front door. Quito and Guayaquil also have Uber.

Variety of Low Cost Service Providers

Because of my back, my days of cleaning bathrooms and doing lawn work are over. Luckily, Ecuador is a service culture with a variety of different low cost service providers.

We had a housekeeper in Cuenca (pictured above) and we also have one in Olón. They charge $5/hour and clean for about 4 hours. That’s $20/visit and we have them come every two weeks so it costs us $40/month to have our house cleaned by a professional.

Lawn guys typically charged us between $10 and $20 depending on how much work needs to be done. They usually came once per month in Cuenca and once every 2 weeks here in Olón (but that’s included in our rent here).

We had plumbers come several times in Cuenca. We paid between $10 and $20, including parts.

Massage therapists charge between $20 and $30 for an hour. Mani/pedis and haircuts cost between $5 and $10. And some service providers will even come to your house.

Whether you have health restrictions or you just don’t like do things yourself, Ecuador is a great place to retire because you can hire someone cheaply to do almost anything.

Lots of Things to Do

If you enjoy traveling and sightseeing, Ecuador could keep you busy for years between the Amazon Rainforest, the Andes Mountain Range, the Pacific Coast and the Galapagos Islands. There are simply too many things to see in Ecuador to list them all here.

However, if you’re more of a homebody and prefer to stay close to your new expat city, Cuenca has a huge variety of activities, from cultural events to card games to hiking in the Cajas National Park to soaking in the hot springs. If you’re board in Cuenca, it’s because you’re not leaving the house.

We haven’t lived in Quito, but we know it’s similar to Cuenca where we lived for 2 1/2 years, and Cuenca is like a cruise ship on dry land: There are lots of things to do and the food is great!

Strong Expat Community

There are thousands of expats living in Ecuador from all walks of life. We’ve met retired postal workers, bus drivers, bankers, college professors, software project managers, marketing executives, electricians…you name the profession and we’ve probably met someone who retired from it.

We’ve also met people from one end of the political spectrum to the other. We made the conscious decision to leave politics back in the US, but some people continue to attend regular meetings for their respective political affiliations here in Ecuador.

Expats have created Facebook groups for playing games, bird watching, river walks, mountain hikes, South American travel, watching American sports, learning Spanish, and more.

If you’re worried that retiring in Ecuador will leave you bored and lonely, that’s not a concern unless you’re really shy and choose to stay home. Most expats make a lot of new friends when they retire in Ecuador.

Challenges of Retirement in Ecuador

Ecuador is a great retirement destination for most people, but there are a few things that make it challenging for retirees to live here, especially if you have mobility issues or altitude sickness.

Here are several challenges that might make retiring in Ecuador more difficult for you:

Uneven Sidewalks

The sidewalks throughout Ecuador are not great. They’re uneven, full of holes and often disappear in the middle of a block. Amelia and I have both tripped on rebar and metal posts that have been cut off leaving an inch or two sticking out of the sidewalk. We’ve also seen unattended open manholes. You really have to watch where you step in Ecuador!

Not Handicap Accessible

Cuenca is making an attempt to improve its handicap accessibility, but there is no ADA compliance in Ecuador. We’ve noticed this in most places we’ve visited, including Latin American countries, Europe and India. We’re very lucky in the US to have the Americans with Disabilities Act (ADA) with functional ramps and elevators.

In Ecuador, very few sidewalks have ramps and some curbs are so high we have difficulty stepping up on them. Many of the walk lights at intersections barely last long enough for us to make it halfway across the street before the light changes, and drivers pay very little attention to them. Pedestrians don’t have the right of way in Ecuador.

Some buildings do have wheelchair ramps, but most have been added recently and are so steep they’re dangerous. Once you get inside, many buildings don’t have elevators.

Despite all this, we have seen several people in Cuenca driving motorized wheelchairs around the city, but without sidewalk ramps, they’re usually on the street.

If you have a physical disability that makes it difficult for you to walk, retiring in Ecuador will be a bit more challenging for you.

High Altitude in Popular Expat Mountain Cities

Most of the popular expat cities for people who retire in Ecuador are very high altitude, which can cause health problems for some people. Amelia has no issues with altitude, but I do.

The high altitude is the main reason we left Cuenca. I simply couldn’t handle the thin air and it was getting worse, not better. Almost daily, I felt light-headed, dizzy, short of breath, and full-body tingles. I frequently had headaches and difficulty sleeping. On rare occasions, I felt nauseated. That’s not a fun way to live.

Here are the altitudes for the popular mountain cities where expats like to retire in Ecuador:

• Quito: 9,000 feet (2.700 meters)
• Cuenca: 8,400 feet (2.500 meters)
• Cotacachi: 7,900 feet (2.400 meters)
• Ibarra: 7,300 feet (2.200  meters)
• Girón: 7,100 feet (2.200 meters)
• Loja: 6,900 feet (2.100 meters)
• Vilcabamba: 5,200 feet (1.600 meters)

Unfortunately, there’s no way to know if you’ll have issues with altitude until you’re at altitude, and then it’s hard to escape. You either need to get on an airplane and fly to a lower altitude, or spend several hours driving to a lower altitude.

You can also try Mate de Coca tea, which is made from the same plant used for cocaine. It has a powerful caffeine like effect and will amp you up for hours, but it helped me. There is a prescription drug called Diamox that may also help, but it has a long list of side effects.

Poor Medical Care in Popular Expat Beach Towns

If you have altitude issues, there are lots of cities and towns on Ecuador’s Pacific Coast that are popular with expat retirees. And since they’re at sea level, you certainly won’t have altitude issues.

However, living in an Ecuador beach town is a lot different than living in a cultural mecca like Cuenca or Quito. There aren’t nearly as many things to do so you might get bored unless you really love the beach.

The biggest drawback for most people who want to retire in one of Ecuador’s beach towns is the lack of quality medical care. Guayaquil has some of the best hospitals in South America and Manta has a new IESS hospital that has great reviews and looks amazing, but there are no high quality hospitals between Guayaquil and Manta, or north of Manta.

The stretch of beach between Manglaralto and La Entrada including Montañita and Olón is very popular with retired expats in the younger age bracket (under 70), but many move to Cuenca or another more developed city as they age.

Manglaralto has an urgent care clinic that mostly deals with ocean injuries, stitches and broken bones, but not serious medical conditions. If you need a real hospital or specialized doctors, it takes 3 hours to drive to Guayaquil and 2 1/2 hours to drive to Manta.

If you have a lot of health issues and take a lot of medications, it’s best to retire in Cuenca or Quito. If you can’t handle the altitude, Guayaquil and Manta (including Manabí, Canoa and San Clemente) are your best choices.

Limited Direct Flights to the United States

Cuenca, Loja, Salinas and Manta claim to have international airports, but they only fly to Quito and/or Guayaquil. That means you’ll need to take a domestic flight or drive several hours to catch your international flight back to the United States, Canada or Europe.

If you have aging parents or young grandchildren and you plan to return home from your retirement haven in Ecuador, it makes for a long travel day unless you live in Quito or Guayaquil.

We rarely travel back home so this isn’t an issue for us, but it’s a major challenge for many expats who retire in Ecuador.

Most People Don’t Speak English

Learning a foreign language is very difficult later in life, but you’ll need to master at least the basics of Spanish if you want to retire in Ecuador because most people don’t speak English.

We aren’t fluent yet, although we are studying and hope to be fluent someday, but we’re very good with taxi, mercado and restaurant Spanish. If you focus your learning efforts on those areas, you’ll be better prepared for your life abroad in any Spanish-speaking Latin American country.

Conclusion

While there are several challenges to retiring in Ecuador, those challenges apply to nearly all low cost of living countries around the world and especially in Latin America. However, we feel the benefits far outweigh the challenges, making Ecuador the perfect place to retire.

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Amelia Basista

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I grew up in the Chicagoland area and spent most of my career working as a sales rep in the commercial lighting industry. I still work online for a company in Denver doing sales CRM administration. YouTube is my part-time gig, but I'm so happy we can share our Unconventional Life and hopefully inspire you live yours!