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My wife and I are retired and intend to travel for 1 year across Latin and South America on a limited budget. We are USA Citizens, but USA Med Travel Insurance is too expensive.

Is it possible to buy cheaper medical insurance upon arriving at our first destination (which is Ecuador)?

I don't know if you can get cheaper insurance in Ecuador, but there are many potential problems with this plan.

• It's very unlikely that travel insurance in Ecuador will pay to fly you back to the USA in the event of you becoming seriously ill, or fly your body back to the USA if you die. Either of those things would be extremely expensive.




• As I recall, the insurance companies I've bought policies from in the UK will only insure UK residents. Ecuador could, of course, be completely different but you'd need to check that.



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  The travel insurance policies I'm familiar with must be bought before the travel begins.

  
  
  

  • Even if you find an insurer who's happy to cover a trip that has already started, what if you're taken ill on your way to Ecuador or before you've arranged insurance in Ecuador?

  
  

  • What happens if you get to Ecuador and find you can't buy insurance after all?

  
  



• I guess at least one of you speaks Spanish pretty well, given that you're planning to spend a year in South America. But is your Spanish good enough to deal with a Spanish-speaking insurance agent if you need to make a claim? Do both of you speak good enough Spanish to do that? Either one of you might be unconscious in hospital when this conversation needs to happen.




• This goes for any insurance policy but, as a rule of thumb, cheaper premiums means less coverage, lower payouts and higher excesses. Can you really afford any of those things?

You might want to look at long-term travel insurance policies. The upside is that you might be able to find plans which have no specific residence requirement, are probably cheaper than US-based insurance, might be easier to deal with than local insurance, and could even be bought after the travel has started. Unlike run-of-the-mill travel insurance, these plans can also cover a long stay abroad like the one you are planning.

You could also get repatriation insurance separately if need be but the real killer is going to be coverage for health care back at home. Should a serious accident or illness befall you, you will probably want to be treated in the US rather than being stuck for months in a foreign country, possibly with a lower standard of care. The problem is that healthcare in the US is so expensive that travel insurance plans available elsewhere in the world frequently have “with US” and “without US” options, with US coverage requiring much higher premiums. There is just no way around that.