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Doctor retiring to farmingThis forum post has messages dated from 10/06/09 through 03/07/12, please be sure to read all the messages. If you feel it is old or outdated, please follow up with a question or comment and someone may be able to update it, or reply with newer information if you have it.
| Doctor retiring to farming reposted on behalf of Robin:I’m a US citizen and have always liked what I’ve read about Uruguay. I’m a doctor (dermatologist) and I don’t know if I would be able to practice medicine there. If I can't practice, I’m in my 50s and am thinking about retiring on a farm and raising cattle, goats and chickens and doing some farming of vegetables. what’s the process for getting a resident visa and citizenship? can foreigners own land there? Is it difficult to puchase a farm? are property taxes expensive? are there income taxes? Thank you for your kind assistance. Robin Fleck Arizona, USA |
| Hi Robin, Those are very common inquiries and so you will find pretty comprehensive answers to topics such as residency requirements in the free ebook this website offers (its available at the link below). But to answer briefly: - Residency in general is quite simple. It is a bureaucratic and tedious process but in the end everyone gets it, they're not going to refuse you. - Yes foreigners can own land. Try reading under the Colonia section of the ebook - There is no income tax on money earned from outside of Uruguay (which includes a US pension). There is income tax if you work for a Uruguayan company but I don't know the rates. I hope you will find many of the answers you're looking for, either in other forum posts or in the ebook, but feel free to post as many questions as you like. I think its best to post new questions to get fresh answers. |
Comment #210/07/09 09:03Rural east Colonia departmento | > what’s the process for getting a resident visa and citizenship? Please see elsewhere. > can foreigners own land there? Is it difficult to puchase a farm? Foreigners can own land and its not especially difficult to buy a farm. > are property taxes expensive? Rural property taxes are laughable here in Colonia dpto. This year I paid 810 pesos (38 U$S) on my 30 acres. Rural houses and buildings aren't subject to property taxes at all (though this might change in future.) > are there income taxes? Yes there are on profits made within the ROU. Certain crops (like sorghum or alfalfa for animal feed) can be sold "on the black" but things like wheat or maize will have to go through the books. A good accountant and a skill with creative accounting can minimize them :-) The unavoidable "tax" on farm land ownership is the BPS charge. This is a form of national insurance and is usually paid in 3 installments a year. Once you have a cedula, you can be transformed into a unipersonal farmer which will increase your BPS payments slightly but which will provide you with a free subscription to your local health mutualista. I currently pay about 15, 000 pesos/year (about 700 U$S) Patrick |
| Patrick, do you have an idea of what size acreage subjects one to the BPS contribution or is based on something other than size, such as farm revenue? |
Comment #410/08/09 06:08Rural east Colonia departmento | As far as I recall the standard rate of BPS for small farms applies from 3 or 5 hectares (the minimum sizes of agricultural holdings) to 280 something hectates. The basic rate is not dependent on revenue, turnover or whatever you do on your chacra. Of course if you employ staff you'll be smacked for BPS contributions on their wages as well. I don't know the BPS rules on holdings larger than 280+ hectares as I live in an area of small farms. Patrick. |
| "Doctor retiring in Uruguay"
I, too, am an MD wanting to retire in Uruguay and to work there as a dermatologist. I have been researching on getting a medical license to practice there. Unfortunately, I have not found out very much about practicing medicine there as a foreigner. My wife and I are also interested in having a farm and eat what we grow. If you like I can share with you what I know about practicing medicine in Uruguay. Contact me at fgrege@juno.com. |
| "Why not..."
Click post new message at the top of the screen and share with everyone what you have found. Though only a few have posted many more are probably interested....Expert Page: Quick Tips for Getting Settled in Uruguay |
Comment #712/21/11 08:51Rural east Colonia departmento | "Farming and taxes"
A slight amendment to what I wrote wrt taxes on crops and other produce which are sold through official channels. For small "unipersonalised" farmers there is now a flat rate tax of about 8% on the value of the crop sold. There are no requirements to prepare and submit farm accounts. The merchant in question will deduct the tax before he pays you.Unipersonalised farmers with 50 hectares or less can now claim exoneration from paying the modest agricultural land tax (contribucion rural.) Unipersonal BPS contributions for small farmers remain at about 16k pesos/year. For the non-agricultural self-employed, its about twice this figure. Capital taxes (IP) apply to assets held within the ROU with a free annual allowance of just over 100k U$S per person per annum (twice that for couples.) OTOH there are exemptions to IP which include farms, agricultural machinery, dead and live stock and on other items necessary for farming inc agricultural buildings. Farm houses are assessed in the usual way (that is at a fairly low value) but being farm houses, they get a further 50% valuation discount. Strange to say, money sitting in a bank account which pays no interest is also exempt from IP. There are plans to scrap IP by 2017. |
| "US Doctor wants to work in Uruguay"
As much as i can find from contacting UY embassy and other blogs, to obtain medical license in UY, you need to contact La Universidad de Medicina, tel no: 598-2924-3414, web site:www.fmed.edu.uy or www.mec.gub.uy, email: centrod einformacion@mec.gub.uy. I have called and emailed multiple times but did not receive any reply and only busy signals with phone calls. Someone told me that I have to go to the university in person to get anything done. I was told that in Nicaragua, Italy and Spain, one needs to show proof of education (i.e. your medical degree), verification of courses taken and training to the Uni Med. There is no medical board in the countries mentioned above. I have a feeling that UY is very similar. Getting a license to practice is not difficult, but getting a job is. Because in UY and most other countries, healthcare is state-run, to work as a physician means working for the government. And the governments in these countries are not likely to hire foreigners. I am thinking of opening my own clinic in UY operating as a small business. I heard that UY is business friendly with not much regulation. Everything I've written here has not been confirmed and is based on my assumptions. If there is anyone with first hand experience, their knowledge and info would be more reliable. When the time comes, I will hire an interpreter to help me obtaining a license and work permit. This will not be until I'm actually in Uruguay. |
Comment #912/21/11 15:16Rural east Colonia departmento | "Government workers? Business friendly?"
"Because in UY and most other countries, healthcare is state-run, to work as a physician means working for the government. And the governments in these countries are not likely to hire foreigners"I'm not a medico but I have experience with the local health services as a patient. I'd reckon that most medicos don't work for the gov here. We still have a remnant of the old government public health service in the form of a basic free clinic here in Valdense. I had to go there for a tetanus jab some years ago. I understand that there are still some public sector hospitals in MVD and possibly Salto but nowadays, most of the health services here are run by "mutualistas" (local freestanding health co-operatives.) My local mutualista (CAMEC) has several policlinicos in the area and each policlinico employs a staff of general practitioners, nurses etc. The mutualista also has its own general hospital at Rosario which offers in-patient and out-patient care. The various specialist medicos come to the hospital as often as necessary on a part-time basis so any particular specialist might work for several mutualistas in different places on different days. Mutualistas are funded by subscriptions from registered members. The members either pay a monthly fee or if they are employed and are paying BPS contributions, the BPS will pay on their behalf. Last month I was ordered a bone density scan. None of the local mutualista hospitals had the right sort of scanner so I was given an appointment at what appeared to be a private house near the ferry terminal in Colonia del Sacramento. The bloke in question had a bone density scanning machine plus computers set up in a downstairs room and seemed to make a living by doing contract work for the local mutualistas. He printed off my results for me and I took them along next time I saw the specialist. I'm told that the ROU is a net exporter of medical personnel. "I heard that UY is business friendly with not much regulation." I fear that you've heard wrong. The ROU offers individuals an amazing degree of personal freedoms but makes up for it with enough business regulation to sink a continent and an army of funcionarios (bureaucrats) to enforce it. Fortunately, agriculture seems to escape the worst of it. |
| "Thank you, Patrick "
For the precious details on the Uruguan Healthcare system. Please enlighten me and others on this topic if there is more. What's 'ROU' and how much did you pay for the tetanus shot, bone scan, etc. |
| "tetanus shot"
tetanus shot: $0.00. $0 pesos. Zero. Nothing. Zip. Nada. I think yellow fever is about $200 pesos.Bone scan I can't say. As a PAYING customer at the Military Hospital, I paid around $212 pesos for a Dr. Appt, and US$3000 for thyroid surgery (everything related to the surgery) and US$350 for two nights in the hospital. Those two fees included *EVERYTHING* (except $40 pesos a day to rent a TV). It also included a biopsy at an outside lab. That was in 2006. Expert Page: Quick Tips for Getting Settled in Uruguay |
Comment #1212/21/11 16:40Rural east Colonia departmento | "Clarity"
ROU = Uruguay = República Oriental del Uruguay.Things done at the government clinics like tetanus shots are provided free of charge. The bone scan was booked and paid for through CAMEC (my mutualista.) I had to pay a contribution of 385 pesos towards the cost. Various small charges apply to mutualista services. I pay 53 pesos to see a GP and 135 pesos to see a specialist. On the other hand, once you are viewed to be suitably ill and in need of treatment, all payments are covered by your monthly subscription. The three days I spent in hospital at Rosario cost me nothing at all (not even for the drugs) and neither did 3 visits a day to my local policlinico for 10 days for IV antibiotic drips and goes on the bubbly oxygen inhaler c/w staff to take my BP, temperature, pulse and %O2. I was pleasantly surprised by the whole in-patient experience. The hospital was well-run, scrupulously clean, very well staffed with plentiful spare capacity. I've come to see our mutualista system as healthcare by and for the people :-) |
| "Thank you, Patrick & Glen"
It seems that you are well taken care of medically in ROU with relatively little expense. Do you think a foreigner like myself can make a living there ?(I am not looking to get rich, just enough to pay the bills and to retain my skills and experience as a dermatologist or PCP). I appreciate your inputs. |
| "Lucas."
Some extra explanation about the relation between the State and health care in Uruguay. There is a National Healthcare System (called FONASA) that is gradually being extended to the whole population. The FONASA funds comes out from our BPS contributions. The BPS is basically a previsional institution that manages retirement funds and other social state services. Now, the FONASA is state-run, but it just pays for the basic health service and not gives the service. One of the service providers the FONASA works with is state-run: the MSP (Ministerio de Salud Pública). The rest, wich covers about 60% of the population, is private (the Mutualistas). You should not have any problem for being a foreigner at the Mutualistas, provided your title is legally recognized. The difference between the mutualistas and the MSP is that in the MSP people don't have to pay extra (other than the FONASA coverage), while in the mutualistas you have to pay some small amounts (described by Patrick) each time you use the service, and, eventually, an extra monthly contribution on top of the FONASA contribution, that can vary from zero to, say, 50 dollars, depending on the mutualista. So, as a FONASA user, you can chose between a better service (at the mutualistas) paying a little money on top of what you are entitled by the FONASA, or have a no-extra-charge service from the MSP. So poor people usually choses the MSP, while the middle class usually choses a mutualista. Apart from this, the mutualistas also give health service for a monthly fee to anyone not having FONASA coverage (foreigners, for example), as any private health insurance service. And of course, many Drs., particularly specialists, have their own private clinics which service you can pay for on-demand attention.Now, validation of you title is mandatory and that's the first thing you should do. As you already have experienced, some things in Uruguay have to be done face-to-face. And this is particularly the case. Try to contact the Facultad de Medicina (part of the Universidad de la República) you were directed to at least to be certain you have all the required papers when yo come here. But the process itself will have to be done here (and a with a lot of patience). As you may imagine, fluency in Spanish will be a must at your job. Another comment about previous posts: Though there is a lot of doctors in Uruguay and many have gone abroad for jobs, they are not well distributed through out the country, and most tend to find a job in Montevideo. This may create some opportunities specially for you, planning to live at a farm. A week ago the President was urging new doctors to look beyond the limits of Montevideo to start their carreers. |
| "Muchas gracias, Alberto"
Yours and other messages are priceless. I hope other healthcare professionals can access this posting. I am indeed looking to work in the rural area providing whatever medical service I can. I am glad that the UY president is aware of the need for doctors in rural communities. I guess my problems now are to tackle the bureaucracy and regulatory burdens every business has to face. In many ways, something never changes. These are the same problems I see in the US. |
| "Dermatology"
I just went to a dermatologist at the British Hospital for checkup and had 4 small spots "frozen." Cost was $100.Lucas: you plan on hiring an interpreter to help you with the immigration process. Does this mean your Spanish skills need improvement? I would think you would need to be fluent to work here. Especially in the countryside. |
| "Dermatology"
There is a British hospital in UY? Are there an American, French, German hospitals too? I'm trying to piece together a whole picture of what it's like to work in UY. The charge for your cryotherapy for the 4 spots sounds average as it is here in the US. $50 at my clinic depending on the severity of the spots. Warts and age spots often require more than one freeze, we would charge even less for each session. Did you pay out of pocket for the freezes or insurance pays? Thank you for this tidbit, please write more about your experience with doctors in UY. I'm sure there are other doctors who are very interested in this. Also, are you, as expatriates, happy with the doctors that you see in UY? Are there rooms for improvement, as far as the scope of expertise of the doctors there? And the availability of medication in UY, is it sufficient? Is it true that one can buy medication there without prescriptions from doctors? BTW, my spanish is at an intermediate level, not quite fluent. A large portion (85%) of my patients is hispanic and I can communicate fine with them. I need an interpreter because I'm not totally confident in dealing with governmental agencies and bureaucrats. |
| "British Hospital."
Mutualistas started a century ago as cooperative organizations to give health service out of the initiative of groups of people. For example, one of them (CASMU) was origined and is still linked to the Sindicato Médico (the physicians union), others were origined by group of religious communities (Círculo Católico, Hospital Evangélico, Sociedad Israelita), and others by groups of inmigrants. The latter is the origine of the Asociación Española, the Hospital Italiano and the Hospital Británico. The Hospital Británico had some link with the UK at the begining, and you can still see the portraits of the Queen on its walls. However, all these istitutions were gradually "uruguayized" and their directors, their professionals and their clients (not really clients, in the mutualista you say "socio", wich is more of a "member"; different concept, somehow)are all Uruguayan now. However, particularly the Hospital Británico has tried to retain some original caracteristics and for them it is very important tha their professional are bi-lingual. Thus, the HB is generally the mutualista prefferred by English speaking foreingners, and it's still used as a higher level hospital for patients comming from the Falklands, or british crews in the area (the injured of the british fleet during the Graf Spee hunt were sent there). There's also a "Sanatorio Americano", but in that case, I think it's just the name. So, the answer is yes: there's a British, an Italian, an a Spanish hospital, but the truth is that they are all Uruguayan. |
| "Dermatology."
In some cases, some dermatologic operations may be considered "cosmetic" by the doctor and thus, out of coverage. The fact that the Hospital Britanico charged that amount to Jerry may be due to this fact, or because Jerry is not subscribed to the HB and went there as a private client. If the operation is therapeutic or preventive and you are a member, it should be covered by the monthly fee.Many drugs are sold without prescription. Psycotropic drugs are never sold without prescription. Antibiotics were not, but are now being regulated. Anyway, auto-prescription is not as popular as you could think. The trick is that the mutualistas also gives you the drugs that the mutualista doc prescribes, with generally much lower cost than if you buy it at a store. So, Uruguayans generally make a balance of the cost of the medicines at the store as compare to the cost of the ticket the mutualista charges to see the doctor and the medicines. The balance generally favours going to the doctor, getting the prescription, and having the medicines from the mutualista. For a few drugs (for example the ones used by diabetics) the mutualistas even have a subsidy by the Gov, so in that case the difference in cost between getting them from the mutualista, and buying them at the store without prescription is still higher. |
| "Dermatologist"
OK, to clarify things a bit... I have Blue Cross in the U.S., not here, so I have to apply for reimbursement to the US office. The treatments were not cosmetic, but preventative., so will be covered.The BH does accept Blue Cross, but BC Uruguay, not BC US. The dermatologist I saw did not speak English. I have seen a couple of other doctors, one who was fluent in English (and often vacationed in Hawaii) and one who was so-so. As for medication costs, I went to a pharmacy for a medication and they gave me a discount oard, good for 75% off the first purchase and 50% off subsequesnt refills. I didn't even ask for it, they just offered. Cool! |
| "Local input"
I am a physician living (> 2 years) but not practicing in Uruguay. The local physicians I know seem very competent but many do not appear to earn very much.I know physicians who supplement their income doing life-guarding or teaching karate. If I were going to try and practice, I'd try the British Hospital as it being bi-lingual would be the most valuable to their ex-pat clientele. If you went out on your own in Montevideo, you would be competing against them for the ex-pat market and they offer good service. With 3 teenage children we have accessed the healthcare system more than once and I'd choose to have my personal health care here rather than in the US. Opening a business here is completely different than in the US and from the experience of close friends, it offered many unpleasant tax and regulatory surprises.(I've owned two US businesses and looked into it here but decided against it). I'd now only consider doing it with a local partner and only after I really understood the local market. Having recently purchased a car and having the transaction take about 10 days to process the paperwork, I can't image what would be involved in getting a Medical License by reciprocity to the US. I know a physician who practices tele-psychiatry in the US while living in Argentina. Is tele-dermatology an option for second opinions etc? The other option to continue to practice is live in Uruguay and go back for the occasional locums job. My hunch is you could do 3 months locums per year and be ahead of working here full time. In summary, Uruguay is a great country as an ex-pat but the optimal situation is probably to make your income outside. |
| "Local input"
Thanks for sharing. Most helpful advise. |
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