Second passport and best medical care (life, cost, country, place)
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Ive been watching Nomad Capitalist and am considering getting a second passport to our US Passports. My needs currently are medical care for my spouse who has a significant case of RA. She takes a medicine that controls it well called Rituxan. But with her compromised immune system she requires good medical care on situations that are not common here in the USA.
My motive for a second passport is to have an alternative to the USA should things get rocky here in the US and globally as Covid continues to make a normal sustainable lifestyle for most citizens challenging, The ideal second country passport would be easy to obtain and be in a country where my wife's medical condition is likely to be handled best. I likely would keep my health insurance in the USA so flying back is an option should be feel we need to move out of the USA for some reason as a place to live.
Colombia seems to have the best medical system in Latin America from earlier research I have done on this matter. Any thoughts and alternatives to my thoughts on this matter? I am considering a European country for an additional passport with the same need for a good healthcare country and an easier to obtain passport as requirements. I am not asking about this matter here but welcome thoughts from those who know Latin America and Europe on this matter.
Thanks in advance for any assistance or guidance you can provide me.
PS I mention the infusion medicine my wife gets for her RA as a way to test a countries level of medicines available. This is based upon learning Costa Rica did not have access to some of the meds my wife needed for her RA condition a decade ago when I explored moving the CR in retirement. This matter was the major show stopper so want to test availability of this med as part of the first step. I did test a Colombia RA doctor on this med and was told it was available for use for RA patients in his area of Colombia as well as in Panama too.
I think the BEST bet would be Europa, before Latin America for your family medical needs...Portugal, Greece and Belgium come to mind...Great and unexpensive countries to live in.
What countries have you looked into? I know that some Caribbean and other nations offer passports with a substantial investment made into the country, but I think many (most?) countries passport processes can be pretty significant. And even some European countries seem to offer permanent residency via investment, though I'm not sure if you'd get a passport out of this
Do you have any ties to European countries that could make you eligible for a passport/citizenship by descent?
I think a lot of talk about passports is purely academic unless you have the funds for a citizenship by investment deal or can otherwise easily qualify for a passport otherwise. But most aren't in these circumstances.
I have Argentina, Colombia, Panama, Ecuador, Peru, Uruguay, and Mexico under current consideration in Latin America. In Europe, I have Montenegro, Macedonia, Georgia, Portugal, Italy, Slovakia, Armenia and Croatia under consideration.
My source of info on this matter is Nomad Capital but health care is not something he addresses in depth enough nor in immune system related specialists for my needs. I have sufficient assets to buy access thru programs requiring an investment but as this plan is a contingency plan vs my option of state in Plano, Texas where I am now, am looking for a location with less investment or accessible thru step 1 of getting passport if possible at this time. Wife and I are both vaccinated, wife has her third dose of Pfizer vax as recommended by RA and CDC here.
I am English and Scottish in my family tree, both side of my famly have been here in the USA for centuries so no recent ties to Europe but if that long history is not an issue perhaps I need to look into this aspect. My spouse has a family history of Irish and Spanish so same for her, been a long time for the Irish side but not so long on the Spanish side. So I will explore this aspect for the Spanish side though it is not a country that interests me but getting a Spanish passport can give me access to most if not all the Europe countries under considerion, I will explore this option further as mentioned above, so thank you for the guidance.
Colombia is my top candidate currently. So I am pursuing the RA capability of medical specialist there.
OP, have you read the requirements to obtain citizenship in Colombia? You are putting the cart before the horse. First, you need to become a permanent resident of that country. The same applies to almost any other country unless a person is getting citizenship based on a parent's (or perhaps grandparent's) country of birth.
Yes, the above link is in Spanish, because after being a permanent resident (and taxpayer) in Colombia for at least 5 years, you will need to pass a Spanish language knowledge test, and a knowledge test on the history, geography and constitution of Colombia (in Spanish) as part of the application process for citizenship.
What languages do you speak, and what countries have you spent time in outside the USA, aside from short tourist visits?
Let me clarify, I am looking for a second passport not now to become a citizen of or a resident of another country. Travel for my spouse is not really very feasible right now. I am some what familiar with a number of countries passport and for longer term needs, their residency visa requirements and citizenship requirements as well
I may be looking for a purple squirrel as far as this forum is concerned but thanks for your time and desire to help me
Ok. That's helpful. I could be wrong, but I think passports are tied to citizenship. You're most likely looking for legal residency in various countries. If you're not prepared to pay a hefty sum and absent having any recent familial ties to a country, the countries that offer relatively simple residency may not be ideal in terms of safety, adequate healthcare, etc.
Dominican Republic is an option given how cheap is high quality medical care. Health insurance is also on the cheap side and policies cover more than similar policies in the USA.
While there are good hospitals and clinics anywhere, the twotop hospitals are Hospital Metropolitano de Santiago (HOMS) in Santiago and the General Hospital/Cedimat at the Plaza de la Salud. The HOMS is currently going through an expansion with a new tower acrosx the street (everything will be connected with a walkway or covered pedestrian bridge). Doctors in both tend to be top notch and they have all sorts of equipments including CATScans and MRI machines. They cover the gamut in all sorts of medical care. HOMS has a separate small building behind the current towers that specializes in all sorts of cancer. In Santo Domingo there is a separate top notch hospital devoted to all sorts of cancer.
The only problem with Santo Domingo is that it's a big city and traffic is an issue. Don't be fooled with the images on Google Street View, those were taken on Sundays and holidays, which is why the streets are devoid of heavy traffic for the most part. Santiago is going the same way as Santo Domingo regarding traffic, but it isn't there yet. It's also a third the size of Greater Santo Domingo and much cleaner. Both cities offer enough for a modern comfortsble lifestyle. Generally, if there is something that can't be found in Santiago, the likelihood is very high it is available in SD. If it isn't, then it isn't available in the country.
Flights to major US cities on eastern seaboard are plenty and rather short (about 2 hours to Miami / 3 hours to New York / a few minutes more to Boston.) Other than Mexico, Cuba, and Puerto Rico; there is no other Spanish-speaking country geographically closer tl thr USA.
Even though there are some doctors that understand English, especially at the HOMS where many graduated from USA medical schools, you will need to have a good knowledge of Spanish. Not only do all doctors speak Spanish, but all the paperwork, etc will be in Spanish only. Well, I don't see how anyone can live in the Dominican Republic without speaking Spanish and not running into difficulties due to that. It can be done, but I don't think it's an easy process. Unlike in the USA where you can get services, especially government owned such as from public hospitals, in like a million languages; in the DR if you don't know Spanish or at least understand basics of the language, you're screwed. I guess a person could depend on someone else for translating things, but I don't think that's ideal.
Part of Plaza de la Salud in Santo Domingo. Don't be fooled that this isn't a tall tower, it's an expansive complex and has several types of hospitals and health institutes. The neuroradiology department at this hospital was founded by a well known Dominican neuroradiologist who spent many years in the USA (was one of the professors at the medical school in Harvard University) and is the founder of the American Society of Neuroradiology. After many years in the USA, he returned to Santo Domingo and devoted his knowledge at this hospital. https://www.google.com/maps/place/En...9347c55f36a750
Anyway, there are several more that offer top notch medical care and being in them is similar to being in a US hospital with some cultural differences, the language being one of them.
Great recommendation. I am not an ocean front climate fan but I have heard something very positive about DR recently. They were one of the first countries that recommended a third COVID vaccine dose for immune impaired and suppressed patients such as my wife. The USA finally recommended that and we got her third dose recently. But DR was on the list along with Israel and Germany and UK in this protocol.
I will investigate further.
The concept of getting a password before spending time in the country and well before citizenship is sought was a new one to me. But Nomad Capital has many videos about various countries who do this. More in Latin America than Asia and Western Europe but some of the Eastern Europe counties allow this according to Noman Capital who seems very credible to me
Thanks for your recommendation I recall being surprised to see DR on such a progressive list of adopters for the health issues that my wife suffers from. They may well be on the leading edge of treating RA patients and other with compromised immune systems
Oh. I thought you were going to ask about "Fuddle Duddle" by Antiqur Far, which has a wonderful histtory, long overlasting the song's brief success in 1971.
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