How To Get Health Insurance In Colombia
In this article we will explain how to comply with the new Colomiban visa health insurance requirement as well as how health insurance works in Colombia. Health insurance is required by law for all working or independent Colombian citizens and legal residents of other countries. Colombia has three major forms of health insurance plans available to all citizens and legal residents. Before we discussed these health plans in detail, let us briefly discuss health care in Colombia.
Colombia’s health care system is a hybrid system that consists of public and private health insurance. The quality of the services varies from being world-class to 3rd-world depending upon geography, funding model, and management. Hospitals can be public or private.
Along with specialty clinics, there are doctor’s clinics and urgent care facilities called IPS (Independent Health Provider). These may charge patients directly for services or receive payments by several EPS (Health Provider Entity) programs.
EPS plans are similar to health insurance plans or cooperatives, just like in the US, and are normally paid for by employers or the federal government. In the case of independent workers or self-employed, they are paid directly by the policyholder.
Low-income citizens or residents have their monthly EPS premiums subsidized or paid for by the government. Some EPS plans are well run; others are mismanaged, while others still are quite questionable in practices.
Hospitals sometimes complain that EPS plans generally are several months behind in making payments for services rendered. Generally, employees, rather than employers, choose their EPS plans. Then the employers contribute a fixed amount to the EPS coverage on behalf of the employee.
Optionally, Colombians and foreigners may purchase “medicina prepagada,” or private health insurance that works “on top” of EPS plans. These plans provide an additional level of care with separate facilities and doctors, and benefits such as doctor’s house calls, sports medicine, and coverage abroad for traveling policyholders.
Some companies, like SURA, operate EPS plans, private insurance, and their hospitals and clinics. In most cases, these plans offer dental and vision coverage with copay in some cases.
New Colombian Visa Health Insurance Requirements for 2020:
Type of Insurance for First Time Applicants – time then you probably need to obtain traveler health insurance if your are not in Colombia. However, if you are in Colombia you may also purchase a premium health insurance policy up to about 60 years old. For this type of policy you may pay about 1,000 dollars for a 1 year premium. Finally, if you are in Colombia you may apply for the EPS insurance. .
First Time Visa Applicant – Health Insurance Duration and time of the visa – Travel insurance duration of coverage will be the maximum time of the visa. Foreign Insurance and 1 year premiums will probably get a maximum time on a visa for 1 year. EPS insurance will not restrict your visa, however, it may be expensive for certain people. Please see Calculating EPS insurance costs.
First Time Visa Applicant – Value of Coverage – Foreign Policies – As a first time visa applicant you have the option to present health insurance that is not from Colombia. The amount of coverage that one must have has been varying slightly depending on the age of an applicant. The amount of coverage only applies when you have a foreign insurance or a travel insurance coverage, under current Ministerio de Relaciones Visa office requirements. For senior citizens, the ministry is asking for 60-70k USD coverage on travel insurance but these are individuals over 65.
Time to process insurance application usually it takes one week to several weeks to get an EPS policy approved, and it may be longer during COVID-19 EMERGENCY, so plan in advance. Don’t be shy, we can help with the process if need be.
If you are renewing a Colombian visa you are required to obtain EPS state mandated insurance, and pay correctly based on your income. As of August, 2020, the Colombian visa officials are reviewing bank statements, employment certificates, tax returns, or other financial documents to determine if applicants are hiding any income. Officials may ask for other documents. In Colombia rules and processes change with no notice.
Calculating EPS Insurance costs You may use an insurance agent, or an accountant to help you out with calculations, however the amount you must pay is based on your MONTHLY INCOME. Take your monthly income in pesos multiply by .40 then by .12.
Renewing / Changing Visa – Proof of Coverage for Visa Application Visa officials will probably ask for 6 months of bank statements to prove you reported your income correctly to your EPS health insurance IF YOU ARE PRESENTING EPS HEATH INSURANCE. For persons that are not receiving income, you maybe asked for proof of how you are supporting yourself, such as savings, etc. If you have no income then you should tell the insurance company to quote your policy based on the minimum salary. The minimum salary insurance costs aprx 110,000 pesos.
Renewing / Changing Visa – If you have a job with a Colombian Company – The company accountant should provide a copy of the autoliquidacion de planilla de pagos de seguridad social and a certificado laboral.
Renewing / Changing Visa – If you have income as an independent – You will need to sign up with an EPS as an “independent person”. Once your are signed up and make your first payment, then ask provider for copy of the planilla de pagos, or download from your EPS provider website.
Renewing / Changing Visa – If you are retired receiving a pension – You will need to get insurance with EPS based on your pension income. See paragraph on calculating EPS insurance costs. Visa officials will ask to see 6 months of bank statements from your bank account where you receive pension payments.
Renewing / Changing Visa – If you have no income – You need to sign up as EPS as an “independent person”, and pay over the minimum salary. You will be required to show how you are living, savings accounts, bank statements, etc.
Insurance for Minors – of course may be beneficiares of parents policies.
How to Search for Health Insurance Providers in Colombia?
The keywords to search for in google are “affiliar eps” + name of insurance provider. This insurance complies with the Colomiban visa insurance requirement. You must have a Colombian ID card to get this insurance. Here is the list of the top health insurance providers in Colombia.
Here are some Popular Colombian Health Insurance Providers
Remember Colombia Legal & Accounting SAS can help you with this process if you need help, (click here).
We recommend that you search around. We don’t have a long list as this requirement is relatively new. We have had many people obtain insurance here in Colombia with assist card. They are an old company but are not very cheap. They charge based on amount of coverage and duration of trip.
The other way to find insurance for foreigners traveling is search EXPAT HEALTH INSURANCE or Expat travel insurance on google.com.
Remember its best that your insurance specifies 70,000 USD COVERAGE for hospitalizations, as well as the duration you need to get insurance for. Many have a one year limit. Always check with a visa expert or the government offices to verifiy any last minute changes, as this policy is very new and may change.
A Local Colombian Provider Is Assist Card
You may find a good Expat Health Insurance Quote Here
*The IMG plan offers expats a wide range of deductible levels with the freedom to choose your medical provider and a sizable medical network. The IMG plan is not ideal for expats over the age of 60 – senior expats should look at the Allianz or Cigna plans above.
Please give us feedback with your experiences with health care provider’s quotes and customer service!
What Are the Types of Health Insurance Plans in Colombia?
There are three types of health insurance available in Colombia:
EPS – Entidadas Promotoras de Salud
This is the public health insurance that is mandatory for everybody who is a resident of Colombia. The monthly premium is calculated as 12.5 percent of the monthly gross income that you declare to the EPS.
This is private healthcare insurance in Colombia. The monthly premium for Prepagada varies depending on your age, the plan you choose and any pre-existing conditions.
This is a free government subsidized healthcare system, which is only for very poor or homeless Colombians.
What Is EPS?
The acronym EPS, stands for “Entidades Promotoras de Salud“, or Health Promoting Entities in English, and in Colombia medical care is an elementary right that all citizens have, regardless of whether they are nationals or foreigners. EPS is Colombia’s basic state mandated insurance
EPS Colombia forms the public health system of this country and is mandatory for all residents. Having a monthly premium of 12.5% of your gross monthly income.
– What the Min Salud numbers showed regarding EPS
– Best EPS Colombia 2020
What Are the Min Health (Ministerio de Salud de Colombia) Numbers With Regard to EPS?
Every year, the Colombian Ministry of Health conducts a satisfaction survey of the Colombian health system among its users. The objective of this survey is to assess each one of the classes that intervene in the quality of the services offered by the Health Providers (EPS).
The consultation is carried out both for EPS Colombia that are in the contributory and subsidized regimes. At the same time registering the perception of the respondents regarding the health system in general.
According to the latest data provided by Min Salud, of a 100% of respondents, around 51% belong to the subsidized sector and the other 49% to the contributory sector and answered questions that sought to rate EPS Colombia based on opportunity, access, the quality and satisfaction of the service.
About 65% of those surveyed concluded that the service provided by EPS Colombia is good, while 7% stated that it was very good.
What is EPS Insurance?
In Medellin the most stable EPS for the recent years has been SURA. SURA is a Bancolombia company. While popular in Medellin, it’s a good idea to figure out what works has the best service where you are living.
– The EPS covers preexisting conditions while the premium policies do not
– The EPS covers medicine, although options are limited, it’s quite nice to have. EPS will reimburse for medicine or you can order medicine through the free system.
– Reimbursements are always a time consuming hassle but if you need your medicine fast you will probably pay for it.
– Look for an EPS with a good local clinic. A clinic handles minor procedures, doctors’ appointments, and many times has dental service. You will be assigned your local clinic based on your address.
– The amount you pay for EPS depends on your salary.
– If you are retired this value depends on your pension. However, many times people work with their accountant and sign up as an independent person with minimum wage.
– If you have a job or receive income, then the Colombian government wants you to pay social security equal to the amount you pay for the EPS, HOWEVER, if you’re a foreigner and you pay social security in another country then you may be exempt for this payment. (see an accountant or attorney to help review laws)
– It is recommended to work with an attorney or accountant as they can help with the forms, and declaring a legal minimum salary, so that you are not paying much for health insurance.
-If you can afford it, it is recommended to have both EPS, and Premium Insurance.
What is Premium Insurance?
Most foreigners will go for the prepaid medicine or policy option for VIP service. What this means is that you don’t have to be dying in the emergency room to see a doctor or to get attention. Usually this means that you will be seen by a doctor in an average of about 30 minutes.
While some insurance companies have their own clinics, when it comes to serious surgery or treatments those are almost always forwarded on to major hospitals. If you are in a hospital with VIP prepay or policy insurance you usually get a private room, and you will definitely get better attention from doctors and nurses.
How Is the Quality of Health Care in Colombia?
While this depends on where you live, the larger more developed cities have excellent clinics, and if you have premium insurance or cash you will get the best care.
The World Health Organization recently ranked EPS Colombia, in position number 22 among a total of 191 countries that were reviewed. Most of the hospitals and clinics in the main cities of Colombia have a large number of bilingual medical personnel.
Are Medications and Vaccinations Generally Covered Under EPS Insurance?
Many generic medicines in Colombia are extremely cheap, sometimes 10% of what they cost in the United States. However, foreign brand names are very expensive. Certain EPS will reimburse but it’s always good to verify ahead of time. In most cases a good generic will do that job, but always check with your physician. Most vaccinations are covered.
The best and worst qualifications for basic health insurance providers from the Minister of health for 2020 are:
The Best EPS in Colombia in 2020?
Asociación mutual ser con 91.675 %
Compensar con 89.44 %
Sanitas con 84.92 %
EPS Convida con 79.82 %
Famisanar con 78.84%
Emdisalud con 77.58 %
Cajacopi Atlántico con 77.53 %
Asmet Salud con 77.45 %
Suramericana con 75.79 % (also referred to as SURA)
Salud Total con 76.33 %
Nueva EPS Contributivo con 75.75%
The Worst EPS in Colombia in 2020?
Brief Spanish Health Insurance Glossary
- Pago particular (pay in cash no insurance)
- Afiliacion (sign up)
- Policy Prepago (Prepaid Premium Insurance)
- EPS (Basic Health Insurance)
- Especialista (Specialist)
- Red (network)
- Factura (Invoice)
- Cotizacion (quote)
- Formulario (form)
- Formula (prescription)
- Mensualidad (monthly dues)
- Copago (co-payment for services)
Services we Offer our Visa Clients
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