The essential things you need to know about healthcare in Colombia

I wanted to share a post on my experience of healthcare in Colombia so far, but in this post I’ll just give a non-expert summary of how things work here and the different insurance options. Please note that this is just what I have picked up in the four and half years I’ve lived here. Any opinions I give are based purely on my personal experience. Different healthcare providers may have different approaches to treatment. To be 100% confident about your coverage, you should buy some comprehensive international/expat insurance to cover you for your first 3-6 months in Colombia while you get settled and work out what your best in-country insurance options are.

Healthcare in Colombia – a brief summary

If you’re from the US or another country with a private healthcare system, healthcare in Colombia may not be so different from what you’re used to. As I’m from the UK, where healthcare is free at the point of service and paid for by the state, most people don’t have health insurance, so this was a new concept for me when I got to Colombia. Foreigners who do not have a cédula de extranjería (Colombian ID card for foreigners) will not normally be able to sign up for the general EPS health coverage.

EPS (Entidades Prestadoras de Salud) are healthcare providers and there are quite a lot of them. All employees in Colombia are required by law to sign up to an EPS. If you work for a company as a permanent employee, your employer must provide you with this basic health insurance. Sometimes they are affiliated with a particular EPS, in which case you’ll be signed up with them. In other cases, you will need to tell them which company you wish to be affiliated with. If you have a partner/spouse with EPS coverage, you can be added as a beneficiary of their health insurance policy. Normally, you will need a visa and cédula first, but it’s worth asking the EPS if you can be added as a beneficiary without a cédula, as the policy is actually your partner’s, not yours.

EPS Healthcare in Colombia

EPS are healthcare providers. You pay your insurance monthly and organize medical appointments via your EPS. If you are self-employed or a contractor, you will have to arrange your own health insurance, and if you have a cédula de extranjería, you can sign up to an EPS. According to a customer satisfaction survey carried out in 2017 by the Ministry for Health, the top five EPS are:

Suramericana (also just called Sura),
Sanitas
Aliansalud
Nueva EPS
Compensar EPS

I am with Compensar and haven’t had any major problems with them other than adjusting to the different approaches when it comes to healthcare. I’d avoid Café Salud, which has been associated with major corruption scandals in recent years.

Private and Prepaid Healthcare in Colombia 

Many people don’t feel comfortable with only having EPS coverage, and take out additional insurance. My EPS is Compensar, but I pay a premium each month for their Plan Complementario. This gives me access to the best hospitals in Bogotá and throughout the country. It also allows me to book an appointment directly with a specialist without having to be referred by a general doctor. Other EPS offer similar options and it’s often called a Plan Prepagado (prepaid plan).

You also have the international private insurance companies such as Allianz, which is also prepaid. You pay a certain amount each month and you normally make a co-payment for each appointment or treatment. This may be a good option for people with pre-existing medical conditions who want to be sure they’re covered for any treatment they may need. Private health insurance policies normally need to be in addition to the obligatory EPS coverage, unless you are taking it out as international [expat] health insurance.

The Healthcare Culture

Before moving to Colombia, my only experience of a healthcare system was Britain’s National Health Service (NHS), which is paid for by our tax and National Insurance (social security) contributions. Historically, it has been a very good service, so most people don’t buy additional health insurance.

Now that I’ve experienced healthcare in Colombia, I can say that I’ve noticed some differences. On reflection, I think these relate to the fact that one system is a state-provided service, and the other is private. For example, I now get the feeling that in Britain, general doctors won’t refer you for a scan, to a specialist, or prescribe particular medication unless they feel it is necessary. This is because doctors in Britain need to be conscious of not wasting public money. The upside is that doctors tend not to over-prescribe in the UK. It therefore isn’t common for the average person to be taking a lot of different pills unless they have a particular medical condition. The downside is that people find it difficult to access specialist doctors and there is usually a long wait for appointments.

In my experience, a visit to the doctor in Colombia seems to involve being prescribed every single drug that may conceivably help with whatever ailment you’re suffering from, being referred to one or two specialist doctors, sent for blood tests and scans and basically having your diary filled with medical appointments, when all you went in for was a sore wrist! Maybe its because healthcare in Colombia is run by private entities, so it’s in their interest to encourage you to pay for as many different services and drugs as possible, even if you probably don’t need them.

This is good in the sense that anything unusual will be picked up as soon as possible by a blood test or scan. The downside is that it can leave you feeling anxious that there’s something seriously wrong. This may be similar to other private healthcare systems, but it’s just worth bearing in mind when you’re going to the doctor about something which seems minor. Don’t let Colombia turn you into a hypochondriac!

What are your experiences of healthcare in Colombia? Is there any information you would add? Would you recommend your EPS/insurance company? Please leave a comment in the section below!

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