Health insurance in Colombia for expats

Colombia has a very high standard of healthcare. It ranks 22nd in the global healthcare system rankings of the World Health Organization², higher than the United States, Canada and any other Latin American country. The standard of care can be patchy in rural and remote areas but is generally excellent in the large urban areas where the vast majority of foreign expats base themselves.

Colombia’s public healthcare is based around the Entidades Promotoras de Salud (EPS), which translates to ‘Health Promotion Entities’. This is run by a group of more than 30 insurance companies, who facilitate health plans, and enable care to be delivered free at the point of use.

Care is funded by the health insurance payments that are a legal requirement for everyone who is a legal resident of the country, whether they are a Colombian citizen or a  expat. Some Colombian citizens who are homeless or low-income also receive subsidised care, but this is not made available to expats.

Those paying for a ‘contributory’ EPS can access a higher standard of care and service than those using the ‘subsidised option’. Appointments to see clinicians can be booked online and waiting times tend to be much shorter. 

What's covered by the Colombian public healthcare system?

The public healthcare system in Colombia covers a wide range of different care functions, such as:

• Emergency care and hospital stays
• Surgery
• Preventative care
• Diagnostic services
• Rehabilitation
• Mental health support
• Prescription medication
• Maternity care

Colombia is also known for many elective medical procedures such as cosmetic surgery, but these generally have to be funded and accessed privately.

Paying into a public healthcare plan is a legal requirement for everyone who is living in Colombia and is able to do so. The key benefits of this are that there are fewer concerns about whether care is going to be available when it’s needed (especially in the event of an emergency), and whether this may lead to expensive medical bills spiralling out of control in cases of long hospital stays or extensive recuperation and surgery.

What do I need to do to access public healthcare in Colombia?

There are four important steps that every citizen and legal resident must go through to get public healthcare in Colombia:

• Visa: as with any country, a foreign expat must make sure that they have the correct visa not only to live in a country, but to work there as well. Having the correct visa will be essential for successfully applying for public healthcare.
• ID registration: once you have entered Colombia with your visa details in your passport, you should visit an immigration office to register the visa. While you’re there, you will be able to apply for an identification card, which will include a photo and fingerprinting. It isn’t guaranteed that these services will be available in English at your chosen office, so it’s recommended to take a trusted Spanish speaker with you to translate.
• ID card collection: an application for an ID card (known as a cédula) can take up to four weeks to be processed by the authorities. When your application has been approved and your ID card is ready, you’ll be able to collect it from the same immigration office where you applied.
• EPS application: the cédula acts as your health insurance card, which means that as soon as you have it, you can apply for health insurance coverage with your chosen provider. Coverage normally begins from the moment you take out the policy.

Is the Colombian healthcare system free to use for expats?

Not as such, no. Everyone with contributory public healthcare has to make payments out of their earnings to fund their health insurance plans. The amount payable varies depending on the type of employment and the level of earnings involved.

Using the example of an expat that is living in Colombia and employed by a Colombia business, the total contribution is 12.5 percent of an employee’s gross monthly income. However, 8.5% should be covered by the employer, meaning that an employee only has to contribute a further 4% out of their pre-tax income.³

For an employee earning the national minimum wage of 1.3 million pesos per month⁴ - which is around £230 or $300 at the time of writing - that means contributing 52,000 pesos a month (approx. £9 or $12). However, expats will generally be earning much more than this, and so employee contributions of over £100 or $150 a month can be commonplace for foreign workers.³

On top of this, there is also the system of copayments to consider. While many services and care functions are free at the point of use, some require additional payments to be made (similar to places like the UK, where most citizens are required to pay for their prescriptions). Pathology tests, specialist appointments, medication and diagnostics often come under the copayment requirements.

Copayments are charged at three different levels, depending on the earnings of the person involved, but are relatively small: the highest tier is approximately $10.⁵ These rates are reviewed on a regular basis, meaning that small increases year-on-year are likely. However, it’s important to note that private medical insurance policies often cover these copayments.

The flexible nature of private healthcare in Colombia means there is no fixed price for taking out a policy. There are several different variables at play, such as your age and medical history, the offerings and pricing of different providers and the add-on services you choose for your policy.

It’s worth remembering, that the cost of private cover is on top of that standard payment of 4% of gross salary that covers the public health insurance cover.

Do I need private healthcare in Colombia?

On top of the standard contributory public healthcare service, many citizens choose to take out additional private medical cover. These are bolt-on plans that extend the cover provided by the existing EPS arrangement and improve the standard and ease of access to care.

For expats, taking out additional private cover is a legal requirement in Colombia. But this can be considered a positive, as you can have peace of mind that you can access the very best in care whenever the situation arises.

What are the benefits of private health insurance in Colombia?

Taking out private health insurance in Colombia takes your approach to health to the next level, in many different areas, such as:

• Better care and facilities: adding private care means you can massively expand the expertise and medical facilities available to you and access the very best of Colombia’s excellent healthcare system. You should also be able to access private rooms if hospital stays are required.
• Wider choice: a private plan gives you the freedom to select particular types of care or clinicians that are right for you. Additionally, you can tailor your private plan to your healthcare specifics; for example, adding dental care.
• Faster access to care: private cover allows you to avoid the long waiting times and crowded areas that can often be an issue with public healthcare, especially in the big cities. You should be able to book an appointment to be seen within a very short space of time.
• More English-speaking care providers: not all hospitals and public healthcare facilities will have staff on hand speaking languages other than Spanish. If you would feel more comfortable with English-speaking clinicians, you will be more likely to find them at private medical facilities.
• Copayment cover: most private plans will cover the copayments that come with certain elements of public healthcare in Colombia. This can deliver significant savings if you’re likely to need to use healthcare services regularly.
• On-call care: some providers have on-call teams of doctors and nurses, available for an additional fee or as part of private healthcare plans. Some will make house calls or provide care virtually - removing the stress and inconvenience of having to travel to a hospital or doctor’s surgery.

Direct access to specialists: private patients aren’t required to go through a GP (general practitioner) with their initial issue before being referred to a specialist. Instead, they can access specialists directly and get the care and advice they need faster.

Would I need dental insurance in Colombia?

Colombia has become a very popular destination for dental care, for people from all over the world. This is thanks to a combination of high-quality care at extremely affordable prices - sometimes up to 70% cheaper than the equivalent work in the United States or Europe.⁶

While dental work can be paid for on a pay-as-you-go basis, this can get very expensive if major work is needed, or if visits to the dentist are required on a regular basis. It’s therefore recommended that foreign expats add dental cover to their international health insurance plans.

There are several emergency care numbers to call if help is required in Colombia. The national emergency number is 123, but for emergency medical assistance, you should call 125. In the event of a mental health-related emergency, then you should call 192. 

It can’t be guaranteed that the person on the other end of the line will speak English: Colombia is a Spanish-speaking country after all. In some circumstances, it may be worth contacting the tourist police on (1) 3374413, as they normally ensure their operators are English speakers.