Healthcare in Colombia is a Perfect Balance of High Quality, Easy Access, and Low Cost.
When the World Health Organization ranked the healthcare systems of 191 countries, Colombia came in at #22. That is better than Canada at #30 and the United States at #37. On top of this, when financial publication América Economía put together their latest annual list of Latin America’s top 58 hospitals, 23 of those hospitals were based in Colombia. That means that 40% of the top Latin American hospitals are located in Colombia.
Four of these hospitals are Joint Commission International accredited, the gold standard in world health. Two are located in Bogotá (Fundación Cardioinfantil – Instituto de Cardiología, and Hospital Universitario Fundacion Santa Fe de Bogotá), one is located in Medellín (Hospital Pablo Tobón Uribe), and one is located just outside of Bucaramanga (Fundación Cardiovascular de Colombia – Instituto del Corazón).
There are many, many excellent hospitals and clinics all around Colombia which offer services from routine office visits and testing to complex procedures such as joint replacements, organ transplants, ICU services, and cancer treatment.
Colombia has one public and many private health insurance plans.
Public Healthcare Plan
The public plan is called EPS (Entidades Promotoras de Salud) and it is administered by various companies such as SURA, Comfenalco, and Coomeva. To qualify for EPS, you must have a resident cédula (identity card). The premium cost for retirees is 12% of what you declare your pension income is to EPS. There is no maximum age limit to apply for EPS coverage.
Just follow the three-step process to apply for EPS public health coverage:
- Obtain a Visa
Work with a trusted legal advisor to help you apply for the type of visa that fits your circumstances. The most common visas are pensioners, real estate purchase, business owner, and business investment. The process to get a visa can average two to six weeks.
- Get your Cédula
Once you have your visa stamped in your passport, you must go to a Migración (immigration) office to register your visa and apply for your cédula. You will need to complete a form, pay a fee, have digital fingerprints, and a photo. The process usually takes two to three weeks for your card to be processed and ready for pick up in the immigration office.
- Apply for EPS Insurance
With your cédula in hand you can sign up with EPS. There are many intermediaries to choose from. SURA which ranks either first or second in quality every year is one of the most popular choices for expats. Once you are approved, coverage starts immediately. They do not issue cards, your cédula is all you need to present to the doctor´s office, hospital, lab, or other medical facility.
Many retired expats report paying $70 to $85 per couple per month for their premiums with EPS public insurance. This is the same regardless of which company you choose to administer your EPS. Colombia’s healthcare system operates in a similar fashion to a preferred provider organization (PPO). Insurers enter into contracts with specific hospitals and physicians. The insured must seek care within the approved network of providers.
By law, everyone in Colombia must have the same basic coverage, which covers medical, dental, and vision care. If you want additional services, you can purchase a private policy.
Private Healthcare Plan
Health insurance works like building blocks. The basic EPS policy serves as a foundation from which you can build. For example, if you want the freedom to choose your own doctor or specialist, you can obtain it by paying for a private policy. If you want a policy that will cover more than a basic set of eyeglass frames and lenses, you spruce up your coverage with a private plan. Private plans require you to have EPS as a base.
Maximum age for initial enrollment in most private health plans is 60. They are not required to accept you based on your medical history and pre-existing conditions. Your premiums will vary depending on which carrier you choose, the level of coverage you select and your medical history. It is best to choose the same company for your private plan as you have for your EPS.
Private plans will give you direct access to specialists without having to go through your primary care doctor as a gatekeeper. Other benefits include private hospital room stays, coverage for some non-covered EPS services and you will be exempt from EPS copays.
EMI, a private healthcare company, provides services in most large and medium-sized cities in Colombia. If you enroll in one of EMI’s supplemental healthcare plans, you can often avoid trips to the doctor or hospital because EMI has a team of doctors and nurses that make house calls, 24-hours per day, 365-days a year. Most expats with this service report paying $25 per month for coverage.
The EPS public health insurance has a three-tiered system for calculating co-payments for lab tests, imaging procedures, specialist visits, and medications. These rates change in January of each year. The 2019 tiers are $1, $4.25, and $11.15. Many of the retired expats fall into the second tier.
Even if you decide to pay-as-you-go, and not sign up for health insurance, your out-of-pocket costs will be quite low. A consultation with a specialist will cost about $50 and you will get an appointment within a couple of weeks, not months.
In Colombia pharmacists provide a greater service than simply filling a prescription. They are trained to listen to your symptoms and make recommendations. You don’t need a prescription for many medications—they can be bought over-the-counter for very low prices. An antibiotic cream costs about $1, and a 10-day supply of ciprofloxacin costs approximately $3.
Comparing Colombia to U.S. Healthcare
Colombian health insurers, hospitals, and clinics use an electronic medical record system. All of your information is tied to your cédula number. This allows clinicians to access information about medications, test results, and hospital stay discharge information anywhere in the same system. State-of-the-art equipment and technology are used in most larger hospitals. Well-trained clinical personnel use best practices protocols for treatment plans.
HIPPA (medical privacy) laws do not exist in Colombia. Doctors, nurses, and other clinical personnel can speak with other family members or friends without needing a signed document allowing release of information. Many prescriptions, laboratory tests, and referrals to specialists do not require a physician’s order. Not all brand-name medications are available in Colombia.
However, you can find generic brands for many of the diabetes, high blood pressure, and high cholesterol medications. While quite a few physicians have had some of their training in the U.S. and speak English, the office staff, nursing staff, and technicians most likely will only speak Spanish. Larger hospitals have an international relations department and can help with translation. Speaking Spanish will be extremely helpful as you navigate the health care system.
Dentists provide excellent care at a fraction of the U.S. cost. The larger cities have English-speaking dentists who offer services from a simple ultrasonic cleaning, cavity filling, or whitening, to more complex procedures such as root canals, crowns, implants, and orthodontics. Prices are one-quarter of what you would spend in the U.S. A routine ultrasonic cleaning costs about $30. A session of Zoom whitening costs $150 verses over $600 in the U.S.
Orthodontics is not just for kids. You will see many Colombian adults wearing braces. Throughout the country you can find English-speaking specialists who offer treatment using traditional metal braces, clear ceramic braces, and Invisalign. While prices will vary depending on the degree of difficulty of your dental case, an average course of Invisalign will run you about $3,000. It will cost you $6,000 to $8,000 for the exact same product in the U.S.
As part of the rise in medical tourism, people from the U.S. often combine their vacation to Colombia with dental procedures. After a couple of weeks investigating Colombia, they return home well-rested and with a bright smile.