Healthcare System in Colombia: everything you need to know

How does the Colombian healthcare system work?

In Colombia, the General System of Social Security in Health is made up of three main institutions: the state, through the Ministry of Health and Social Protection, which is the body in charge of coordinating, directing and controlling the public sector. Secondly, insurers, mainly Health Promoting Entities (Entidades Promotoras de Salud, or EPS), and providers, Health Providing Institutions (Instituciones Prestadores de Salud) that are responsible for providing medical care to affiliated users.

The system is divided into two forms of affiliation: the contributory and subsidized programs.  

The subsidized mode of affiliation is designed for people in conditions of poverty or vulnerability, classified in strata I and II within the Identification System for Potential Beneficiaries of Social Programs (SISBEN), together with the abandoned child population, indigenous communities, people of third age, migratory rural populations, among others. These groups have access to emergency care, general or specialized medical consultation, dental consultation, as well as supply of medicines and hospitalization. 

The contributory mode affiliates people with capacity to pay by means of a contract. By meeting the affiliation requirements, the benefits are that, both the paying affiliate and their family have access to the services provided by the Health Benefits Plan. These include: health promotion, prevention of illness and recovery. Coverage includes everything from preventive care to complex treatments. 

There are also prepaid medical plans which are voluntary and an addition to Health Promoting Entities (EPS). They offer a larger service network which optimizes waiting times to access health services.  Apart from this, it grants access to specialists, new and better technology and covers high cost diseases, among other benefits. One must be affiliated to a Health Promoting Entity (EPS) and prove that they are able to pay the monthly cost in order to have access to prepaid medical plans.

Finally, complementary health insurance, or “polizas” offer more extensive coverage than prepaid medical plans. They include international coverage, high cost procedures and reimbursement in case of receiving attention outside of a set network. 

How does the system work for foreigners?

If you are traveling to Colombia for tourism, local authorities recommend that you have travel or other form of insurance to cover any health problems you may have during your stay.

However, if you do not have health insurance and do not have the ability to pay, the law requires emergency services to provide care to any one who is in need of it.

EPS are only available to Colombian residents and citizens. If you are going to live in Colombia permanently, the government requires you to be affiliated to a health insurance company. In order to enroll in an EPS, you must have an identity document, which can be:

• Local ID car (Cedula)
• Diplomatic card
• Special permanence permit
• Permit to stay in the country
• UN Passport for refugees or asylum seekers
• Passport for children under 7 years old

If you are eligible to for an EPS, you must opt for the contributory or subsidized regime depending on the factors explained above.

Learn more about health insurance plans for Colombia

Wether you have a travel insurance or an international medical insurance to travel to Colombia, it will cover any medical expenses that you may have during your trip. 

At InternationalHealth.com you can compare and quote the best travel and international medical insurance for your next adventure.

Which are the main clinics, hospitals and medical centers in Colombia?

According to Newsweek, which is in charge of ranking the best hospitals in the world, the best ranked Colombian medical institutions are:

Fundacion Valle del Lili (Cali)
Santa Fe Foundation (Bogota) 
Pablo Tobon Uribe Hospital (Medellin) 
San Vicente de Paul Hospital Foundation (Medellin) 
Hospital Universitario San Ignacio (Bogotá)

In the following link, you can find a variety of clinics and hospitals throughout the country. 

How do I schedule a doctors appointment in Colombia? 

First, you must identify which EPS you are affiliated to. If you do not know which EPS you belong to, in the following link, enter your information to find out.

Once you have identified your EPS, you must go to their website or call their customer service number and schedule your medical appointment.

However, if you have a prepaid medical plan, through your provider you can schedule a medical appointment indicating your location, what specialty you need and in which clinic. Remember to check the services offered by your prepaid medicine provider since some of them have phone applications where you can schedule a medical appointment in an efficient way.

What to do if I have a medical emergency in Colombia?

The national emergency line in Colombia is 123. By calling this number you can access all emergency and security services offered by the State free of charge 24 hours a day.

This service has the responsibility of providing emergency assistance to any person who requires it regardless of whether or not they have health insurance, EPS, prepaid medicine or health policy.

Other emergency telephone numbers are:

• National Police #112
• Fire Department #119
• Traffic Police #127
• Anti-kidnapping unit #165

How do drugstores/pharmacies work in Colombia?

There are a variety of medicines in Colombia that you can purchase over-the-counter. Check which ones they are in the following link.

Any other medication that requires previous evaluation from a doctor can only be purchased with a prescription directly from a pharmacy/drugstore.

Requirements to enter Colombia

Any person wishing to enter Colombian territory must be fully vaccinated against Covid-19. At the point of entry, you must show proof of vaccination.

Prior to entry you must also fill out the Check Mig form to report your health status 24 hours before your flight.