Healthcare services in Colombia have been gaining a lot of popularity in the past few years due to factors like affordability and the availability of high quality facilities.
The right to healthcare for all citizens (and foreign residents) was incorporated into the Colombian Constitution, which was drafted in 1991 and implemented in 1993. This led to many improvements in the healthcare system in Colombia.
One of the main highlights of the health care system in Colombia is that it enables everyone to have access to healthcare services in the country. The country has always prioritized its goal of achieving universal health care coverage.
Readers might be surprised to find out that, according to the World Health Organization, Colombia has a top tier health care system. Currently ranked #22 out of 191 different countries, Colombia’s health care system is first in Latin America, and ahead of Sweden (#23), Germany (#25), Canada (#30), and the United States (#37). Colombia’s neighbors to the south, Ecuador and Peru, rank #111 and #129 respectively. So Colombians have a lot to be proud of in this area.
Tourists are taking note, as medical tourism is booming in the country. Many international patients have been coming to Colombia to take advantage of high-quality healthcare and cutting edge facilities at low costs. There are a couple of excellent hospitals right near the international airport in Rio Negro, and it is not uncommon for patients to come in for a procedure, stay near the airport to recover, and then return home, without ever entering the city. Given that major surgeries can be as much as 80% cheaper than the United States, it is no surprise that some make the trip. Let’s look at how the health care system is set up in Colombia.
Types of health insurance in Colombia
Most Colombians and expats have coverage that falls into one of three areas: SISBEN, EPS, and Medicina Prepagada. We’ll examine each.
SISBEN
SISBEN (Sistema de Identificación de Potenciales Beneficiarios de Programas Sociales) is the subsidized program meant for underprivileged citizens. The government covers all health care costs for people chosen for this program. Most of these subsidies go to residents of estrata 1 or estrata 2 housing. (All residential neighborhoods are classified between 1 and 6, with 6 being the wealthiest). While the notion of extending free access to healthcare for Colombia’s most needy citizens seems altruistic and moral, the fraudulent delivery of these SISBEN ID Cards is a serious problem within the Colombian health care system. Corrupt politicians have been accused of administering them to people who do not need them, in exchange for votes. SISBEN ID Cards provide cardholders with benefits beyond simply healthcare, such as childcare and subsidized housing. Because it can be so beneficial, many seek to join the SISBEN system, even those who don’t need it. To enroll, Colombians need to take an online poll and see how they score – and only those with the lowest socio-economic scores are supposed to receive the cards. Some things I found interesting while learning about SISBEN:
- They have a special word (colados) for people who try to do really bad on the poll on purpose, in an effort to receive the benefits.
- According to the most recent government data, there are more than 35 million personas registradas in the database. There are only 48 million in the whole country! The majority of people that you see out and about are in there, whether added personally or by their parents. Just a fraction are actually approved for the program.
EPS
EPS (Entidadas Promotoras de Salud) are the insurers that provide public health insurance to the rest of the residents of the country. EPS’s are associated with different public healthcare providers that offer their services to the insured. An EPS plan is compulsory for all Colombians, who are not covered under SISBEN.
EPS plans are offered by many insurance companies, such as Suramericana (SURA), Nueva, Coomeva. The cost of the EPS plan is 12.5% of one’s gross monthly salary. The EPS plans offer coverage to family members and dependents of the insured.
EPS plans are also available to foreigners in Colombia. To become eligible for an EPS plan, you need a cédula (local ID). With an EPS plan, you are assigned a local health center as your primary care facility (called a Instituto Prestador de Salud), although your primary care physician can change. I have always used EPS Sura and found them to be great to deal with. The co-pay for a doctor’s visit is surprisingly low, usually around 9,000 COP ($3 USD). You must see a GP first, before being referred to a specialist. Over the years, I have been a little bit frustrated with some perceived inefficiencies in the health care system here in Medellín, however, generally the care has been quite good and it has undoubtedly been inexpensive.
MEDICINA PREPAGADA
Translated as “prepaid medicine”, this is private health insurance that offers more benefits than the basic EPS plan. The premium for Prepagada plans depends upon different factors like the type of plan, age, and any pre-existing medical conditions. These types of plans are often purchased in addition to an EPS plan, as a form of supplementary coverage.
You only need to provide your passport or cédula to obtain a Prepagada plan. People over the age of 60 are not eligible for a Medicina Prepagada plan; they are restricted to the EPS plan options.
Some foreigners might be drawn to this supplementary coverage because, generally, there is no need to get a referral to see specialists, you are usually attended to in a timely fashion, and the best doctors in the country are said to work with patients in these types of plans.
Companies like Coomeva, Suguros Falabella, and Suramericana offer Prepagada plans.
The Nation’s Best Hospitals
According to América Economia, Colombia is home to 23 of the best 58 hospitals in Latin America. The top five hospitals in the country have been ranked as follows:
(1) Fundación Valle del Lili: Fundación Valle del Lili hospital, located in Cali, has the distinction of being the top-ranked hospital in Colombia, and the third best in Latin America. Since its inception in 1982, the Fundación Valle del Lili hospital has been able to position itself as a prominent institution in the health care industry in Colombia.
(2) Fundación Cardioinfantil: Fundación Cardioinfantil is a private hospital located in Bogotá. This hospital is regarded as a leading center for cardiovascular care. Fundación Cardioinfantil hospital has also received the JCI (Joint Commission International) certification, a prominent recognition of quality and safety in health care industry. The hospital offers health care services in over 53 specialties.
(3) Hospital Pablo Tobón Uribe: Hospital Pablo Tobón Uribe is located in the Robledo neighborhood of Medellín. It is the top ranked hospital in the city. It is a university hospital and has received the JCI accreditation. Hospital Pablo Tobón Uribe is a Catholic hospital and was established in 1970.
4) Hospital Universitario de San Vicente Fundación: Hospital Universitario de San Vicente Fundación is the oldest hospital in Medellín. This renowned hospital is located in the Seville neighborhood of Medellín. It is particularly known for its expertise in advanced transplant procedures. The hospital opened a new facility in the Rio Negro municipality in 2011. It is located very close to the airport, making it convenient for international patients to seek medical care in the city.
5) Fundación Cardiovascular de Colombia: Fundación Cardiovascular de Colombia is located in Bucaramanga. It is a private hospital and is JCI accredited. The hospital offers services in a wide range of specialties, including Cardiovascular Surgery, Transplants, Ophthalmology, Nephrology, and Neurosciences among others. Fundación Cardiovascular de Colombia is also known for its extensive investment in various research and development programs.
Hopefully, this article gave you a general idea about how the health care system operates in Colombia. While many foreign visitors will be covered by their international travel insurance or through credit cards, those wishing to stay in the city longer-term will eventually need to join one of these plans and become part of the local system. Fortunately, you’ll be joining a national health care system that is considered the best in Latin America and among the best in the world.
What’s your experience been like with health care in Medellin?
Tell us about it in the comments and feel free to Contact Us with any questions you have.
