20 Facts About Healthcare In Colombia Every Expat Must Know

Overview of the healthcare system in Colombia

Quality of healthcare in Colombia

The quality of healthcare in Colombia is, in a word, excellent. Ranked #22 by the World Health Organization, it is considered to be better than Canada (ranked #30) and the United States (ranked #37). Consider the following: if health care is a priority for you, especially if you are considering living in Colombia vs. other Latin American countries: a full 41% of Latin America's top hospitals are Colombian.

In fact, five hospitals in Colombia are internationally recognized for their world-class quality and are accredited with the Gold Seal of Approval from the Joint Commission International (JCI), which globally identifies and scores healthcare quality and patient safety in healthcare organizations.

Quality Colombian health care is widely available in all major cities and towns, though the quantity and quality of clinics and medical services decline in remote rural areas. Colombian hospitals offer services from routine office visits to complex inpatient care such as joint replacements, organ transplants, stem cell therapy, and cancer treatment.

On top of quality, health care in Colombia is relatively inexpensive, especially compared with the US. As a result of this combination of quality and cost, Colombia’s healthcare system is growing the country's reputation in medical tourism. In fact, many foreigners now come to Colombia for healthcare, with transplants, joint replacement, dental treatment, and fertility treatments topping the list.

More Guides On Living In Colombia

20 Things To Know About Healthcare In Colombia

1. Colombia's healthcare system quality is better than you think

Colombian healthcare is also considered to be the best in Central and South America. In fact, 26 of 61 of the region’s best hospitals are located in Colombia, according to the 2021 ranking in América Economía of the best Latin American hospitals. The Joint Commission International accreditation qualifies hospitals in Colombia's healthcare system as having some of the highest standards in the world.

By some metrics, Colombia is ranked higher in healthcare quality than the US. At 22nd, the World Health Organization ranks Colombia above the US (37th).

In other metrics, Colombia and the US are very close. Numbeo's recent 2022 Global Health care Index, which measures a country's healthcare system's waiting times, skill, modern equipment, and cost, ranked healthcare in Colombia at #38 and the United States at #33. Although the rankings are five spots apart, the US scored only 2% better.

However, keep in mind that the quality of hospitals and Colombian physicians drops considerably if you move outside of the major cities. This fact is important to consider if you have chronic medical issues or health concerns. In this case, you should strongly consider staying in Bogota, Medellin, or Cali for access to the best hospitals in Colombia.

2. Healthcare in Colombia is a 3 tier system.

There are 3 types of health insurance in Colombia. One layer is EPS (Entidades Promotoras de Salud), the country's primary public health insurance plan. The second type of health insurance is called "medicina prepagada.” This insurance is for wealthier Colombians and expats unsatisfied with the benefits of the public plan.

Colombians and foreigners may pay extra for “medicina prepagada," or private health insurance that works on top of EPS plans. Keep in mind that the cost of this insurance is extra and varies according to your age, the plan you choose, and any pre-existing conditions.

There’s a third form of insurance, called SISBEN, but it isn’t available to foreigners. This insurance is intended for extremely vulnerable lower-income groups, providing homeless or very poor Colombians with medical care for free or at subsidized rates.

3. Colombia has a universal healthcare system

Colombia's system offers universal health coverage that's affordable and easy to use. The Colombian government subsidizes access to health care for 96% of the population. Compare this coverage to American healthcare, which only covers 28% of adults with public health coverage.

4. Universal Healthcare in Colombia includes expats

Even expats are eligible for health insurance coverage through EPS. In fact, all temporary or permanent residents MUST enroll in the EPS healthcare system. For most expats, public health insurance in Colombia starts at $50 and ranges up to $200 per month, depending on monthly income.

To renew your visa in Colombia, you will be required to show that your purchase of EPS coverage extends long enough to cover your entire visa duration.

The public healthcare system will even treat you if you are a tourist with a medical emergency. Read that again: If you go to a public hospital and need urgent care, they will treat you. The cost isn't free, as you haven't paid into the public healthcare system, but healthcare in Colombia is very affordable. See section #12.

5. You need international health insurance to get a Colombian visa

As of October 2020, the Colombian Ministry of Foreign Affairs requires all expats applying for a visa to include proof of international health insurance. Depending on your age, citizenship, and required coverage, global health insurance costs roughly $75 to $300 per month USD.

• The level of coverage required depends on your Colombian visa type:
  • Visitor Visa (V): $35,000 USD
  • Migrant Visa (M): $60,000 USD
  • Resident Visa (R) : $100,000 USD

Here are two recommended international insurance companies. 

6. The rates you pay to access Colombia's public health systems are based solely on your income

The cost of the plans Colombian insurers provide you for EPS will be the same, and there is a mandatory list of services in place that every EPS plan must cover. This list is referred to as Plan Obligatorio de Salud (POS), or translated to Mandatory Health Plan. Remember that neither your age, gender, pre-existing conditions, or prior health history factor into your cost.

All employees, including self-employed, pensioners, freelancers, and local employees, contribute a percentage of their wages to the Sistema General de Seguridad Social en Salud [SGSSS]. The Colombian Ministry of Health uses the SGSSS to fund social services and provides health security to all citizens and legal residents.

Self-employed expats (such as freelancers or digital nomads) pay 5% of their net income for medical coverage.

The EPS premium for retirees is based on 12.5% of their declared social security or pension income.

If you are employed by a Colombian company, 4% of your monthly salary goes to a contributory health fund that grants you access Colombia's advanced healthcare system. Note unlike in the US, employees are not stuck with the company's choice of health provider.

See how much you would pay for Colombian health insurance using my EPS calculator.

7. Not all EPS providers provide the same level of healthcare service

EPS health insurers act as administrative intermediaries between doctors and patients, similar to the PPO health insurance model in the United States. While EPS health insurers have no control over your insurance rates or what is covered under the public plan, they do control the doctors and hospitals you can access, the quality of customer service, the speed with which they approve treatments, and the efficiency with which they pay your claims.

Although these benefits sound one way on paper, in reality they may be different. Some EPS insurers are in precarious financial positions and have been withholding payments to their health care providers to ease a cash crunch. For example, the SaludCoop EPS was even liquidated completely to pay off its debts.

What’s a safe choice? Most expats choose SuraAmerican, mostly just called Sura, as they are the financially healthiest EPS insurance company, consistently ranked as offering the best EPS service. SURA has more than 4,600 physicians in its network and more than 400 medical centers and hospitals, offering a wide range of specialists and locations to receive care.

8. Public health services include vision and dental benefits, including:

• Dental prophylaxis (cleaning).
• Endodontics (root canal treatment).
• Oral surgery (tooth extractions)
• Cavity filling
• Root canals
• Total dental prosthesis (complete set of teeth for the dental arch).
• X-rays

9. Public health services include insurance coverage for your spouse and children for free

Consider another possible surprise for expats: your spouse or permanent partner (i.e. same-sex marriage and civil unions are both legally recognized in Colombia) and your children (under 18) are covered by your public health insurance plan. If your children are dependents and are between 18 and 25 years old, they are also covered by your plan.

10. Healthcare coverage is harder for older expat retirees

Colombia is a retirement dream for many older expats, but you need to be prepared for how to handle your healthcare needs as you age. Private medical coverage, or “medicana prepagada”, starts charging older expats over the age of 60 an additional premium.

After 62 years old, most private health insurance will stop coverage. However, there are two exceptions to the age limit:

• Sura's Plan 60 plus provides coverage until you reach 79
• Coomeva’s Tarifa Dorada Plan is one private medical insurance company that will continue to provide coverage until you are 100 years old

Also, keep in mind that there is no maximum age limit for Colombia's public healthcare plans.

11. Colombia's private health insurance system is better for foreign expats

Additional coverage comes at a cost, but it is still laughably low compared to American expats accustomed to US health insurance prices. Plans to cover a 49-year-old male start at $145 per month. (Remember that prices for “medicina prepagada”, or private coverage, depend on your age, coverage level, results of a medical exam, and previous medical history.)

Beyond affordability, private insurance gets you preferential treatment in a private hospital with modern facilities. It means less waiting time for appointments, private rooms when you need to stay at a hospital for treatment, and access to superior health standards. Private facilities have bilingual doctors with excellent education, and many complete a part of their training abroad.

Private coverage allows you to skip the primary care doctor’s appointment if all you need is a referral, allowing you to avoid notoriously long waits to secure an appointment on public healthcare plans. Further, you can contact specialists or get diagnostic testing done directly by making an appointment online or picking up the phone.

All of these benefits are amplified if you choose to settle in particular areas of Colombia. In fact, it's common for larger hospitals in major cities (i.e. Bogota, Medellin, Cartagena) to have special departments with multilingual staff that deal specifically with foreigners.

There is little surprise that the US is Colombia's biggest medical tourist customer. This emerging reputation for quality has led to more and more 5-star health clinics popping up to specialize in serving the foreign market.

12. The Cost of Health Services In Colombia are very affordable

The Colombian Ministry of Health works to keep prices low for everyone. Colombians pay less out-of-pocket costs (14%) for healthcare than most countries. This number is achieved in part by a substantial investment of government expenditures on health care. Nearly 20% of Colombian government spending funds the basic health insurance system for its citizens (That’s nearly 8% of GDP).

Colombia has the lowest cost for prescription drugs in Latin America. As a rule of thumb, expect prices in Colombia to be roughly 1/3 the cost of the United States. More specifically, EPS co-pays are roughly $5 for most expats; expat's prepagada co-pays are roughly $10 for most private plans; and many medications can be bought over-the-counter for very low prices.

Example: the drug Lipitor (used in the treatment of lower levels of cholesterol and triglycerides in the blood) costs $43.45 in Colombia vs $641.40 at Walmart in the United States.

What about if you need health care at your home but are concerned about the cost? Not only do some healthcare plans in Colombia offer house-call service with a team of doctors and dentists that travel to your home for treatment, 24 hours per day, 365-days a year, but doctors provide this service for the same co-pay fee as a regular physician's visit.

13. Pharmacies in Colombia can be your first stop for minor health issues

Sometimes you don’t even need to see medical staff for minor health issues. Pharmacists in Colombia have additional training and knowledge to diagnose symptoms and provide basic medical advice. How? First, pharmacists in Colombia are required to have a college degree or equivalent experience. Pharmacy staff is required to complete continuing education related to health education and patient counseling within their regular activities to help obtain the best health outcomes for patients.

Consider this: A pharmacist can give you injections and vaccines. They’ll shoot you up in the backroom (see section 18 about cultural differences about shots). No trip to the doctor is needed.

Many prescription drugs are available over the counter without needing to see a doctor for a prescription first. You should know that some drugs have different names in different parts of the world. For instance, Tylenol is the brand name for acetaminophen in the US, but the same drug is called paracetamol nearly everywhere else in the world. Google your drug's name to get the translation in Spanish. An added bonus? Drugs are SUPER CHEAP in comparison to the US and Europe (see section 12 above)

Access is another huge benefit to pharmacies in Colombia. Most are open seven days a week. Too sick to move? Most pharmacies also deliver right to your home. Simply message or call the pharmacy, and they’ll arrive at your door. It’s like Uber Eats for prescription drugs. In sum, pharmacies can take care of your minor illness, quickly and easily. That means no long wait times or hard-to-schedule appointments.

14. The best-equipped hospital is in Cali

Given that Bogota is the capital city and Medellin is the retirement hotspot, it's surprising that Cali has the top-ranked Colombian healthcare facility, according to Global Health Intelligence. FUNDACIÓN VALLE DEL LILI- (Valle del Lili Foundation University Hospital) grabbed a Top 5 hospital ranking in 8 separate categories. Out of these 8 categories, the hospital has the #1 ranking in the following categories: Primary Diagnostics, Cancer Treatment, Advanced Diagnostic Imaging, and High-Risk Patients

15. What it's like getting medical treatment in Colombia

16. Yellow and dengue fever in Colombia

Waterborne diseases such as malaria and yellow fever are still a major public health concern in Colombia because of many factors, including its high epidemic potential, the fact that the population of Aedes aegypti mosquitoes is highly prevalent in Colombia, and there is not yet an effective treatment if you do catch it.

In fact, Colombia is the first place I have ever needed to show my Yellow vaccine card. If I didn't have my yellow card, I would not have been able to visit the gorgeous beaches in Tayrona National Park.

if you are traveling from Brazil or specific countries in Africa, the CDC recommends yellow fever vaccine shots for anyone traveling to Colombia, unless you only plan on visiting Bogotá, Barranquilla, Cali, Cartagena, or Medellín. The CDC only has a "Generally not recommended" warning for Americans staying in Colombia's major cities.

You can check the latest updates for Colombia on the CDC website.

17. Medical tourism and plastic surgery in Colombia

Culturally, Colombian women are taught to value their looks at a young age. In fact, especially among lower to middle-income classes, young women are pressured to use their looks as means of catching wealthy men and climbing the socioeconomic ladder to financial success. 

Cosmetic surgery is not only popular among Colombians – many foreigners also the affordable quality of results here. As a result, cosmetic surgery is a growing industry, with more and more people opting to have procedures done in Colombia. In fact, Cosmetic surgery represents the largest segment of the medical tourism market, with 60% of medical travelers seeking aesthetic surgeries or treatments.

More than 75,500 foreigners traveled to cities such as Bogotá, Cali, and Medellín in 2016 to undergo cosmetic procedures, accounting for 15 percent of the total number of surgeries carried out that year. Americans make up a large percentage of patients who undergo cosmetic procedures in Colombia: one study showed 66% of the visitors to a plastic surgery clinic in Cartagena were from the United States.

One reason for this dominance in the medical tourism market is that you can expect to pay less for cosmetic surgery than in other countries. Another reason is choice: There are a number of cosmetic surgery clinics throughout the country, making it easy for tourists to find one that suits their needs. Patients can be assured that they will receive world-class treatment no matter where they choose to go for plastic surgery. Finally, there are a number of affordable cosmetic surgery clinics throughout the country, which makes it easy for people on a budget to get quality treatment without breaking the bank. Consider this liposuction costs $4,000 to $8,000 in Miami, but can be done for as little as $800 at Colombian clinics.

It is no surprise that a survey by the International Society of Aesthetic Plastic Surgery (ISAPS) found that over 366,312 cosmetic operations took place in Colombia in 2020. Colombia ranks No. 3 globally in terms of number of plastic surgeries per capita in a 2020 study, and in 2015, Colombia ranked second, just after South Korea.

18. Cultural differences in Colombian healthcare

Because Colombia offers universal public healthcare, doctors are inclined to use more testing and diagnostic scans than in the US. Increased attentiveness to detection allows for a more efficient diagnosis of the root cause of medical conditions. Tests and medicines are more likely to be recommended multiple times than in other countries, due to the attentiveness of doctors toward patients' diagnoses.

This feature of Colombian healthcare is particularly noteworthy as unnecessary examinations, multiple tests, and longer treatments using strong prescription drugs all result in higher medical bills.

There are other cultural differences in Colombian health care. For one, shots are given in the bum. Outside of Colombia, to my best recollection, every vaccine or shot I have ever received was given in my shoulder. But for reasons unknown to me, Colombian doctors go for the booty. Maybe it is because of plastic surgery butt lifts Colombians get — and doctors just want a peek.

19. All public healthcare in Colombia starts with your IPS

Your IPS (“Prestadoras de Servicios de Salud”, or “health center” in English) is assigned to you by your EPS based on your address.

Your IPS is your primary medical provider and where general practitioners provide most of the initial medical treatments such as:

• General medical consultation
• Clinical laboratory tests
• X-rays and Ultrasound
• Some minor surgical procedures.
• Urgent care
• Dentistry
• Additionally, your ISP is where you must initially go for a referral if you want access to specialists.

20. The healthcare system in Colombia is in a bit of flux

In the last 40 years, healthcare in Colombia has gone through a period of tremendous growth and improvement. In 1991, the healthcare system reformation resulted in a change to the national constitution guaranteeing—among other things—that health is a basic right of all Colombians (see Law 100). Since then, the percentage of the country's population with health care soared: from 25% in 1992 to 85% by 2008, and now in 2022 to an enviable 96% universal coverage.

Further, healthcare in Colombia has made significant regulatory progress, which has improved service quality and response times to world-class standards. In fact, Colombia is now a top medical tourist destination, and it consistently ranks as a leader in healthcare quality in Latin America.

Not everything about the healthcare system is improving, however. Due to a number of factors, including the rising cost of delivering health care; widespread insurance fraud; the poor financial health of EPS insurance companies; mismanagement of public hospitals; and allegations of potential bribery of government officials, the system has taken a hit in recent years.

Like many countries, Colombia's healthcare system was slammed during the pandemic. However, Colombia experienced a triple whammy causing it to be stretched thin even now. In addition to the pandemic, Colombia faces the systemic challenges referenced in the above paragraph and the country has seen an influx of refugees fleeing Venezuela over the last several years.

In fact, Colombia was one of the only countries offering safe haven to refugees fleeing the economic collapse of Venezuela. (As it relates to immigration more broadly, Colombia provides visas, access to education, housing, and healthcare programs to an estimated 5.5 million refugees)

These factors have contributed to public hospitals and insurance companies going bankrupt in recent years, and recent reports suggest that Colombia's healthcare system has been operating at a loss of 11 million COP  (roughly $2.4 million USD) over the last two years.

While wealthier Colombians living in major cities with top-ranked hospitals (and often owning supplemental private insurance), still enjoy quality healthcare, the public healthcare system provides insufficient access to high-quality healthcare for rural, poor or indigenous Colombians.

The inequalities in health care quality can be extreme. While 96% of the population is covered by the country's public health plan, estimates suggest an additional 2.3 to 2.7 million Colombians are currently without access to healthcare. The quality of health care itself also varies widely depending on geography and demographics.

Rural healthcare quality

• Rural healthcare in Colombia is not always up to par with that found in more developed countries
• As a result, expats living in the countryside can expect to have worse experiences with both medical professionals and hospitals outside of major cities

Poor with the inability to pay

• 40% of Colombians fall below the poverty level, defined by the government as living on less than $3 per day.
• Lack of money is the #1 reason given by 14% of Colombians as to why they are uninsured, even with subsidized healthcare.

Lack of support for Indigenous people

• One study showed that a group of indigenous people suffered a childhood mortality rate 6 times the national average.

The problem of inequality in healthcare is so big that it factored into a recent presidential election, with the dissatisfaction of the underrepresented helping to fuel the election of the current left-wing president Gustavo Petro.