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Best health insurance?

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Kaizer
  1/14/2017 11:57 EST

Hello! I've recently moved to Colombia to teach English as a second language in Cartagena.

Can anyone provide some insight on what the best health insurance provider would be? Are expats eligible for the federal health insurance program once you get your cedula? Or is it good to have the federal program (taxed from pay) + top up with a private provider (through monthly premiums)?

Any help/advice is appreciated!

livinginmedellin
  1/14/2017 14:10 EST

Sura is the best medical insurance provider in Colombia. With a cedula you can get insurance from them. I have met many expats with Sura medical insurance.

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canpandave
  1/14/2017 14:16 EST

I can second that, I have Sura and use the Los Molinos IPS. Doctors appointments always on time, clean facility, knowledgable Doctors, all of the check in systems for Doctors visits and medical tests work very well, I needed a referral to see a specialist, my primary care doctor was able to get me an appointment in 3 days. I can get my prescription refill orders, make appointments on line for Doctors, Dentist and Optical care all on line. I have a CE cedula from having an RE visa.

fredah
  1/14/2017 14:23 EST

Great advice. Pardon my ignorance but what is a CE cedula and an RE visa?

Kaizer
  1/14/2017 14:38 EST

Thank you!

canpandave
  1/14/2017 14:55 EST

Cedula extranjeria

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livinginmedellin
  1/14/2017 14:56 EST

CE is a cédula de extranjería (foreigner cedula), which is a local ID you receive once you have a visa. Once you have a cedula it is easy to get medical insurance and open bank accounts.

A RE visa is a resident visa.

A Colombia RE visa is good for a period of five years and must be renewed every five years. RE visas do not expire unless you are out of Colombia for more than two years.

The common options for obtaining a RE visa include:

- Having a temporary (TP) visa for a certain time – after holding most TP visas for an uninterrupted minimum time of five continuous years or for a TP-10 visa (Spouse visa) for a minimum of three years.
- Qualified resident – this is available immediately for parents of Colombian children.
- Resident investor – This option requires that you make an investment in Colombia of more than 650 times the minimum wage in Colombia

fredah
  1/14/2017 15:10 EST

Thanks for the info. I will be getting the TP-10 visa and cedula when we go to Bogota late this year. It is just not cost effective to go from Phoenix to the Los Angeles consulate for them.

8901
  1/15/2017 01:42 EST

@livinginmedellin

I am planning on retiring in a 4 years and spending about 6 months in Colombia due to the tax laws.

#1. I am assuming the CE cedula is the easiest of the ceduls to obtain is that correct ?

#2. So that I can have a cedula to open a bank account etc. should I apply for a visa now so that in 4 years I will be able to then qualify for the cedula ?

livinginmedellin
  1/15/2017 13:02 EST

A cédula de extranjería you get immediately after any visa and it's easy to get.

In fact it's required to register your visa or you risk a big fine. Once you get a Colombian visa you are required to register it with Migracion Colombia - which is also integrated with the process to get a cédula de extranjería from Migracion.

8901
  1/15/2017 17:25 EST

Of all visas that will cover you for a 6 month stay in country which is the quickest, cheapest and easiest of all and how long after applying does it take ?

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caribe
  1/15/2017 18:09 EST

I was told like everybody that a cedula is needed, no need to wait.

to speed things up I hired an insurance broker a best friend of the daughter my wife best friend.

She showed me form a document that various ideas like driving license, passport are accepted.

When I tried to ask sura an authorisation to see a doctor for the first time several months late, They asked for my cedula. I was told the number was no good. The right number was the one on my passport.

It's very sad that the people are not told to hire an insurance broker

My 2 cens is that insurance company simply will not insure directly without a cedula for various reasons.

Here is her phone number

Carolina Arbeláez Gaviria
All Protection Asesores en Seguros
[email protected]
Teléfono: 5790606
Celular: 3117796546

cccmedia
  1/15/2017 20:31 EST

“Hire an insurance broker”....

What does that mean?

What is a broker in this case?

What does “hire” one mean?

cccmedia

SunsetSteve
  1/15/2017 21:11 EST

Difficult to follow the thread of thought there.

Andresen
  1/15/2017 21:28 EST

I spoke no Spanish when I arrived here in Medellin 4 years ago. First I understand I was turned down for insurance because I'm not employed here. Finally my gf took me to someone who is probably a broker who got me insurance. I had all my medical documents with me and they copied everything. I'm in good health but have an enlarged prostate. I believe I pay a little more than most others for my insurance. This year it's 118,000 pesos a month.

psyberpete
  1/16/2017 21:01 EST

Hi and thanks for the information.

One question though -- how exactly does such health insurance work? I ask because my (native) family members keep poo pooing health insurance every time I ask about it stating that it doesn't matter whether you have something like SURA, there are long lines and everything takes forever...

Of course this may be related to my having paid cash for a private surgical clinic on one emergency occasion for a family member.

I'm just wondering if they're accurate, jaded, or both. I have my BCBS in the US and could always go back for a serious illness, but it just seems like not buying health insurance here would be a pretty stupid thing to do.

Currently I spend between 120-150 days per year in the Medellin area.

NuevoACol
  1/16/2017 22:10 EST

Hello everyone ----
Let me just butt in here just to say that I am - like many I am sure - very interested in this subject as well: I don' t know why, or perhaps I've missed it, but I have not seen anything about COST?

I have my Medicare in the U.S. but I also would like to get something there on my next six month trip to Medellin.

-=- Can you guys please give us some idea, a range of cost points, just so I can make some planning in advance?

Thanks to everyone for the great info I got this weekend on several posts... tons of useful info.

Eddie.

Andresen
  1/16/2017 22:13 EST

Everyone's going to tell you that 6 months isn't going to cut it. You need to mention that you have Colombian citizenship in addition to US.

canpandave
  1/16/2017 22:40 EST

I pay $197,000 per month

Copay for appointments and prescriptions $2900

canpandave
  1/16/2017 22:40 EST

I pay $197,000 per month

Copay for appointments and prescriptions $2900

cccmedia
  1/16/2017 23:13 EST

Pete, if you’re in Medellín only 120 days (plus) per year, you may be a candidate for travel insurance instead of a year-round COL policy.

Travel insurance does not require having a cédula. Perhaps you are wisely avoiding exceeding 183 days a year in Colombia so as not to become a tax-resident .. and not going through the visa/cédula process.

cccmedia in La Zona Cafetera

edgardiser
  1/16/2017 23:18 EST

I'm in Bogota and have Compensar, the Doctor's and Services are equal to or better than I had in California
For My Wife, Daughter and I
Copays $1 to $4 USD Monthly $104 USD depending on the currency exchange.

NuevoACol
  1/16/2017 23:53 EST

Andresen, where are you coming from? :-)

It's Eddie!!!... and you know everything about me... but the thing is, I am just talking about RATES/COST... Do you know anything about that?... I heard they mentioned SURA which I never heard of it. And I will have to get some helath insurance etc etc.

Eddie

Andresen
  1/17/2017 09:26 EST

Eddie. I know it's you. I know you have Colombian citizenship but others don't know. When you start mentioning 6 months here everyone will assume you're on a visitors visa and that could invite long off the track discussions. I'm just trying to help direct the conversation for you. Terry.

psyberpete
  1/17/2017 12:19 EST

Actually the issue is I'm not old enough to retire yet. I own a business in the US that needs my attention so my trips tend to be between 2 weeks and a month at a time.

I have a spousal visa and Cedula and we own a home in Envigado though and I just want to have all our ducks in a row so to speak.

NuevoACol
  1/17/2017 16:30 EST

OOOhhhh I see :-), cause I could not believe you did not know me!... But I see your point. --------- Ok, for my benefit as well as others: I am 69, Citizen of US & Colombia, in good health (main problems: knee arthritis (some pain) and Diabetes 2, controlled with medicines. I say this simply so that others can compare. I have Medicare in the US, but also need something here. ------- I heard already that SURA health insurance is considered good by several people here, therefore, I would like to get insurance with them If I could as I were going to live here the 12 months of year, same AS YOU señor Andresen. -----------

Now, the question is HOW MUCH / month. I would love to hear this from several of you expats to get a good idea on the subject.

QUESTIONS: I Imagine you get a general examination by one of the doctors at SURA?.... Or, would they request a report from your primary doctor here in USA? (I doubt it). I just want some details…..

TIA

-Eddie

Andresen
  1/17/2017 16:38 EST

Want to talk about my experience? I could call you, although you probably already know everything if you're reading my blog.

NuevoACol
  1/17/2017 16:45 EST

Nooo... The whole idea is to SHARE the information with others. -------- I would love to hear your experience(s) and the experience of OTHERS AS WELL....

-Eddie.

happytraveler
  1/17/2017 16:49 EST

Do most of you expats (over 65 years of age) living full time in Colombia, with Colombian health insurance, also keep their Medicare ins. in the US? I ask because I am concerned that if I decide to return to the US to live, I will have to pay a penalty of 10% extra per year if I do not continue to pay my Medicare premiums ( a very unfair penalty for someone who has payed into the system for years ).

Jimbeam7
  1/17/2017 16:51 EST

@ Nuevo

69 with diaberes it's unlikely you'll be able to purchase insurane at any price. I recently went though this at 60 and just squeeked by. They give extensive health exams that you must pass by I doubt that they would even let you take the exam. 65 yrs seems to be the cut off If you don't have your insurance in place by then you can't get it.

Andresen
  1/17/2017 17:23 EST

Retired here 4 years ago. Cancelling my $100 a month Medicare is the first thing I did. Btw, I thought to buy back into the system you had to pay all the missed payments but I could be wrong.

Andresen
  1/17/2017 18:41 EST

I got insurance at the age of 67 but i had lots of medical records i brought from the states and they copied everything. My only health issue was an enlarged prostate.

NuevoACol
  1/17/2017 18:43 EST

Hi Dave,

Can you give details about the company? ---- When did you purchase the plan? In what city? In person or on-line? - Did someone examined you as a condition to be accepted?--- You said you pay 197,000 COP/month (~ $66.00 USD).--- You said you pay "$2900" for appointments and copayments. I AM CONFUSED HERE. Did you mean $29,000 COP? (~$30.00 USD). ---- Surely it could NOT be less that ONE dollar????? $2900/3000??>


TIA
-Eddie

NuevoACol
  1/17/2017 18:49 EST

happytraveler

Well, that is my situation too. I tried finding out online, but you need to be a lawyer to understand it! -- But I am under the impression that you just don't dump it and go back into whenever you want to. I tried finding out the details online... forget it!...... Part A, Part B, Part D,.... and so on.... --------------- Anyway, I am keeping mine until I understand my options clearly.

NuevoACol
  1/17/2017 18:59 EST

Andresen,

But in your case, it seems you never had a physical examination in order to be accepted?... How do Colombia health cos, know the accuracy of your health records?
---------------- Or, were you able to get a "special" deal (wink wink?). ------------ I know enough about Colombia to know there is always a "way".... althought this is pure speculation on my part... :-)

-Eddie

NuevoACol
  1/17/2017 19:04 EST

Jimbeam7

Jim what you are saying is horrible! :-) But I am afraid you maybe correct (Besides you said you went through it... so you KNOW)-------------. Let's just remember the way it was here in the US, prior to ObamaCare.... ------------ The older you got and specially with a medical condition..... no body would take you!... I still remember.

I wonder if others share your experiences?...

-Eddie

Andresen
  1/17/2017 19:13 EST

I don't recall having to get a physical. I also checked my blog notes and i don't see that I had one.

Kee
  1/17/2017 21:21 EST

I had to take a physical for ColSanitas, the prepagada that I signed up with. They will not cover pre-existing conditions, but the E.P.S will (I have E.P.S. Sanitas).

That's in Armenia. Which company is best depends a lot upon where you live. And some prepagadas will not take you over a certain age. I signed up when I was 63.

fecherklyn
  1/18/2017 07:04 EST

@Kee

I have the same deal that you have for my entire family and it provides the best medical coverage you can find in Colombia IN MY OPINION, with SURA as the only decent competitor.

My family includes me (74 years) and Mother in law (83). and I find our medical costs to be very expensive.

The COMPULSORY medical coverage (EPS) cost COP 86,200 per month in 2016. Up until 2016, this cotisation covered me AND my wife, but they have now imposed a seperate subscription from my wife because they deem she has sufficient income to pay for herself. Thus, I presently pay 3 x COP 86,200 for me, my wife and her mother.

To supplement the basic EPS policy we have also taken the Colsanitas Prepago medical coverage. This is very complete (save for pre-existing conditions) but very expensive, especially for the elderly. The new 2017 contributions amount to COP approx COP 1, 900,000 per month, so not too many people can afford that.

To spice matters up, I have just been informed that we may have to pay more for our EPS contributions because the new Decreto 780 de 2016 may require us to pay a "premium BASED upon the levels of my income (as stated in my Colombian tax declarations). In other words, whereas up to now EPS medical coverage cost the same to everybody, from now on it may be linked to your level of incomes.

Affair to be followed carefully. Colombia's reputation as a cheap place to take your retirement is becoming more tarnished by the day!

cccmedia
  1/18/2017 07:31 EST

Your post contains valuable information, Fecher, but let’s not get ahead of ourselves.

The sky is not falling until it does fall.

Let us know how much this so-called premium will be .. when you have the information.

Do you have the option of reducing your expensive supplement premium by increasing the deductible?

cccmedia

Kee
  1/18/2017 08:00 EST

Fech, ColSanitas is expensive by Colombian standards, more expensive the older you start coverage. That's good to point out. I don't remember our exact cost but it's around $400 U.S. dollars a month for the two of us. But still that's about 25% of what we paid in the U.S.

Interestingly, I signed up a month or so before my 64 birthday and was told that if I had waited until after that birthday my cost would have been significantly higher the rest of my life.

A lot of people seem to be happy with just their E.P.S. coverage and nothing additional. I've used it for a CT scan and a combination stress test/echocardiogram which were almost free (like a $1 U.S. co-pay). But from what I understand services can vary a lot depending upon location, which E.P.S., etc.

The best news about coverage in Colombia is that you don't have to worry about getting surprise bills in the mail.

fecherklyn
  1/18/2017 08:26 EST

@cccmedia

I imagine your reference the sky staying in place was spurred by my assertion that Colombia is getting costly? If so, let me assure you it is FACT the Colombian cost of living is increasing rapidly relative to most of the other countries we are probably interested in....the USA, Europe. On this subject, I am a bit of freak because I like the numbers' game and collect statistics like others collect stamps. If you would like some figures to show how our cost of living has changed in Colombia, let me know and I will provide some examples.

The "Medicina Prepago" does not operate like a typical insurance policy as there are no "deductibles" other than the pre-existing conditions that are relegated to be treated under the compulsory EPS schemes.

edgardiser
  1/18/2017 09:52 EST

With the upcoming 19% IVA "TAX" on most everything yes Colombia is getting more costly.

awalles
  1/18/2017 16:48 EST

My medicare is automatically taken from my gross amount of Social Security. They take out about $100 per month. When I lived in Ecuador they still took it out but I couldn't use medicare outside the US.

cccmedia
  1/18/2017 18:09 EST

That’s correct, Fecher, in my “sky” analogy, I was referring to Colombia’s supposed cost of living.

This is an eye-of-the-beholder scenario IMO.

On the other side of the issue... for most Expats (USA) the currency exchange has been working in their favor here.

Since early 2016, the exchange rate has been hovering around 3,000 COP to the U.S. dollar. That’s a lot more Expat buying power than in previous years when the rate was closer to 1,800 to the dollar.

Yes, the tax on some things has just gone up to 19 percent. It was at 16 percent already.

For many Expats, rent and health services are the biggest expenses. These are still extremely reasonable compared to USA pricing of such services, although it’s becoming apparent that over-65 ‘tax-residents’ may face a growing challenge.

cccmedia in La Zona

T

cccmedia
  1/18/2017 18:16 EST

Uncle Sam took out $100 a month from Awalles’ SSA benefits when he lived in Ecuador.

For the vast majority of USA Expats in South America, this situation is avoidable by opting out of Medicare Part B. Part A is typically no-extra-charge.

Of course, if you opt out and later opt back in, the system penalizes you.

So anyone considering opting out has to do the math in advance .. based in part on one’s expectations for how long they’ll likely remain outside the U.S.

cccmedia in La Zona

fecherklyn
  1/18/2017 20:42 EST

@cccmedia,

Your "eye of the beholder" observation is a neat and very true assessment about expat costs in Colombia. The result very much depends on how the expat chooses to spend what money he has.

I and my family are elderly and we CHOOSE NOT to live as cheaply as we could because we are expatriated here to IMPROVE on the way of retirement life we would have elsewhere. Hence, we do NOT live like most locals as we choose to follow many habits we value from our lives elsewhere, like: undertaking regular preventive maintenance on our assets (house, car, etc), taking good quality insurance on all our assets, having a medical coverage whereby we are protected from the less desirable experiences you may have with the simple EPS coverages. All these types of costs are too high for most people in Colombia and they certainly do NOT track the official inflation statistics.

All this does not mean we feel "superior" to the average Colombian, only that we are here because it has certain advantages to elsewhere and our higher than average expenditures are a boon to the Colombian finances. Unfortunately, this "advantage" I once had is slowly disappearing. Your exchange rate gain (over a very specific period) may be true for USA expats with US$ source incomes, but it can be very different for other nationalities and different time periods.

cccmedia
  1/18/2017 21:06 EST

Once an Expat obtains a COL cédula.....

True or Not True.... The Expat is required to enroll in mandatory EPS healthcare.

True or Not True... The Expat now has all the ID necessary to obtain EPS coverage.

Andresen
  1/18/2017 21:16 EST

Ooh, I love true false tests. Not true. True. Final answer.

edgardiser
  1/18/2017 22:22 EST

Medicare took the $100 per month because you signed up for Part B
If only Part A $0

caribe
  1/28/2017 12:31 EST

We all hear that we need the cedula to get health insurance in Colombia. Every health insuance company says that when we contact them.

We also hear that it's very difficult to get insure if over 60.

I was denied insurace when I bouught a new motorcycle 3 years because I didn't have a cedula.

When I moved to Colombia 2 years ago I was 2 months short to reach 60.

A very good connection of my wife was an insurance broker. I had him explain in detail the coverage of each company.

I opted for alianz, much more expensive than Sura, but it offers out of country coverage up to 4 months a year.

The broker filled all the paper, when it was time to sign I asked don't we have to wait for the cedula to apply?

The answer was no, She showed me from the papers of the seguro that a passport was a valid idea to buy health insurance in colombia.

fecherklyn
  1/28/2017 12:59 EST

I have some "latest" information regarding the cost of COMPULSORY health coverage in Colombia and I have opened up a new thread, "EPS, are you sure you have the correct affiliation".

Be careful, there are changes afoot and they may concern you.

jaym
  1/28/2017 17:16 EST

I would not advise anyone to drop their Medicare coverage. One never knows when they will have to return to the US someday, and the way things are going in Washington, it is much better to be already in the system. The option to rejoin may not be there in the future.

Has anyone in Colombia had any experience using American insurance like BC/BS? My policy includes international coverage, with doctors and hospitals listed in the major cities who participate in the program. I have been told that you would pay upfront and then be reimbursed later.

cccmedia
  1/29/2017 02:39 EST

Medicare Part A is typically awarded at no charge to USA citizens turning 65. They have already paid into the system during their working lives.

Ipso facto, they are already in the system and will remain in it provided they remain USA citizens.

No action needs to be taken to stay in the system, with the possible exception of keeping the system up to date as to your location.

Paying $1,300 or so per year for Medicare Part B is a judgment call -- and may or may not be worth it to Expats who plan never to live in the USA again.

cccmedia

David68
  2/1/2017 21:38 EST

You can always choose an offshore insurance that will cover in the region (South America) or worldwide (excluding or including the USA. Many providers - Aetna / William Russell / Best Doctors ... - are specialized in the expats market. If you are traveling outside of Colombia i would recommend to take a proper expat cover. Does anyone knows a insurance broker in Bogota offering such types of plan?

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