My wife and I currently have United Healthcare in the US where we can go to practically any doctor or hospital without referrals We will be living in La Mesa and will probably need to go to Bogota for services not in La Mesa. Any ideas on similar plans and costs? The premium is pretty high here
United Healthcare is not covering us in Colombia. We are still living in Arizona and will be moving to Colombia next year. I wanted to get a feel for what we would be paying for private health care given the same options - any doctor and any hospital in Bogota and La Mesa
My few doctor visits in Colombia were cheap enough I can't remember what I paid, maybe $10US for a routine office visit. Anything really bad happens and you might want to weigh certain translation error-driven outcome possibilities. Whether for good or for ill, whatever ensues likely will at least be a relative bargain. And if your time is just plain up, then paying the bill with the right credit card can translate to an award ticket that gets you home in time for the funeral. Lemons-lemonade.
At the risk of being attacked by the trolls, I thought I would share my experience. Recently, I received my resident (5 year investor) and then went to work on understanding health insurance in Colombia (Medellin). If you are a legal resident, with a cedula, you are entitled to enroll in the Government sponsored insurance called EPS. EPS covers all of your basic health care needs and includes drugs, doctor visits, specialist visits, and even serious issues such as transplants and cancer. The amount of your monthly premium depends on your monthly income and as I understand, it is 12%. Your copay for drugs and doctor visits is also based on your monthly income.
The research I did and advice from trusted friends indicated that Sura is the top choice. I also had a Sura salesman give me a quote for a 'policy' that enhances the coverage provided by EPS. The 'policy' will only be sold to those under 60 years old and while it provides for coverage when outside of Colombia, it will only cover for absences 30 days or less, The cost depends on your age and for myself aged 59 was around 6 million pesos per year, I could add coverage for my wife for an additional 2 million.
In consultation with my trusted friend, who uses the system on a regular basis, I decided that the additional was not necessary.
I signed up for eps and Sura assigns you an 'ips' which is the place you go to obtain your healthcare and also your assigned family doctor. I was assigned to 'central' and my friend suggested I have a look at others to see if there was something that would be more to my liking. While I did not visit 'central' I was told it is housed in a large former house. Instead, I visited the ips at Las Molinos in Belen, Nice place, air conditioned, you make an appointment online, go to a machine and enter your cedula and it spits out a ticket, you take that to the counter and they give you set your consultation room and name that is displayed on screens throughout the waiting room, when your name comes up you go and see the doctor. I went online and changed my ips from central to Los Molinos and it takes effect the first business day of the next month.
I have not actually used the system as there is a 30 day wait from your enrollment date to use the system except in case of emergency.
Los Molinos has everything on site, emergency, farmacia, eye care, dental care and more.
My cost for a single person (my wife does not yet have her cedula) is $197,000 pesos per month.
As a Canadian used to socialized medicine, so far this appears to be very modern, civilized, quality care. Unlike Panama, where I would not let them treat my animals, nevermind myself.
I use Nueva eps for my medical care here in Envigado. I pay 115,000 COP per month. I can, and sometimes do, skip it and just use private doctors. The wait for an appt can be hours in a Jon air conditioned room. And then they can just tell you to come back next month and try again. Privately I had laser surgery on one if my eyes last year and it cost 180,000 for the use of the clinic and 200,000 for thevOpthamologist.
One thing to take into account is that many of the medical plans and hospitals in Colombia aren't in great financial shape. That's another reason to choose Sura which is arguably the healthiest of them.
We're enrolled in Sura. I'm moving towards 60, my wife quite a bit younger. Our plan with Sura is one of the higher end ones. It provides a long list of Sura physicians but we can use out of group provided we pay the difference between the standard reimbursement fee and the doctors costs. Doctor costs here incidentally are way, way lower than the US, and one reason that some expats choose to 'self insure' Doctor salaries here are surprisingly low.
We pay the standard (as others show) of around COP 130 million a months and then pay the 'top up amount' for the Increased benefit Sura plan. That gives us a total medical plan for two of around COP 500,ooo a month.
Sura does have more extensive plans and probably cheaper plans. However some of those have pretty extensive physicals before entering the plan, something which probably is less friendly for people near or at retirement age. The plan I'm enrolled in didn't require any physical examination before acceptance.
Plans generally include some basic level of dental coverage. However dental costs here can be very low. One of my caps needed to be put back on (I should have learnt by now to avoid toffee) and the cost in a very pleasant office, for a same day appointment was around COP 50,000 (($15).
Back on the plans you may find that they don't cover things like Private Rooms. However it's probably worthwhile choosing the 'self insure' route for those sort of features and pay for it if and when you need it. Again, compared with the US you will be pleasantly surprised at the cost.
The plans that we have provide very limited cover if we travel outside of Colombia and you can buy coverage for such travel either online or through agents. Some of those plans are of limited use though - the price on 10 cover for the US was very attractive, but the $50,000 cover would have provided little protection beyond a bad head cold. Coverage of $250,000 to $1 million is available albeit at higher rates.
One thing to find out if you take any prescription medications is their availability in Colombia - or what the alternatives might be. Obviously given the cost that is associated with some international drugs they may not readily be available in Colombia.
Thanks Canpandave for sharing your experience.......and I hope you don´t get trolled either, or any of us for that matter. I´ve lived in Colombia several years with basic Coomeva health insurance coverage. Several of my gringo friends have the similar plan.
I´m located in Pereira, which may be a lot different from Medellin. For the two of us I am paying 84,200 pesos per month, which is only a fraction of the 12% that you referenced. Naturally I´m curious what the difference would be if I paid the higher amount and got a better plan. Over the past five years I´ve had little need for the insurance. My main Coomeva clinic with my doctor and my dentist are in downtown Pereira and I live outside Pereira so usually its just easier for me to go see a local doc and local dentist and buy my own meds. My last visit to a local clinic for a nasty cough cost me 25,000. A teeth cleaning at the local dentist also costs 25,000. That time I had strep throat I self-diagnosed based on the white striations and visible swelling in my throat compared to extensive photographs on the Internet and my own past experience having had the problem once before about 30 years ago, so I walked to the corner drugstore and bought my own antibiotics without a prescription. I think the full ten day treatment came to like 4.000 pesos. Doctors make about 3,000,000 month here, same as a police sergeant. Nurses make anywhere from 500,000 to 1,500,000 month. Dentists are similar to doctors income. The times I HAVE used the Coomeva insurance I´ve had good coverage and good treatment. I was having a high blood pressure problem and the doctor gave me a thorough exam and talked with me about my diet and exercise and said I could control the blood pressure on my own, and he encouraged me to do that before prescribing treatment, and I took his advice and three months later I was healthier than I´ve been in years. After 3 months on the program I´ve lost 13 pounds, halfway to my goal. I had a root canal and a tooth removal using the Coomeva insurance. Both cost me 2,500 copay. The teeth cleaning twice a year is free, no copay. When I first arrived in Colombia and before I had insurance coverage I had to have a cap replaced, that cost me about 200,000 pesos at a dentist in Bogota. That´s the extent of my personal experience. But, I had a gringo neighbor for a few years who also had the Coomeva basic insurance and he was 76 years old and had lots of health problems, centered around his addiction to cigarettes, he was a two pack a day guy. The cigs finally got him with lung cancer. He had a wife and three kids on his Coomeva policy and was paying the same as I am paying for two. The insurance paid all his claims, sometimes he had to pay the 2,500 copay. He was on a steroid breathalyzer and I know he had to pay copay for that, but not sure about any of the other visits or treatments that he had over the years. One day very early in the morning on I was walking past his house and he was standing in the front door very red faced and dazed looking and didn´t recognize me. I called for the ambulance at the local hospital but it was on a run out of town, so then I called the local taxi and couldn´t get anyone at that hour of the day, so then I called the fire department and they sent a pickup truck right away to carry him to the hospital. He was in there for three days and I visited him each day. That cost him 2,500 copay for medication he received while there. So, having experienced all of this, I´m simply baffled by the insurance customs here. I hear about folks like you who are paying 3 and 4 times per month what I am paying and I wonder if I´m doing something wrong. Sometimes I think I should upgrade from the basic plan, but then I wonder what more could I get from a more costly plan? I simply don´t know.
We have Sura plan Classic Familiar for my wife; and it is excellent - she gets fantastic service. Copagos vary from place to place, however generally are around 25,000 for a specialist appointment.
It includes overseas travel insurance for 3 months from date of departure. We had to use it for her when visiting Australia, and it is with Assist Card. They did eventually pay up several thousand dollars, however it was an absolute nightmare dealing with Assistcard to get it sorted (diabolical).
They do not offer that service to foreigners with cedulas on the plan - only bonafide Colombians!!
You hear a lot of stories about Colombian methods of handling payments. This is first hand, it really did happen to me. Through an oversight on my part about 4 years ago I missed a monthly payment on my Coomeva health insurance so they put me in a special status....not cancelled, just not active. Unknowingly I went ahead and made my payments on time for three more months then one day needed a dental appointment and the dental clinic said i was on non-paid emergency care only. So I went to the main Coomeva office in Pereira and they said yes, you´ve paid these past three months so we will refund you the money. I was puzzled. Why wouldn´t they have refused my payments if I was on a hold....or, why didn´t they reactivate me after I made the last three payments? No explanation, but they were very kind to give me the address where I could go and apply for my refund. In the meantime I paid the fourth payment and they reactivated me. Wow, confusing. I went to the other address and filled out a form and they told me to wait 45 days and come back for my refund of three months of payments. 45 days later I went back and sure enough they gave me a check. However, the check was for only one month. They then explained I could come back next month for another payment, and then the following month for the third and final payment. Wow, confusing. But, I did it and finally got all the money back, and I´m still unsure why they couldn´t just apply the three months to my future payments, although they did tell me they can´t accept payments into the future because their computer system is not set up that way. This is all very different from the US, and sometimes confusing, and sometimes you just have to go with the flow.
Mr. Lost, is correct on the financial stability of the system. Be careful. For all the good stories, there are equal number of horror stories. Here is an article by someone in the medical field, not a story from a friend of my wife's cousin.
That´s a very interesting article and points out the same argument the US is having, whether to subsidize health insurance for all, or continue the way it used to be. In Colombia it is also clear that the waste and fraud in the EPS system of health care is outlandish. Something like $2 billion USD simply vanished and none of the hospitals or clinics received payment. As a result some 500 hospitals in Colombia are teetering on the edge of bankruptcy. Here´s an article about that: http://colombiareports.com/500-hospitals-close-to-bankruptcy-acesi-director/
At the same time, back in 2011 and again in 2013 and again in 2015 the medical industry went on national strikes because they haven´t been paid by the hospitals or by the insurance companies. My girlfriend is a nurse and was going for 4 and 5 month stretches without any pay, then receiving only half of what was owed her. A fellow gringo in Valle del Cauca married to a nurse told me his wife had not been paid full salary for over two years, and had not received any salary at all for the year of 2013 which is the last year she worked until she took voluntary retirement rather than continue to work for free. So, keep these things in mind when seeking medical attention here in Colombia.
WOW . . . NOT real sure why your monthly payment is SOOOOOOO high.
We also have Sura . . . Absolutely love ?? it BTW . . . I have MY Cedula & our monthly payment is ONLY$80,000. I was added as a "beneficiary" entitled to ALL of the benefits as my husband at NO additional cost.
We both have FULL medical & dental coverage that I would say is actually BETTER than coverage in the USA.
We recently had an emergency with my husband resulting in a brief hospital visit.
We weren't even charged a penny co-pay & his treatment was THE best.
A couple years ago I had THE worst asthma attack & I was treated quicker & better than anytime I was in the USA.
Sura ROCKS !!!
BUT . . . Like I previously stated . . .
I don't understand why YOUR monthly payment is SOOOOOOO high AND why it's extra to add your spouse to the policy
Not sure who the post on SOOOO high was aimed at, but as I've posted some of the higher figures here let me respond.
Medical plans are no different here than anywhere else. Pay more, get more benefits. COP 80,000 sounds very low (put it this way, we pay the medical for our landlord and his wife and it's more than that).
It isn't as if we don't understand the medical system here either and have erroneously bought some inflated policy. My father in law was a well known and respected doctor in the city, my brother in law is a doctor and sits on the board of one of the well known clinics here and his girlfriend is also a doctor. Plus, my wife has a long association with Sura and worked for a while in the health care industry.
A short stay in hospital or an asthma attack isn't going to stretch a policy. But if you need something more serious, with either an extended hospital stay or ongoing treatment it makes a difference.
I'm not sure how your policy is so low - think of it this way how much full medical care are you expecting for two for $300 a year?
I´ve heard several times that some gringos are paying in the hundreds of thousands each month while I have heard from just as many gringos that they are paying less than or close to 100,000 each month. Usually with more than 1 person per policy. I´ve also heard that paying for a better policy ensures better health care, but really can´t prove that from my experience. For example, the gringo neighbor mentioned above wound up dying of lung cancer in the hospital and received good treatment right to the end with no questions asked....and he had the 80,000 per month Coomeva same as me. I was referred to a specialist for the root canal and new cap and that only cost me 2,500 copay. So, I can´t say specifically what better treatment I would get if I paid 3 or 4 or even 5 times more than I am paying now. My partner and I are both in excellent health so I´m not going to sweat it and If either of us ever gets injured in an accident I know we will be covered. What is appalling is to think how much this basic health care plan would cost me in the US. One figure above is $800 a month. Good Lord.
Cafetero I think we all see different experiences. What I do think is true is that 'full' isn't the same as what exists in the US - which is where this thread started.
One of my wife's elderly relatives on basic coverage is in the final stages of cancer. Unlike your example (and despite some intervention from my wife's family,- see above) the quality of care that she has had isn't great. Clearly the system gave up on her pretty early as being untreatable. She's had little intervention either from the medical point of view or from a quality of life aspect. In the US there would have been far more care. Of course perhaps it's likely the final outcome will be no different, but the healthcare system here, at least at a basic level doesn't have the funding for the level of care that you'd get in the US.
Again we have a trade off for anyone coming here. US medical care is the best in the world, but it is extremely expensive and the worst aspect is that after paying in for decades if you need to use the coverage insurers go to great lengths to try to avoid paying, or drop you from future coverage. Going bankrupt over medical bills is pretty common in the US.
In Colombia medical care - at least at most levels is excellent and very good value for money. But the care that can be provided in the US for the $800 month plan has to be more comprehensive than the $30 plan we're talking about here. Some costs - I can confirm the doctors salaries and that medical staff often wait a long time to be paid - are low, but others like medicine and equipment aren't that different as much of it comes from abroad.
The truth is that retirees are more likely to need that 'serious' illness treatment. For a retiree the focus on policies should be less on the co-pay for any out of program doctor but an understanding in terms of any limitations on coverage or access to specialists if they experience serious illness.
When my father-in-law was in ICU a year or so ago in the room next to him was a patient who had cancer. The treatment she needed wasn't available in Colombia, but it was at the Mayo in NY. The family were taking the health plan to court to try to get them pay to send her there and cover the treatment. They failed - because the precedent would have broken (the already broken) system. If everyone could have access to treatment options in the US that weren't available in Colombia it would have game over for every medical plan in the country.
Lastly we often have postings from people coming to Colombia in one or two years and asking about costs. With the current levels of inflation and with the need at some point to fix the Health Care system I think we can guess that Health Care prices, at least for all but the very poor, are likely to increase substantially.
H.I.P. Is a NY Health Insurance Plan. It is a plan based on doctors are all part of a group, all services are provided on site. It's a lower cost plan, generally for city workers amd families. Lots of patients, many patients in the office, fewer doctors, less personal service.
By staying on top of your game, I mean if you need something, maybe a special service amd you are getting the run around, you need to educate yourself a bit on prices and procedure. Sometimes you need to go being the receptionists, you may need to file up with administrators etc.
My fiance is the holder of the plan amd myself amd our children are the beneficiaries of the health plan services. In my case the plan is called Coomeva.
Yes,we want to come as pensionados, but we hear Colombia's healthcare's a disaster,and we can't afford international healthcare.The rest of the pensionado program seems to be very good.Where do you live? Does your plan include dental and eyecare? Thanks for the info!!
The spell check on this site sucks......I´ve noticed it even leaves out words that I remember typing......
My Coomeva doctor referred me to an ophthalmologist and I received complete examination including glaucoma and other stuff without copay. However, I did have to pay for my own eyeglasses to correct my vision. From what I can tell, the eyeglass industry here is a joke compared to US. But, the eyeglasses are very cheap so even if you have to replace them every year or even twice a year its not too onerous. They use a very soft plastic for the lenses that will scratch just from wearing them because there is a lot of dust and grit in the air here at certain times of year. What I was told by the dentist is that cosmetic procedures on the front ¨smile¨ teeth is covered, but not on the back teeth. But, please don´t go on my experience. I´ve learned that if you ask three different people here you will often get three different answers.
You said "Bogota" ? Why are you going to Bogota ? It is not the safest of cities in Colombia, plus the infrastructure is bursting at the seems=traffic jams, like you've not every seen, etc...and the crime issue. Even 25 years ago, when I traveled to Colombia...on business, I avoided Bogota. No me gusta Bogota. Es una ciudad que turistas no necesitan a visitar Entiende ? Epero que si.
Cafetero...great post ! As my Grandad said "if it ain't broke...don't fix it". You are basically healthy so keep on, keeping on. Life is for the living, and you are definitely one of the living. Keep On ! Keeping on !
One needs only to look at the tradeoffs. I can stay in Arizona and live pretty well and as I get older look forward to long term care. As a matter of fact I am able to sell long term care insurance here. However, since my wife's family is so united I am willing to accept an "alternative lifestyle" in my retirement years. I am confident that my reasoning mirrors those expats with Colombian spouses. My wife's relatives are in Bogota and surrounding areas but we will be living west of the city. Life is what you make of it.
Sky Man. Why try to put someone off a particular place just because you don't like it. We have had this same thing many times on these boards,
Everyone says go to Medellin. But from all the posts about Medellin, everyone complains about the traffic jams, the pollution, the sky-high prices of property, and yes, so many reports of horrendous crimes too. Medellin still has the legacy of the cartels, and the violence and murders which go along with it. Whereas in 15 years of visiting Bogota for up to 2 months at a time every year, and now almost 3 years of living here permanently, I have never ever felt afraid, intimidated, or in any kind of danger.
We all look for different things in our choice of where to live. Climate is important, and I don't like the heat which after a while, I find oppressive, and can't wait to get back to Bogota. Others like it hot, and yes, even 365 days and nights a year, but not all of us like to live in that kind of environment.
So before we try to change people's minds on where they should or shouldn't live, maybe we should bear in mind we all look for different things, and our circumstances are also vastly different.
If Fredah or anyone else has investigated moving here, no matter to which town or city, who are we to try and change his mind, just because your own personal preference is based on maybe quite different requirements?
Because it doesn't fit your criteria doesn't meant we should all alter our criteria to fit yours.
Agree with you LP. We may live in Medellin but we've been impressed with how we've seen Bogota changing in the past few years. Take something simple like cycle lanes the way that Bogota has done it is years ahead of Medellin. Walk around the area around Parque 93 and it's becoming very international, extremely livable. It's a little like Medellin talks about being the city of change and Bogota actually does it. If we buy further property Bogota would be top of our list.
Somewhere above stated something like the US has the best medical care. That's debatable. What's not debatable is it is the most expensive at all levels.
Perhaps in the US if you challenge the system, it's pretty good. But I've seen several cases where I'm not so sure when the patients simply took the recommendation of their in plan doctors.
We met a German couple cruising on a sailboat in Santa Marta. They had hiked up to the lost city. I think the uphill part of that would do me in... But after that, they flew to Bogata and he had some chest pains at the altitude there. Bogata doc referred him to Barranquilla for open heart bypass. We met them after all this, and he was doing pretty good. They paid for this out of pocket, and I don't remember the cost to quote here, but it was very reasonable in my way of thinking at the time, and a tiny fraction of the cost in the US.
In my own case, I had early stage bladder cancer a few years ago. Went through the standard US treatment protocol, and so far no issues. But there was a slightly off the wall treatment regime using extracts from giant sea mollusk designed to improve the immune system response. Creditable research supported this, but the FDA never approved it since no big pharma behind it with trials, mostly NIH research, so the rights belonged to the government and no one to pay for trials. But It was a semi routine treatment in Europe, but not available in the US. The US doc that participated in the research wanted to send me to Mexico.
In my opinion, US healthcare is overateted by some.
It was I who said that US health care was the best in the world. I think from a technology point of view it is. There is a tendency with the program to get people hooked on as many expensive medications as possible, but if you've got the money the US has the leading edge treatments. Other countries - like the UK and their NHS struggle with huge waiting lists. UK Private medicine is good - but expensive.
In terms of Colombia when you're next on a New York flight out of Medellin or Bogota, count those wheelchair using passengers - many off for treatment in the US that they can't get here.
my wifes ESP cost 80,000 pesos a month with SURA. It has to include pension, and as she doesn't work we have to pay the minimum for that, about 110,000 pesos - so a total of 195,513 a month (people have said you can get away without paying the pension, however we could not find out how with the many places we contacted). We (myself and son) are beneficiaries of this, so pay no extra.
We got the wife the private plan, which costs 2,186,000 pesos a year. This is the one which provides O/S travel insurance for 3 months from date of travel.
The difference between the two (EPS and private) is a lot - much better service, nicer facilities and quicker appointments. For us it is worth her having.
On the issue of the financial crisis related to health plans and care providers El Colombiano has a front page story on the issue and the impact that it's having on medical care in Medellin. The headline is 'Lack of Medical Supplies Hospital Crisis Worsens'.
The print version is longer and better, including listing the EPS in financial trouble and the growing amounts of unpaid bills to the medical services.
If it is your intention to live here legally, and not try to avoid your legal commitments, you have to pay into the National Health System, albeit you can pick your Health Provider, provided they are in your area. I pay into SURA, my payment then covers my immediate family, in aaddition a pay for an additional Complimentary Health Plan (PAC) with the same company, which gives me direct access to Specialists, and others benefits, not available on the ordinary health service. Unfortunately I have had to test out this plan on a number of occasions since moving here, and found it to be excellent, far better and quicker than I would have received back in the UK. The only downside for some, is that most of the Doctors don't speak English, if you want that, then you are going to have to pay for Private Medical Insurance, and use the International Clinics, of which there are many. There are some treatments no available on the health system, which you have to pay for, but then I have not found those to be too expensive.
As for the cost, it is a % of your declared income, you declare your income to the health Provider, as long as it sounds reasonable they accept it, there is not requirement to provide proof, The only problem I had initially is that I came here with high blood pressure, and some companies are not happy taking on people with pre-existing conditions.
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