Colombia Forum

yolatengo
Joined 2019
Posts: 545

3 years ago

Insurance experience

3 years ago

There is a lot written in this forum about health insurance – government (EPS) or private. I don’t intend to get into this too much since it’s all here in the forum, somewhere. I don’t profess to be anything close to an expert on this. Others here know a lot more. Instead, a few thoughts dating back to when I came to Colombia a year ago until now.

1. I took out a basic EPS Sura policy here as soon as I was eligible, which was within a month after I got here. I tried to use it early on and walked out of the Sura office in Sabaneta in a daze. I had nightmares from all the ticket machines, ticket counters, waiting rooms and being lost in general since I spoke very little Spanish. Long story short and some months later, with people helping me, I’ve become more familiar with the system and if necessary, I bring someone along to facilitate things. It took a long time for me to work up the motivation and courage to go back to Sura, but I did a few months ago. Sura is free, or almost! I was on a mission to make it work.I wanted to stop paying private doctors.

2. For a long period of time I paid out of picket. I used private healthcare. Private care and out-of-pocket are synonymous when used here. Fortunately, I don’t have serious medical issues, but I have enough to keep the doctors and me busy. I found the customer service to be spotty, no different than the rest of Colombia. I only bring it up because I think customer service at Sura is super. I found the trick is to apologize in advance (in Spanish) for my lousy Spanish but I say I am trying. They like that. I have that phrase memorized. I get 10 sympathy votes for that.

Back to private. At times, it was costly though still a lot cheaper than in the US. But then again, I have Medicare. I also found private is bureaucratic also, though in a different sense.

One of the drawbacks with out-of-pocket costs (big drawback for me) is medication. I find medicine in general to be expensive. The system here is weird – for most medicines, no prescription is needed, others yes to a prescription (a.k.a. formula – written and sealed by the doctor in duplicate). You have to pay a doctor to approve it and write it. It’s a lot cheaper than in the US, but I guess I’m accustomed to having Medicare cover most everything. In order to get the medicine through EPS, it’s a big bureaucratic process but it costs virtually nothing.

I found the trick for getting EPS to work for me is having two bilingual paisas help. Much of the time, they do all the work – going to clinics to get authorizations, formulas and stuff, going to Sura for an approval, finding the Sura farmacia where he waits on line and gets the medicaiton. I just had all that done and it was well worth it and still a lot cheaper than if I went private.

Lastly, I am considering relocating. One of the standard things I do when I investigate a place is to check out what kind of health insurance is available along with the details. It's easy enough. My research has been limited to Mexico, Ecuador and Panama so far. I found them all to be vastly different than EPS and EPS won hands down. I wasn’t even eligible in Mexico due to my age and a pre-existing.

I went through lots of different thoughts about EPS, but I've come to the conclusion it's the best option for those in my circumstances. And that includes having the time to deal with the system.

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