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Healthcare Setup

The full path from "I need insurance for my visa" to a settled healthcare stack in Colombia — the sequence, the providers, the costs, and a client-ready recommendation. Built on 2026 rules; every figure carries a verify-before-quoting flag.

Prepared under rules verified 9 Aug 2026 · FX ≈ 3,249 COP/USD · Not medical or insurance advice

The one thing everyone gets wrong

Yes — they need health insurance to get the visa. No — the Colombian public system (EPS) does not count for that. It's not a swap; it's a sequence.

🛡️ Visa policy (international) 🪪 Get cédula 🏥 EPS (Colombian, mandatory) ➕ Prepagada (optional)
1

Visa stage — a private/international "all-risk" policy

Required by Resolución 5477/2022: must cover, inside Colombia, accident · illness · maternity · disability · hospitalization · death · repatriation, for the full visa term. EPS does NOT satisfy this — it has no repatriation or international cover. The policy's length caps the visa's length (1-yr policy → 1-yr visa).

2

After the cédula — affiliate to a Colombian EPS

Mandatory for M/R residents, enabled by the cédula de extranjería. Time it so EPS activates as the international policy expires — don't cancel early. EPS cannot exclude pre-existing conditions (unlike prepagada).

3

Optional — add a medicina prepagada

Most expats layer a private premium plan on top of EPS for fast, private-clinic care. It's a complement to EPS, not a replacement. Watch the pre-existing-condition exclusions and the age cap on new enrollment.

Bridge the gap: the cédula + EPS activation takes weeks after arrival. Keep interim travel cover so the client is never uninsured between the visa policy expiring and EPS turning on.

"Can I just keep my international insurance the whole time?"

The question every client asks. The answer splits by visa type — say it honestly.

V

Digital nomad — basically yes

Nomads generally aren't EPS-eligible (transient status), so a good international/expat policy from arrival onward — renewed as needed — is the model. No EPS step.

M/R

Residents — you can keep using it, but it doesn't replace EPS

A resident can keep a strong international plan as their real, day-to-day coverage (private, English-speaking, no waits) — and a compliant policy is needed at every visa renewal anyway. But EPS affiliation is legally mandatory for residents (Ley 100) and is increasingly checked at renewal. So the compliant setup is EPS as the mandatory base + international (or prepagada) on top — not international instead of EPS.

$

The trade-off

Full international ≈ $2,000–6,000/yr vs EPS (~$67/mo min) + prepagada (~$70–150/mo). International-only is simpler but pricier — and for residents still doesn't remove the EPS obligation.

⚠️ Edge case to verify per client: whether EPS is strictly enforced for a pensionado/rentista with no Colombian income is genuinely murky. Frame it as "keep international for real care; enroll in EPS to stay compliant," and confirm the edge cases with a Colombian immigration/insurance lawyer — don't tell a resident they can skip EPS entirely.

Pathway planner

Enter a client profile → get their recommended 3-stage pathway, a monthly cost estimate, and the flags specific to their case. Nothing is sent; this is an internal planning aid.

Provider directory

Costs are 2026 estimates (FX 3,249). Insurance is sold by a licensed partner — we coordinate and verify compliance. Confirm live before quoting.

🛡️ Visa-stage policy — must carry all 7 coverages incl. repatriation, full term

ProductType~CostVisaNotes
EG Visa Protect (EG Assist)CO travel-medical$495/yr ($742 age 76–85)YesBuilt for Res. 5477; refund-if-denied add-on
SafetyWing NomadNomad subscription~$56/4wk (~$730/yr <40)YesConfirm cert lists repatriation
Genki NativeExpat monthly~€180/mo (<35)YesPopular for 1-yr DNV
Continental AssistTravel-medicalverifyYes2-yr max; reimburse if denied
Cigna Global / IMGFull international PMI$2,000–6,000/yrYesReal ongoing cover; premium budgets
Assist Card · SURA · AXA travelCO travel-medicalverifyVerify certMust name repatriation + full term

Rejection traps: no repatriation clause (#1), missing maternity/disability, term too short / hidden 30-day cap, doesn't cover care in Colombia.

🏥 EPS — public base, after cédula, mandatory for M/R residents

EPSFit (Medellín)
SURA EPSTop pick Antioquia-based, best network (Las Américas/El Rosario) + tooling
Sanitas EPSStrong nationally, secondary in Medellín
CompensarGood perks, Bogotá-focused
Nueva EPSAvoid for expats longer waits

Cost: employee 4% · independent/rentista 12.5% on IBC (40% of income, min 1 SMMLV ≈ COP 218,863/mo · ~$67) · beneficiary $0. 26-week wait for high-cost care (pay-the-difference escape); emergencies immediate. ⚠️ Decreto 0182/2026: confirm which EPS operate in the client's department.

➕ Medicina prepagada — premium layer, on top of EPS (+5% IVA)

Provider<64 / mo64–6975+
SURA~$90–150step-upcap ~64
Colsanitas~$104 (Medisanitas ~$70)~$337~$429
Colmédicaquote-only

⚠️ No prepagada covers pre-existing conditions (excluded or surcharged). Carencias: maternity 60–90d, surgery ~mo 4–5, cancer mo 7–13. Enrollment age cap ~60–70 — enroll before the cap; once in, kept for life.

Client brief generator

Turns the planner result into a client-ready explanation with the disclaimer. Build a pathway first, then generate here.

Language:

Build a pathway in the planner tab first.

Guardrails

Licensing We coordinate; a licensed partner sells. A non-licensed agency may advise, gather docs, submit EPS affiliation, and refer to a licensed intermediary for a referral fee — and charge a flat coordination fee. It may not place/sell the policy, bind cover, collect premium, or take a placement commission. (An agencia de seguros can't be an SAS; a corredor needs Superintendencia Financiera registration.)

Not advice Not medical or insurance advice. We explain options and coordinate; clinical and coverage decisions rest with the provider and the client.

Human gate The Healthcare Coordinator agent drafts recommendations and outreach; a human reviews and sends. No policy is bound without the licensed partner + the client.

Honest Verified figures only; version stamp on every client deliverable; no guarantees of coverage or acceptance.

Verify before client-binding use: per-article M-visa health text (Cancillería); that each insurer's certificate names repatriation; pensionado/rentista EPS eligibility with no Colombian tie; nomad EPS ineligibility; retail prepagada prices + Medellín clinic-to-plan mapping; the licensing-line questions → Colombian insurance lawyer/broker. Full detail in HEALTHCARE_SETUP.md.