Colombia's healthcare system explained for Americans

Colombia has a national health system, the Sistema General de Seguridad Social en Salud (SGSSS), that covers most of the population through insurers called EPS and providers called IPS. Foreigners with the right visa and a Cédula de Extranjería can join it. Many Americans use it alongside private plans, and some visas require private coverage instead. This guide explains how the system is organized, who can enroll, what you pay at the point of care, and where to complain if something goes wrong.

The two regimes

The Ministry of Health and Social Protection (MinSalud) describes two main ways of belonging to the system:

• Contributory regime (régimen contributivo). For people with payment capacity: formal employees, independent workers with income, and pensioners. Members pay monthly contributions based on their income, and employers pay part for employees.
• Subsidized regime (régimen subsidiado). For people without payment capacity, financed with public funds.

Most foreigners who join do so through the contributory regime, as employees on a Colombian payroll or as independent contributors.

EPS and IPS: insurer and provider

Two kinds of organizations make the system work:

• EPS (Entidad Promotora de Salud). The insurer you enroll with. It manages your membership, authorizes services and contracts with providers.
• IPS (Institución Prestadora de Servicios de Salud). The hospitals, clinics, laboratories and doctors that deliver care, contracted by your EPS.

When you enroll, you choose an EPS that operates in your area. The EPS then assigns you to a primary care provider network. Specialist visits, tests and many procedures require referral and authorization through the EPS.

Who can enroll as a foreigner

To join the contributory regime, a foreigner needs a valid identity document recognized by the system, which in practice means the Cédula de Extranjería for visa holders. Migración Colombia issues it for visas valid more than three months, after registration within 15 calendar days of entry with the visa or of its issue date.

Visa type matters:

• Workers on a Colombian contract are enrolled through the employer.
• Independent workers with income can enroll and pay their own contributions.
• Pension visa holders face a restriction. The Cancillería states that the M Pensionado visa does not allow its holder to join the Colombian social security system, except under international agreements. Such holders rely on the private coverage the visa requires.
• Digital nomad visa holders must show health insurance valid in Colombia for the visa.

What the plan covers

Members of the system have access to the services included in the benefit plan financed by the system's capitation payment, which covers a broad range of primary care, specialist care, hospitalization, emergencies, medicines and procedures. Coverage is the same benefit plan regardless of which EPS you choose; the difference is in the provider network and service.

What you pay at the point of care

Decree 1652 of 2022 sets the framework for two types of charges in the system:

• Cuotas moderadoras. Payments by contributory members and their beneficiaries for using services, intended to encourage appropriate use. Examples include general and specialist consultations and some diagnostic tests.
• Copagos. A share of the cost of the service, paid by beneficiaries in the contributory regime and by members of the subsidized regime.

The decree states that both charges must never become a barrier to access, that the EPS must inform members about them, and that a cuota moderadora and a copago cannot be charged at the same time for the same service. The charges scale with the income of the contributing member.

For 2026, the Ministry of Health's Circular 048 of 2025 set the values in Unidades de Valor Básico (UVB), with the 2026 UVB at COP 12,110. The resulting contributory regime cuotas moderadoras:

• Income under 2 minimum wages: COP 5,000
• Income between 2 and 5 minimum wages: COP 20,100
• Income over 5 minimum wages: COP 52,800

Copagos for beneficiaries are 11.5 percent, 17.3 percent and 23 percent of the service value in the same three bands, with a maximum per event of COP 373,715, COP 1,497,644 and COP 2,995,409, and a maximum per year of COP 748,882, COP 2,995,409 and COP 5,990,696.

Emergencies

In an emergency, call 123, Colombia's national emergency number. Carry your cédula and insurance details so the hospital can identify your coverage.

Private options

Many residents add private coverage:

• Prepaid medicine plans (medicina prepagada) offered by companies authorized in Colombia, which give access to their own networks of doctors and clinics, often with shorter waits.
• Complementary plans offered by some EPS.
• International health insurance, often used by visa holders who cannot enroll or prefer coverage that travels with them.

Medicare does not travel

Medicare.gov states that Medicare usually does not cover health care outside the US, and that Medicare drug plans do not cover prescriptions bought abroad; in most cases you pay all costs. Medigap policies may cover some emergency care abroad. Americans in Colombia aged 65 and older need to decide whether to keep Medicare Part B for visits home, and plan Colombian coverage separately.

Complaints and oversight

The Superintendencia Nacional de Salud (Supersalud) supervises EPS and health providers. If an EPS denies a service, delays an authorization or fails to deliver medicines, file a complaint first with the EPS, then with Supersalud. Colombians also use the tutela, a constitutional action to protect fundamental rights, including health, before the courts.

A practical start

1. Get your visa and Cédula de Extranjería.
2. If employed, confirm your employer enrolled you in an EPS and note your EPS card details.
3. If independent, choose an EPS and register as an independent contributor.
4. Learn your primary care site and how to book appointments through the EPS app or phone line.
5. Keep any private or international policy active until your public coverage is in place.

Using the system day to day

A few habits make the EPS system easier to use:

• Book through official channels. Most EPS offer an app, a website and a phone line for appointments. Primary care appointments are booked first; specialists usually follow a referral.
• Keep your authorizations. When a doctor orders a test, procedure or specialist visit, the EPS issues an authorization that names the provider. Save it, since the provider will ask for it.
• Collect medicines promptly. Prescriptions covered by the plan are dispensed at pharmacies contracted by your EPS. Ask where to pick them up when you leave the consultation.
• Pay the cuota moderadora at the visit. It is charged per service, according to your income band.
• Bring your cédula to every visit. Providers check your identity and membership.
• Update your data. If you move cities, change employers or add family members, tell your EPS so your coverage and network follow you.

Adding family members

Contributory members can register beneficiaries, such as a spouse or permanent partner and dependent children, under their membership. Each beneficiary needs a valid identity document. For foreign family members, that again means a visa and a Cédula de Extranjería or the document that applies to minors.

Common questions

Can foreigners join Colombia's public health system? Yes, with a Cédula de Extranjería, through the contributory regime as employees, independent workers or pensioners. Pension visa holders cannot join unless an international agreement allows it.

What is an EPS in Colombia? The insurer that manages your membership in the health system, authorizes services and contracts the providers, called IPS, who deliver care.

How much is a cuota moderadora in 2026? COP 5,000, 20,100 or 52,800 in the contributory regime, depending on whether the contributor earns under 2, between 2 and 5, or over 5 minimum wages.