EPS vs Private Health Insurance in Colombia

In Colombia, EPS (Entidad Promotora de Salud) is the health insurer. You affiliate to an EPS to enter the public health system. Private cover is a separate, optional layer. It is a prepaid medicine plan (medicina prepagada) or a health policy (póliza de salud). A visa can ask for a third thing: a policy with a specific list of risks. People mix up these three things. Then they buy cover that does not match what they needed it for.

This guide does not say which layer applies to you.

The three layers

EPS. You affiliate to the contributory regime (régimen contributivo) or the subsidized regime (régimen subsidiado) through an EPS. The Ministry of Health says affiliation happens through these insurers (Minsalud, health affiliation page). Law 100 of 1993, Art. 157, sets who belongs where. The contributory regime is for people with an employment contract, public servants, pensioners and independent workers who can pay. The subsidized regime is for people who cannot pay the full contribution (Ley 100 de 1993, art. 157). The Minsalud migrant guide links subsidized affiliation to the Sisbén household-classification survey or to special census lists (Minsalud migrant guide).
Additional health plans (planes adicionales de salud). The decree defines these as an optional, voluntary set of benefits. Money other than the mandatory contribution pays for them. The decree lists three types: complementary care plans (planes de atención complementaria, PAC), prepaid medicine plans and health policies. EPS, prepaid medicine companies and insurers offer them. The same text says a company may sign or renew these contracts only with people in the contributory regime, as contributors or beneficiaries (Decreto 806 de 1998, as compiled in Decreto 780 de 2016). By this rule, private plans sit on top of an EPS affiliation. They do not replace it.
Travel policies. The visa resolution defines travel insurance with health cover (seguro de viaje con cubrimiento en salud) as a private policy. The policy has coverage in Colombia against accident, illness, maternity, disability, hospitalization, death or repatriation (Resolución 5477 de 2022, art. 3). The visa text decides if a policy meets a visa requirement. The next section gives the visa wording.

People say "plan complementario" for a paid upgrade attached to an EPS. The official term is complementary care plan (PAC). It gives benefits that the mandatory plan does not include, or different conditions of care, such as comfort or the network of providers (Decreto 806 de 1998, arts. 19 and 23). It is one type of additional health plan. The contributory-regime rule above also applies to it.

What the visa rules say about health cover

Resolution 5477 of 2022 of the Foreign Ministry (Cancillería) sets the visa rules (Foreign Ministry, Resolution 5477 of 2022). The wording differs by visa type.

Several visitor visas (visas V) ask for a policy. Examples are the digital nomad visa (Art. 46), the student visa (Art. 36) and the retiree-income visa (rentista) (Art. 56). The policy must have coverage in Colombia. It must cover all risk in case of accident, illness, maternity, disability, hospitalization, death or repatriation for the intended stay (official wording: contra todo riesgo en caso de accidente, enfermedad, maternidad, invalidez, hospitalización, muerte o repatriación).
Some migrant visas (visas M) use different wording. They include the independent professional, pensioner and investor visas (Arts. 76, 77 and 79). They require proof of health coverage in Colombia, or a health policy (cubrimiento de salud en Colombia, o póliza de salud). The same list of risks applies.
Some other visas ask for no policy. For example, Art. 53 (work practice) asks for a letter from the legal representative of the company. In the letter, the company takes responsibility for the person's social security.

Two points follow from the text. First, "repatriation" is in the coverage list. It means transport home for medical reasons or after death. It is not the same as repatriating money from a property sale. Second, some visas say "health coverage in Colombia or a policy". The resolution reads as two routes for these visas. The Foreign Ministry decides how it judges an individual file. Ask the Foreign Ministry.

For the investor route to a visa, see visas for property buyers.

The pensioner question

Residents disagree most on this point. The official page for the M pensioner visa lists health coverage in Colombia, or a health policy, as requirement 4 (cubrimiento de salud en Colombia, o póliza de salud). The page also says the visa does not allow its holder to affiliate to the Colombian Social Security System, except as provided in bilateral or multilateral agreements (no le permitirá a su titular afiliarse al Sistema de Seguridad Social colombiano, salvo lo dispuesto en acuerdos bilaterales o multilaterales) (Foreign Ministry, M pensioner visa). Art. 77 of Resolución 5477 de 2022 has the same two passages. Neither text says if the Social Security System includes affiliation to an EPS, or only the pension system. We found no official statement that settles it. We do not settle it either. Ask the Foreign Ministry. Ask the EPS you would approach.

If you get sick before you affiliate

The Minsalud migrant guide covers a person who falls ill while regularizing their migration status. This person did not buy the required health policy and has no resources. The State guarantees this person initial emergency care. The person must regularize the stay and get a valid ID to affiliate (Minsalud). The guide lists these valid IDs for affiliation: the foreigner ID card (cédula de extranjería; see how the appointments work), the special stay permit (PEP), safe-conduct and the diplomatic card. A passport is valid only for children under 7. The guide is written for Venezuelan migrants. Ask the EPS what it accepts for your document.

Pregnancy: what the official sources say

The Minsalud guide says every newborn must be affiliated to the system. The hospital or clinic must arrange the baby's registration with an EPS on the date of birth.
The guide also says contributory affiliates can receive a cash benefit for maternity and paternity leave. The subsidized regime does not pay this benefit.
For additional plans, the decree allows an entry exam. The exam can exclude conditions that already exist. The decree bars adding pre-existing conditions at renewal beyond those present at the start (Supersalud normograma). We found no official rule on waiting periods for maternity in private plans. Read the contract for any waiting period.

What residents report

Reports from Colombia expat Facebook groups, October 2026; individual experiences, not official figures.

Members report that a prepaid medicine plan costs about 550,000 COP a month. They report about 560,000 COP (around US$170) for a private policy and about US$115 for a mid-tier plan. Members report EPS cover for a family of three, affiliated as independent workers, at about 218,900 COP a month. They say EPS premiums depend on income.
Members report waiting periods of about 11 months (one thread says 300 days) before private plans give full maternity cover. Members who tried to sign up mid-pregnancy report quotes of extra fees of about 8,000,000 COP and about 13,000,000 COP. One member estimated an out-of-pocket private birth at up to about 6,000,000 COP.
Many members describe EPS births as well handled. Others describe problems: a medicine that the EPS authorized but never delivered, and a record that showed "not affiliated" while they paid contributions.
Members report that they pay private doctors out of pocket, on top of EPS, for speed.
Some members report that an international travel policy was declined for a visa application. They report that another insurer approved an applicant and later asked for the foreigner ID card because of the repatriation clause.
Members say that declaring less income, to lower the EPS premium, caused problems at visa renewal in earlier years.
On pensioners, some members say pensioners cannot affiliate to an EPS and must buy private cover. Others report pensioners affiliated without problems.

Questions to ask before you buy or sign

Ask the Foreign Ministry or a consulate: for my visa article, does "health coverage in Colombia" mean an EPS affiliation, a policy, or either?
Ask the Foreign Ministry or a consulate: does the visa require the repatriation clause in the wording the policy uses?
Ask an EPS: which documents do you accept for my ID?
Ask an EPS: which regime applies to my situation?
Ask an insurer: does the plan require EPS affiliation first?
Ask an insurer: what does the entry exam exclude?
Ask an insurer: how long are the waiting periods, especially for maternity and existing conditions?
Ask any insurer: how does the plan handle a claim for care in Colombia and abroad?
Ask any insurer: what proof does the visa authority receive?

If the EPS does not give care

The National Health Superintendence (Superintendencia Nacional de Salud, Supersalud) sets this process (Supersalud citizen guide; PQRD channel).

File the complaint, petition or claim (PQRD) with the EPS first.
Go to Supersalud if one of these is true: the EPS does not answer in time, the problem continues, or you disagree with the answer.

Educational information, not legal or tax advice. For your own case, ask a licensed immigration adviser or a lawyer (finding trusted services), and your EPS or a licensed insurance intermediary for the plan terms.

Frequently asked questions

EPS or private insurance in Colombia?

They are different layers. EPS is the insurer of the public system. Prepaid medicine plans and health policies are optional additional plans. Under the decree, a company signs them only with people in the contributory regime. A visa can ask for a separate policy. Check the wording for your visa.

Can I get health insurance if I'm already pregnant?

Official sources say every newborn must be affiliated to the system. For private plans, the decree allows an entry exam. The exam can exclude existing conditions. We found no official rule on waiting periods. Read the contract. Residents report waiting periods and extra fees.

Does a travel policy work for the digital nomad visa?

Resolution 5477 of 2022, Art. 46, asks for a policy with coverage in Colombia. The policy must cover accident, illness, maternity, disability, hospitalization, death or repatriation for the intended stay. Check each policy against that list.

How much is private health insurance in Colombia?

There is no official price. Members of expat groups report roughly US$115 to US$170 a month for private plans (October 2026). These are individual experiences only.

Can pensioners join an EPS?

The official M pensioner visa page says the visa does not allow affiliation to the Colombian Social Security System, except under agreements. It does not say if this covers health. Ask the Foreign Ministry and the EPS.

Own property in Colombia, or planning to buy? The Colombia Owner Kit (US$79) covers the dates, documents and questions owners face. See what's in it.