Health Insurance Policies in Colombia: What Are They and How Much Do They Cost?

With the recent reforms the national government aims to implement to transform Colombia's healthcare system, a key issue is once again coming to the fore: health insurance.

This is why more and more people are seeking this alternative to avoid long waits in the traditional healthcare system. Health products offered by private entities are often more effective in some cases than services offered by the country's public sector.

According to data from Fasecolda, the sector grew 23% in Colombia by November 2024. According to information collected by El Colombiano, a citizen invests, on average, $1,065,064 in the insurance sector in general.

These health policies are part of the portfolio of insurance services offered by these companies to the Financial Superintendency. They differ from the Health Benefits Plan; they are private contracts that operate under the prepaid model.

Generally speaking, these coverage policies allow people to access private clinics, specialist doctors, exams and treatments, home health care, and complementary care, avoiding the long lines and waits that can occur when accessing these services through the public system.

It's worth clarifying that these policies are not a substitute for Colombians' mandatory enrollment in the contributory or subsidized health system. Rather, they serve as a complement for people who desire faster, more personalized care.

These policies offer benefits such as international coverage, newborn care, care for high-performance athletes, personalized hospitalization, dedicated beds for patients and their companions, and laboratory services, depending on the policy chosen.

The entity responsible for overseeing private sector products is the Colombian Financial Superintendency, which is responsible for supervising all insurance companies nationwide. Its functions include ensuring that the contracts offered by insurers comply with the law and protect the fundamental rights of users.

In the event of a denial of service, this entity must intervene to prevent medical problems or issues in the provision of care. As much as this has its advantages, it also has its disadvantages. Over the years, various cases of restrictions on funds have been reported, such as waiting periods, exclusions for medical conditions, and limits on the amounts that can be covered per year.

The purchase and sale of this service in Colombia began to grow in the 1990s, along with Law 100 of 1993, which regulates and structures Colombia's current Social Security system.

Since then, the sector has had to evolve and adapt its needs to users' changing consumer habits. Extreme sports policies, international injury assistance, electric bike accident coverage, and several other services have had to be included.

Currently, the cost of a policy in this category ranges from 250,000 to 1 million pesos per month. This includes the premium plans offered by some insurance companies and the supplementary plans offered by EPSs.

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