Colombia's health system is divided into two parallel universes. The first is the contributory regime — the EPS (health promoting entities) system, funded through mandatory payroll contributions, available to workers with Colombian employment contracts and their families. The second is everything outside that: private insurance, international medical assistance plans, and the out-of-pocket market that foreigners without employment contracts navigate on their own. Understanding which universe you are in — and what it means for your visa application — is the first thing every foreigner in Colombia should know about healthcare.
on salary above 1 SMLMV
employment contract
La República 2025
visa medical requirement
The EPS System: Contributory Regime for Employed Foreigners
A foreigner with a worker visa and an active Colombian employment contract contributes to the EPS at the same rate as a Colombian employee: 12.5% of the salary base, split between employer (8.5%) and employee (4%). Coverage under the EPS includes general and specialist medical consultations, hospitalization, emergencies, medications included in the PBS (Plan de Beneficios en Salud), and scheduled surgeries. The network of affiliated hospitals and clinics is extensive in major cities.
The leading EPS providers in 2026 — Sura EPS, Nueva EPS, Sanitas, Compensar — vary in service quality by city and specialty. Sura EPS and Sanitas are consistently higher-rated in Bogotá and Medellín for appointment availability and hospital network quality.
The EPS and the Visa: What Cancillería Accepts and What It Does Not
This is the distinction that confuses more foreigners than any other. The Cancillería, under Article 11 of Resolution 5477/2022, accepts EPS coverage for visa applications only if the foreigner has an active Colombian employment contract sustaining the affiliation. A foreigner applying for a resident visa who presents their EPS as medical coverage must demonstrate an active employment contract — otherwise, the EPS does not satisfy Article 11, because the coverage depends on a condition (the contract) that could cease at any time.
For foreigners without a Colombian employment contract — digital nomads, pensioners, rentiers, spouses of Colombians who do not work — mandatory medical coverage for the visa can only be an international medical assistance plan or health insurance policy with coverage in Colombia, independent of any employment relationship.
What the EPS Does Not Cover
EPS affiliation does not mean free and immediate access to all services. The system establishes copayments for hospitalization and procedures, and cuotas moderadoras (access fees) for consultations and tests. Amounts depend on the contributor's income level. For 2026, cuotas moderadoras range from COP 4,700 to COP 23,900 per general medical consultation. The EPS also does not cover outside Colombia — a significant limitation for foreigners who travel frequently.
Private Hospitals and Out-of-Pocket Costs
For foreigners who access Colombia's private healthcare market outside the EPS — either because they lack a work contract or prefer a private clinic — the cost structure is different. A general practitioner consultation at a private clinic in Bogotá costs between COP 80,000 and COP 180,000. A specialist consultation: COP 150,000 to COP 350,000. An ICU night: COP 1.2 to 1.8 million. Without insurance, these costs are entirely out of pocket, and Colombia's hospitals require payment guarantees before elective procedures.