Expat insurance and health insurance in Colombia

The Colombian healthcare system relies on the SGSSS (Sistema General de Seguridad Social en Salud), which covers illness and maternity as part of a broader social protection scheme that also includes workplace accidents, old age-disability-survivors and unemployment. It is organised around two parallel schemes. The contributory scheme is aimed at employees, self-employed people and retirees with sufficient income: they contribute and choose an EPS (Entidad Promotora de Salud), a private, public or mixed body responsible for affiliation, collecting contributions and access to the guaranteed benefits basket. The subsidised scheme, free or with a very low co-payment, targets economically vulnerable people, whose eligibility is determined by the Sisbén classification (level 1 or 2), a household scoring system.

For a foreign resident, affiliation with an EPS in principle follows the same rules as for a Colombian national once their immigration status is regular: an employee under a Colombian contract is affiliated by their employer, who deducts and pays over the contribution. CLEISS notes that this affiliation is voluntary for foreigners with a local employment contract who are not already covered in their home country — in practice, obtaining a residence permit or formal employment is the trigger that makes affiliation effective.

The private sector is particularly well developed in Bogotá and Medellín, with internationally accredited facilities (ICONTEC, JCI) that treat a large share of the expat patient population, outside the EPS network or alongside it. France Diplomatie points out that only the largest cities have facilities capable of treating every type of emergency, most often private clinics that generally only admit patients who have paid in advance.

• Tourist stay (under 90 days): no health insurance is legally required to enter the country; France Diplomatie nonetheless describes it as essential, with an assistance contract or insurance covering medical expenses, hospitalisation and medical repatriation considered a must, since the embassy can never cover these costs.
• Working Holiday Programme (PVT) : bilateral France-Colombia agreement, open to those aged 18 to 30 inclusive at the time of application, annual quota of 400 places (never reached), maximum stay of 12 months. Mandatory insurance covering illness, hospitalisation, disability, maternity and repatriation for the entire stay is required in the application; no minimum guarantee amount is set by the texts consulted. A minimum savings amount of €2,000 is also required.
• Travellers entering by air or sea: the Check-Mig migration form is mandatory before entering or leaving the country, independently of any insurance requirement.
• Seconded employees and temporary or permanent residents: affiliation with an EPS as soon as formal employment is declared or regular immigration status is obtained, with a contribution of 12.5% of income (8.5% employer + 4% employee, capped at 25 SMLMV).

No official fixed fine has been identified for simply lacking coverage outside the PVT; the documented risk is refusal of admission without prior payment at the large private clinics, and the Colombian authorities also heavily penalise any irregular stay or any paid activity carried out under tourist status.

No bilateral social security agreement between France and Colombia has been identified: neither on the CLEISS country page for Colombia, nor in the CLEISS documentation of agreement texts, unlike Chile or Argentina, countries for which such agreements exist and are published. Based on the sources consulted, Colombia must therefore be considered a country with no social security agreement with France.

• A working expatriate in Colombia falls entirely under Colombian law for their health cover (EPS affiliation), with no totalisation of insurance periods and no coordination with French Sécurité sociale.
• No secondment form (A1, SE 401 Q…) applies: an employee sent to Colombia without an agreement remains, barring a specific contractual arrangement, subject to the Colombian scheme as soon as they work there.
• This lack of an agreement should be checked with CLEISS before any departure, as a change in the treaty situation can never be ruled out.

In the absence of bilateral coordination, voluntary membership of the Caisse des Français de l’étranger (CFE) or international private insurance are the solutions most often cited to keep a link with the French system, alongside or instead of local affiliation with an EPS.

• Before departure: take out insurance covering medical expenses, hospitalisation and medical repatriation, whatever the length of stay planned.
• For a PVT: put together the application with insurance valid for the entire stay (illness, hospitalisation, disability, maternity, repatriation) and proof of a minimum of €2,000 in savings, before filing the application.
• Before any flight to or from Colombia: fill in the Check-Mig migration form.
• For a stay of more than 90 days: start the residence visa process (visa M) with the Colombian authorities before the visa-free period expires.
• As soon as you have formal employment or obtain regular immigration status: affiliate with an EPS under the contributory scheme, or check eligibility for the subsidised scheme via the Sisbén.
• Within 6 months of arrival: register with the roll of French nationals living abroad at the general consulate in Bogotá (free, valid for 5 years, recommended).
• In the absence of a France-Colombia agreement: consider voluntary CFE membership or international private insurance as soon as you settle.