°µÍø½ûÇø

PhilCo58 wrote:

My mother-in-law on the other hand is with Coomeva who are diabolical.

Dear Phil,

Thanks for clarifying a potentially complex issue for forum readers.

Coomeva is known as perhaps the lone insurance company in the country that insures seniors.

Is this true, or do you know of another company or companies that insures folks over 65?

How diabolical has Coomeva been in the case of your suegra?Ìý

cccmedia in Depto. de Nariño

Phil, let's get into some of the details, starting with the issue of insurance premiums based on declared income.

Is a certain percentage -- how much? -- applied to declared income to determine premiums?

What kind of premiums are we talking about for adults, couples .. and seniors?

What is the maximum premium that can be expected for a well-off °µÍø½ûÇø with a large monthly income?

How are preconditions handled in the insurance programs with which you are famliar?

cccmedia

One more thing, Phil.

Please share with us how medical pre-conditions are handled in setting premiums and exclusions for subscribers to the medical programs you mentioned?

cccmedia

I will try to answer each of your queries separately. As far as I and my Colombian family are aware there is no age restriction on admission to EPS. it is a National Health Service, and as such everyone has a right to medical treatment, you may be confusing this with Private Health Insurance, which most of these Providers also offer, on that I can't help you.

Coomeva have to my knowledge, cancelled appointments without informing my Mother-in.law, they have lost examination results, they have misplaced her medical file as a result of which her operation date had to be postponed without notice, need I go on? It may be that it is the Branch in Bello that is at fault and elsewhere is fine, but from the stories we have heard that is not the case.

I believe the cost of EPS is 12% of your declared income, hence the reason no one declares their income in full, there is also an input relating your declared income to the minimum salary, so it goes up in Bands, by this I mean that in addition to your monthly payment on declared income, you also contribute to each Doctors visit, prescription issue, specialist visit according to your income. These have just gone up and now are:

Group AÌý Ìý Ìý Ìý ÌýIncome less than 2 Salario MinimoÌý Ìý Ìý Ìý Ìý Contribution 3000 COP
Group BÌý Ìý Ìý Ìý ÌýIncome between 2-5 Salario MinimoÌý Ìý Ìý ÌýContribution 12000 COP
Group CÌý Ìý Ìý Ìý ÌýIncome more than 5 Salario MinimoÌý Ìý Ìý ÌýContribution 31600 COP

This cost, covers the Worker paying, his or her spouse and children, however if both Partners are working, they both should be paying into the system.

Pre-existing conditions, again these do not effect the EPS contributions you pay, If you apply to join an EPS, you obviously have to declare any pre-existing conditions, and they can and will refuse to take you, if they are not happy, but if they all refuse you, you appeal, and one is appointed to take you, whether they like it or not, likewise you would not have a choice.
Once you are in an EPS, you can apply to move to another, if you are healthy, there will be no problem subject to that Company having cover in your area, if you have a pre-existing condition, the likelihood of being accepted is nil, hence my Mother-in-law can't move from Coomeva (we tried).
When I first came to Colombia I registered with Comfenalco, they were great, but because of the problem of the Government not paying their bills to the Company, they packed up their EPS cover, I was then assigned to SURA, at the time I didn't want to be with them, and applied to another, but because I was on a program for High Blood Pressure, they refused me, so I had to stay with SURA, as it turned out that was a good call.

There are advantages to being placed on an EPS program, whether it be Blood Pressure, Diabetes, etc. you dont pay for Doctors appointments related to that, and if you have a good Doc, he will ensure all appointments related to your condition.

You keep talking about premiums, just to clarify this, the system of EPS is NOT an Insurance policy it is a National Health Service, with prices fixed by the Government, if you want to pay premiums, then take out a Private Health Insurance Policy with one of these Companies, with EPS the prices are there for all to see. If you go to the site of a Provider, of which there are many, the prices are listed.
Before deciding which EPS to join, find out which Providers operate in your area, then ask about, people will soon tell you which is the best.

Hello steve the best you can do is get the cedula, that way you can do everything here in colombia. If you want i can give you the contact and he give the cedula legal in 1 week.

OK I didn't mention cedula, but as I said

"If you are going to live in Colombia, and intend to abide by the laws of the country, and not the laws of °µÍø½ûÇø, then you are obliged to pay into the National Health Service in Colombia, or as it is known here EPS."

And if you live in Colombia you have to have a cedula to conduct any business, unfortunately there are °µÍø½ûÇøs who live here, who dodge all the legalities, they want the financial benefits of living here, without paying their way in the system, which I find, bends over backwards to accommodate us, but again that is for another post.