Share your needs with us, get contacted by law firms.
Free. Takes 2 min.
Health insurance in Manizales, like all of Colombia, is governed by a framework that seeks to guarantee access to health services for everyone. The health system operates under the General Health Social Security System (SGSSS), which establishes mandatory insurance for all residents, either through the contributory regime (for workers and their families) or the subsidized regime (for those with limited economic means). Health insurance law oversees how these systems are implemented, managed, and what rights and obligations both insurers and insured individuals have. In Manizales, health insurance is provided by various private and public entities known as Health Promotion Entities (EPS), responsible for affiliating users and ensuring they receive medical care as established by the law.
There are many situations in which a person in Manizales may require the assistance of a lawyer regarding health insurance matters. Common circumstances include disputes over denied coverage or services from your EPS, difficulties in accessing essential treatments or medications, disagreements concerning the complexity of your care, issues with insurance affiliation or contribution payments, or cases of discrimination or unjustified termination of service. Legal counsel can also be crucial when dealing with claims for compensation following medical negligence, errors in billing or fees, and threats to your right to health due to administrative delays or inadequate attention from health providers.
The foundation of the health insurance system in Manizales comes from national laws, most significantly Law 100 of 1993, which organizes and regulates health insurance. Complementing this, several decisions from the Constitutional Court defend the right to health as a fundamental and immediately enforceable right. Local authorities in Caldas and Manizales also regulate how EPS operate within the city. Some key points include:
Anyone residing in Manizales can obtain health insurance by affiliating with an EPS, either through the contributory regime (if you are employed or an independent worker) or the subsidized regime (if you have limited resources).
You can file a written complaint (reclamo) with the EPS and, if not resolved, approach the Health Superintendency or file a tutela (a constitutional protection action) in court to protect your right to health.
No, Colombian law prohibits health insurers from denying coverage based on pre-existing conditions or chronic illnesses.
A tutela is a legal mechanism to protect fundamental rights. If access to essential health services is denied and your life or wellbeing is at risk, you can file a tutela in court for rapid intervention.
Costs depend on your income and affiliation type. For the contributory regime, a percentage of your income is paid. For the subsidized regime, the State covers the cost.
The Health Benefits Plan (Plan de Beneficios en Salud, PBS) establishes what must be covered, including general consultations, hospitalization, prescribed medications, surgeries, maternity care, and preventive services.
Yes, you can change EPS after remaining with your current one for at least one year, provided there are no outstanding legal matters between you and the EPS.
You are entitled to clear information, timely and quality care, the right to choose your EPS, to make complaints, and to confidentiality of health data.
You can report such situations to the EPS itself, the Health Superintendency (SuperSalud), local health secretariats, or via tutela in the courts.
Yes, foreign nationals with legal residency in Colombia can affiliate with an EPS under the same conditions as nationals.
If you need information or help regarding health insurance in Manizales, consider the following resources:
If you believe your health insurance rights have been violated in Manizales, it is important to act promptly. Start by gathering all relevant documents (affiliation forms, medical prescriptions, denial letters, etc.) and contacting your EPS for an explanation or resolution. If the issue persists, seek assistance from the Superintendencia de Salud or the local Secretaría de Salud. For complex cases, particularly if urgent health services are denied or there is risk to your life, consult a lawyer experienced in health law in Manizales. Legal aid may be available through public defenders, Defensoría del Pueblo, or university legal clinics. Remember, timely legal advice can be the difference in securing your right to health care.
