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Post by buenopues on Oct 17, 2016 9:22:24 GMT -5
I have medecina prepagada (Coomeva Plan Oro) which serves me well but I am forced tp pay for EPS as well. It is a complete waste of money. I used it just once to have my teeth cleaned and they did a lousy job. Does anyone know a way to get around this? What happens if you formally withdraw from an EPS with letter etc.?
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Post by bickmed on Oct 17, 2016 12:40:53 GMT -5
We tried to obtain comprehensive cover without an EPS plan and couldn't do it. I have heard people say they do not pay EPS, but we tried a few places and EPS was a requirement. We ended up with SURA.
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Post by livinginmedellin on Oct 17, 2016 13:30:22 GMT -5
We tried to obtain comprehensive cover without an EPS plan and couldn't do it. I have heard people say they do not pay EPS, but we tried a few places and EPS was a requirement. We ended up with SURA. Yes SURA is the best IMHO.
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Post by barrumundi on Oct 17, 2016 15:56:51 GMT -5
The way I understand it is that it is a requirement (maybe a law) that you must have EPS. If you have your EPS with a different company to your Prepago insurance you will have a huge headache.
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Post by ozgringo on Oct 17, 2016 16:59:57 GMT -5
By law you have to have EPS with prepagda.
You could try switching to another provider as I believe Coomeva gold is basically the most expensive plan. ( not including plus plan).
Try SURA you would save the EPS costs and as stated they are very good.
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Post by redriver on Oct 17, 2016 17:37:45 GMT -5
Had to call the doctor to come by the house today. We use Sura insurance and i was pleased with the treatment. Got lucky that one of the guys speaks english.
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Post by buenopues on Oct 17, 2016 18:02:17 GMT -5
Thanks for the responses. I guess I am trapped and must continue to pay for this "service" which has been utterly useless to me for fifteen years.
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Post by elexpatriado on Oct 18, 2016 12:43:45 GMT -5
I have medecina prepagada (Coomeva Plan Oro) which serves me well but I am forced tp pay for EPS as well. It is a complete waste of money. I used it just once to have my teeth cleaned and they did a lousy job. Does anyone know a way to get around this? What happens if you formally withdraw from an EPS with letter etc.? No you dont. I will send you the name of the person who will set you right. Unless you are a citizen you dont have to. I have had Coomeva Prepaga for 4 years now and no EPS. I have gone to GPS, specialists, sports medicine doctors, etc., etc. without any questions. I am considering it when I renew, but I have to sit down with them and see ihat the benefits are. Things like vaccinations and prescriptions may be covered by EPS. Best todo a detailed cost benefit analysis. But the answer is NO , as an expat, non-citizen, EPS is NOT required if you have Prepaga . I am 100% sure of that. Checked it out from several sources. Dont let anyone tell you otherwise.
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Post by elexpatriado on Oct 18, 2016 12:44:37 GMT -5
By law you have to have EPS with prepagda. You could try switching to another provider as I believe Coomeva gold is basically the most expensive plan. ( not including plus plan). Try SURA you would save the EPS costs and as stated they are very good. You are 1000% wrong. Someone is feeding you a line of BS.
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Post by elexpatriado on Oct 18, 2016 12:45:01 GMT -5
The way I understand it is that it is a requirement (maybe a law) that you must have EPS. If you have your EPS with a different company to your Prepago insurance you will have a huge headache. WRONG
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Post by elexpatriado on Oct 18, 2016 12:46:05 GMT -5
We tried to obtain comprehensive cover without an EPS plan and couldn't do it. I have heard people say they do not pay EPS, but we tried a few places and EPS was a requirement. We ended up with SURA. They are selling you a bill of goods. For citizens yes, EXPATS-no. Punto Cerrado
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Post by elexpatriado on Oct 18, 2016 13:02:44 GMT -5
I sent you the PM BP.
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Post by ozgringo on Oct 18, 2016 16:04:25 GMT -5
By law you have to have EPS with prepagda. You could try switching to another provider as I believe Coomeva gold is basically the most expensive plan. ( not including plus plan). Try SURA you would save the EPS costs and as stated they are very good. You are 1000% wrong. Someone is feeding you a line of BS. That's Colombia for you. I had Coomeva Gold + my wife and we were told specifically that we, I required EPS as well.
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Post by elexpatriado on Oct 18, 2016 17:53:06 GMT -5
You are 1000% wrong. Someone is feeding you a line of BS. That's Colombia for you. I had Coomeva Gold + my wife and we were told specifically that we, I required EPS as well. Well your wife yes, but not you-unless you are a citizen. But your wife can affiliate you under her EPS for cheap. Not only that, you will get cheaper fees and prescriptions under her EPS. Fees and costs in EPS all depend on Estrato. Your wife as an estrato3 (for example) can gey much t lower visitation and emergency charges and prescription costs than under medicine prepaga. For example, my Colombian friends have only EPS and pay only 2 mil pesos for an emergency visit. I pay 20 mil, but then I get priority in the emergency room vs EPS people (for non-life threatening cases- which are all the same priority) If you have both get EPS and prepaga(your wife gets the EPS and affiliates you is the cheaper way to go), you can choose between lower fees of EPS versus no waiting in emergency, less waiting time for citas, supposedly "Better" doctors" and other benefits of Medicine Prepaga. The whole health care sytsem is a cluster F**K here, in reality.
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Post by barrumundi on Oct 18, 2016 17:57:33 GMT -5
The way I understand it is that it is a requirement (maybe a law) that you must have EPS. If you have your EPS with a different company to your Prepago insurance you will have a huge headache. WRONG I can't argue that you MAY be correct in YOUR case elexpatriado because you are a sole (some people would put an ass in front of that) member and a gringo. When you are in a family group insurance, whether it be EPS or PrePago you are treated exactly the same way as everyone else. We (my family) have been warned more than once by Medisanitas that we MUST keep our EPS paid up or they won't cover us for prepago treatment. End of story.
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Post by elexpatriado on Oct 18, 2016 18:00:18 GMT -5
I can't argue that you MAY be correct in YOUR case elexpatriado because you are a sole (some people would put an ass in front of that) member and a gringo. When you are in a family group insurance, whether it be EPS or PrePago you are treated exactly the same way as everyone else. We (my family) have been warned more than once by Medisanitas that we MUST keep our EPS paid up or they won't cover us for prepago treatment. End of story. BuenPues is single He is the one that asked the question. Also, as I explained above, there are more than one ways to skin a cat. Wife and kids can be under thier own system as Colombians, and husband under his own as an expat- and doesnt need EPS. Whether this is economically advantageous or even advisible (even if it is cheaper) is is another question
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Post by barrumundi on Oct 18, 2016 18:05:46 GMT -5
Point taken.
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Post by ozgringo on Oct 18, 2016 18:19:48 GMT -5
That's Colombia for you. I had Coomeva Gold + my wife and we were told specifically that we, I required EPS as well. Well your wife yes, but not you-unless you are a citizen. But your wife can affiliate you under her EPS for cheap. Not only that, you will get cheaper fees and prescriptions under her EPS. Fees and costs in EPS all depend on Estrato. Your wife as an estrato3 (for example) can gey much t lower visitation and emergency charges and prescription costs than under medicine prepaga. For example, my Colombian friends have only EPS and pay only 2 mil pesos for an emergency visit. I pay 20 mil, but then I get priority in the emergency room vs EPS people (for non-life threatening cases- which are all the same priority) If you have both get EPS and prepaga(your wife gets the EPS and affiliates you is the cheaper way to go), you can choose between lower fees of EPS versus no waiting in emergency, less waiting time for citas, supposedly "Better" doctors" and other benefits of Medicine Prepaga. The whole health care sytsem is a cluster F**K here, in reality. I actually think I was on my wife's EPS then we paid extra for prepagada. To be honest not 100% sure. I was very lucky in the 3.5 years I lived in Colombia I never once went to a Dr. A Dentist twice, they were walk in situations. My wife on the other hand seemed to go every month. It was a night mare, somethings covered under EPS other things under prepagada, other things not covered at all. Some Hospitals accepted Coomera others didn't, the list of the Dr's available etc.... It was often easier to go private, definitely quicker. In Cartagena, I believe Coomeva went on your income not on your estrato.
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Post by barrumundi on Oct 18, 2016 18:58:37 GMT -5
"I believe Coomeva went on your income not on your estrato."ozgringo I also believe that to be the case ........in regard to EPS. Many years ago my wife had EPS with Cafesalud and I was 'attached' to her EPS. Then later when we changed insurance company to have our EPS with Medisantas because that's who we had the PrePago insurance with, I became the principal and she was 'attached' to MY EPS. Some time later we received a letter from Medisanitas explaing that my wife could not be attached to my EPS because she earned a living from a business she owned at that time. They said because she was earning money she had to have her own EPS. Long story short ....we cancelled our existing EPS insurance ....took out a new policy with the same company with my wife as the 'principal' and I was the one that was 'attached'. Months later after many visits, letters and phone calls everything was exactly the same as it been before. Typical Colombian bureaucratic bullshit.
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Post by bickmed on Oct 18, 2016 23:39:41 GMT -5
'''We tried to obtain comprehensive cover without an EPS plan and couldn't do it. I have heard people say they do not pay EPS, but we tried a few places and EPS was a requirement. We ended up with SURA.
''They are selling you a bill of goods. For citizens yes, EXPATS-no. Punto Cerrado'''
Expatriado - to clarify, our comprehensive is for the wife, and she is a citizen, she had to pay EPS (Which is inline with what you stated). Our boy is a beneficiary of hers and has prepaid SURA. . I am a beneficiary of her EPS, however I have global insurance cover with BUPA, so not applicable to me.
Another thing we could not get around for the wife, was having to pay additional for her for Pension.
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Post by Luther Blissett on Oct 19, 2016 3:36:11 GMT -5
REQUISITOS DE AFILIACIÓN - NOTAS IMPORTANTES REQUISITOS Para poder estar afiliado a la Medicina Prepagada, la persona tiene que estar afiliada a una EPS.Si la persona se va a afiliar a POS y a la Medicina Prepagada de EPS SURA al mismo tiempo, entonces se deben ingresar los dos formularios de afiliación juntos. Si la persona no está afiliada o no se va a afiliar al POS de EPS SURA, debe presentar los documentos de identidad y el carné de afiliación a la EPS del cabeza de familia y los beneficiarios de la Medicina Prepagada. www.epssura.com/component/content/article?id=106&itemid=53
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Post by Luther Blissett on Oct 19, 2016 3:36:51 GMT -5
Definición: Los planes de Medicina Prepagada, son planes adicionales de salud, de acuerdo con lo señalado en el Decreto 806 de 1998. Es decir, que se trata de un conjunto de beneficios opcionales y voluntario, financiado con recursos diferentes a los de la cotización obligatoria. (Acemi) El usuario de un Plan de Medicina Prepagada podrá elegir libre y espontáneamente si utiliza el POS o el plan adicional (Medicina Prepagada) en el momento de utilización del servicio y las entidades no podrán condicionar su acceso a la previa utilización del otro plan. Para adquirir un plan de Medicina Prepagada en Colombia, es obligatorio estar afiliado a un Plan Obligatorio de Salud (POS). segurosefectivos.com/wpdos/wp-content/uploads/2011/07/Medicina-Prepagada-en-Colombia.pdf
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Post by Luther Blissett on Oct 19, 2016 3:41:30 GMT -5
“Moviéndonos por tu salud las 24 horas del día los 365 días de año” Acercamos la salud, en la comodidad de tu hogar o domicilio en que te encuentres, sin costo por matrícula ni pagos adicionales por el servicio. Así, no tienes que desplazarte a instituciones de salud, en Emermédica resolvemos de forma oportuna cualquier situación altere tu estado de salud de forma grave o leve, como servicios adicionales que complementan tu Plan Obligatorio de Salud o Medicina Prepagada. Requisitos: Debes estar afiliado a cualquier EPS como cotizante o beneficiario.Vivir dentro del perímetro de cobertura de Emermédica. www.emermedica.com.co/web/emermedica-personas/planes/plan-integral/
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Post by Luther Blissett on Oct 19, 2016 3:42:38 GMT -5
2. ¿CUÁLES SON LOS REQUISITOS PARA AFILIARSE A UN PLAN COMPLEMENTARIO? Tener afiliación al Plan Obligatorio de Salud Contributivo vigente. Tener documento de identidad, cedula de ciudadanía y/o cedula de extranjería, Registro Civil y Tarjeta de Identidad (en caso de ser menores de edad). Cumplir con el diligenciamiento de la solicitud de afiliación y declaración de estado de salud. Cancelar la prima del primer mes. www.pac-sos.com.co/preguntas.html
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Post by elexpatriado on Oct 19, 2016 20:11:09 GMT -5
Definición: Los planes de Medicina Prepagada, son planes adicionales de salud, de acuerdo con lo señalado en el Decreto 806 de 1998. Es decir, que se trata de un conjunto de beneficios opcionales y voluntario, financiado con recursos diferentes a los de la cotización obligatoria. (Acemi) El usuario de un Plan de Medicina Prepagada podrá elegir libre y espontáneamente si utiliza el POS o el plan adicional (Medicina Prepagada) en el momento de utilización del servicio y las entidades no podrán condicionar su acceso a la previa utilización del otro plan. Para adquirir un plan de Medicina Prepagada en Colombia, es obligatorio estar afiliado a un Plan Obligatorio de Salud (POS). segurosefectivos.com/wpdos/wp-content/uploads/2011/07/Medicina-Prepagada-en-Colombia.pdfApplies only to citizens. Not to expats. Keep reading until you find the pertinent clause. THese arent the pertinent statuates of the Colombian Bylaw (i.e. Decreto 806 de 1998, and any updates, and ammendments thereof, which I am sure ther are many) , just some guys opinion, and written for citizens.I am sure you read all 290 pages of the Paz acuerdo withthe Farc as well. Did you that there is a lot of disinformation out there? For instance, did you know, that DIAN does NOT, Definitely NOt have acess to IRS personal Tax data or Tax data from any other countries they have tax treaties with?
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Post by elexpatriado on Oct 19, 2016 20:16:03 GMT -5
2. ¿CUÁLES SON LOS REQUISITOS PARA AFILIARSE A UN PLAN COMPLEMENTARIO? Tener afiliación al Plan Obligatorio de Salud Contributivo vigente. Tener documento de identidad, cedula de ciudadanía y/o cedula de extranjería, Registro Civil y Tarjeta de Identidad (en caso de ser menores de edad). Cumplir con el diligenciamiento de la solicitud de afiliación y declaración de estado de salud. Cancelar la prima del primer mes. www.pac-sos.com.co/preguntas.htmlI got mine with my Passport. Been renewing every year , and just Prepagada no EPS. You cant just take copy and paste snapshots out of some "Experts" article, and logically link them together. I am not working in an Engineering company anymore argueing with some junior immigrant engineer that he has misinterpreted and not read all the pertinent clauses and addendas of the ASME Sec VIII boiler code. I dont have an interest in that. The proof is in the pudding . 4 years- no EPS-no problems I gave BuenPues the name of the Lady at Coomeva who can set him right. She will sell him the Prepagada plan without the EPS, or will convince whoever he is talking to she or he is wrong. Whether he chooses to act on it is his own decision. Case closed.
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