Before you start

A cédula de extranjería (foreigner ID) to affiliate with an EPS in the contributory regime — without one you use prepagada-as-medicina, international insurance, or pay cash.
A declared monthly income / proof of income, since self-employed EPS and prepagada contributions are calculated on it.
Passport and (for prepagada/private plans) a Colombian bank account or card for the monthly debit.
Note: M-Pensionado (retiree) and Type V visa holders are barred from affiliating with EPS, so they rely on prepagada-style plans, international insurance or cash.

Step-by-step

1
Understand & join the EPS contributory system
EPS is the backbone of Colombian healthcare and covers the mandatory benefits plan (PBS) cheaply. Employees pay 4% of salary (employer adds 8.5%); self-employed/independent foreigners pay the full 12.5% of declared income, with a floor of one minimum wage (COP 1,750,905 in 2026) — so the minimum is ~COP 218,900 (~US$55) a month. Affiliate once you have your cédula; Sura and Compensar are the most expat-friendly with the best apps, with Sanitas also popular.
OnlineWho: You (or your employer if formally employed)1-2 weeks to affiliate; coverage starts the following month~12.5% of declared income; minimum ~COP 218,900 / ~US$55 per month
2
Add medicina prepagada for faster, better private care
Prepagada is an upper private tier you buy on top of EPS (you must keep EPS active in parallel). It gives direct specialist access with no GP referral, faster appointments, the best private hospitals and private rooms, and often English-speaking staff. Main providers are Sura, Colsanitas and Coomeva; monthly cost runs ~COP 200,000-400,000 for people in their 20s-30s and ~COP 400,000-700,000 in their 40s-50s. The common expat setup is EPS + a complementary/prepaid plan for ~COP 300,000-450,000 (~US$75-110) total.
Mobile appWho: You, via the insurer (Sura / Colsanitas / Coomeva)Days to enrol; waiting periods apply for pre-existing conditions~COP 200,000-700,000 / ~US$50-175 per month (age-based)
3
No cédula? Use international insurance or pay cash
Digital nomads and new arrivals who can't yet get an EPS rely on international/all-risk health insurance (e.g. SafetyWing ~US$56 per 4 weeks for under-40s, or global plans ~US$2,000-6,000/year). Note the Digital Nomad (Type V) and visitor visas require all-risk insurance valid in Colombia for the whole visa period and explicitly including medical repatriation — ordinary travel insurance is rejected. Because private care is so cheap, paying cash is also a real option.
OnlineWho: You, via an international insurer or out of pocketImmediate (insurance bought online; cash care same-day)International plans ~US$56/4 weeks to ~US$2,000-6,000/year; cash GP visit ~COP 80,000-200,000 / ~US$20-50
4
Know the top private clinics & medical-tourism options
Medellín has several of Colombia's best hospitals and is a leading medical-tourism destination, with prices roughly 50-70%+ below the US at comparable quality. Standouts: Clínica Las Américas Auna (JCI-accredited, large English-speaking international patient office), Hospital Pablo Tobón Uribe (top-ranked, transplants/cardiology), Clínica El Rosario and Clínica CES (international patient offices). Dental, cosmetic and specialist care are a major draw.
In personWho: You — book directly or via a clinic's international patient officeSpecialist appointments often within days privatelySpecialist visit ~COP 150,000-400,000 / ~US$60-105 cash; procedures a fraction of US prices
5
Emergencies (123) & pharmacies (droguerías)
Dial 123 for all emergencies nationwide (ambulance/police/fire), or go straight to a private clinic ER. Pharmacies are everywhere — Cruz Verde (largest, many 24h), Farmatodo and Drogas La Rebaja (cheap generics) — with home delivery via their apps and Rappi. Many medications are inexpensive and sold over the counter (including common antibiotics), though carrying a prescription for ongoing meds is wise.
In personWho: YouImmediateMany generics a few USD; OTC consults free

Documents you’ll need

Cédula de extranjería (required for EPS affiliation)
Passport
Proof of declared income (for self-employed EPS and prepagada pricing)
Colombian bank account or card for monthly EPS/prepagada payments

Things most newcomers don’t know

EPS is remarkably cheap and near-universal — but the catch is the cédula de extranjería: you generally can't affiliate without it, and some visa classes (M-Pensionado, Type V) are barred from EPS entirely.

Newcomers expect to 'buy in' on arrival, but EPS is tied to legal residency and income declaration, so the timing is gated by your immigration status, not just willingness to pay.

Source: Stanford Baker expat healthcare guide; expatgroup.co social-security guide

The standard expat setup is EPS + medicina prepagada together, not one or the other — EPS is the cheap legal base and prepagada is the fast, comfortable layer on top (you must keep EPS active to hold prepagada).

EPS alone can mean long waits and overburdened public-leaning networks; prepagada alone isn't sold without an underlying EPS, so the combo (~US$75-175/month total) is how most foreigners get near-instant private care.

Source: Stanford Baker expat healthcare guide; colombiamove.com EPS vs prepagada

Medellín is a genuine world-class medical-tourism destination: JCI-accredited and top-ranked hospitals at roughly 50-70%+ below US prices, with English-speaking international patient offices.

Several of Colombia's and Latin America's best hospitals are concentrated here (Las Américas, Pablo Tobón Uribe, El Rosario, CES), so quality is high while dental, cosmetic and specialist costs are a fraction of US levels.

Source: Medellín Guru hospitals guide; Medellín.guide hospitals (2026)

Paying cash is a perfectly viable strategy for nomads without a cédula, because private care is so inexpensive — a GP visit is ~US$20-50 and a specialist ~US$60-105.

In many countries cash medicine is ruinous; in Medellín the out-of-pocket cost of routine private consultations and tests is low enough that short-term visitors often skip formal coverage and just pay (insurance still matters for hospitalisation/emergencies).

Source: Expatistan Medellín doctor price; Stanford Baker expat healthcare guide

Common mistakes to avoid

Assuming EPS satisfies your visa's health-insurance requirement — it usually does not; Digital Nomad/visitor visas demand all-risk private insurance valid in Colombia with explicit medical-repatriation cover, and plain travel insurance is rejected.
Trying to buy medicina prepagada without an active EPS — prepagada is sold as a top-up and you must hold EPS in parallel, so skipping the EPS step blocks enrolment.
Under-declaring income to lower your EPS contribution — it also lowers the income you can prove for visas, loans and renewals, and can create problems down the line.
Forgetting that 2026 reshuffled EPS territory (Decreto 0182 de 2026): an EPS with under 3% of a department's affiliates can no longer operate there, so confirm your chosen EPS actually serves Antioquia/Medellín before affiliating.