Health Promotion Companies: Everything you need to know from experience

Hello! I introduce myself: I'm Amadeo Pérez and I'm here to talk to you about a topic that, although not usually the most exciting in the world, is crucial for all of us: the Empresas Promotoras de Salud (EPS) in Colombia. As someone who has dealt with these entities throughout my life, I believe I can give you a perspective that mixes personal experience with an in-depth analysis of how they work.

What are the Health Promoting Companies (EPS)?

The EPS are private or public entities in charge of managing health services for their affiliates in Colombia. Be careful! They are not hospitals or clinics, but rather a bridge between us, the users, and the health service providers, known as IPS (Instituciones Prestadoras de Salud).

To put it in simple terms, EPSs are the ones that make sure that when you get sick, there is someone to coordinate your care, that medications are available and that the whole process is as smooth as possible (although sometimes that smoothness is as scarce as water in the desert).

Types of EPSs in Colombia: Contributory vs. Subsidized

Before I get into my personal experience, I want to clarify something important. In Colombia, EPSs are divided into two main types:

2. Contributory EPSs: If you work formally, this is your place. Here, you and your employer make monthly contributions, and the EPS is in charge of managing your access to health services.
4. Subsidized EPS: These are designed for people who, for various reasons, cannot afford a contributory plan. If you are in the subsidized regime, the State assumes a good part of the costs

Now, what happens if you are unemployed or self-employed? Well, if you have the capacity to pay, you enter the contributory regime. Otherwise, you can access the subsidized regime, as long as you meet certain requirements, such as being classified in a low level of the Sisbén

My Story with EPSs: Lessons and Tips

Throughout my life, I have had the good fortune (or bad fortune) of being part of several EPSs. And this is where things get interesting... and a little frustrating. But let's take it step by step.

The first EPS: When everything seemed rosy... at first

I remember the first time I joined an EPS. I was young and thought everything would be simple - how naïve I was! For the first few months, everything went quite well. I felt secure knowing that I had a backup in case of illness. But, as they say, "all good things are short-lived". When the first serious pain came, the bureaucracy loomed in full force.

"Ah, you need an authorization for that," I was told. And then began the dance of appointments, forms and paperwork. It is here that you realize that being affiliated with an EPS is a journey of patience. Because, although they cover you for almost everything, you have to be willing to follow their rules, which are not always the easiest to understand.

The subsidized EPS: A relief for many, but not without challenges

Years later, things changed and I switched to a subsidized EPS. It was a different experience, but no less challenging. This EPS provided me with access to essential services, but I had to learn to navigate a system where resources are limited and sometimes waits are long. But I don't want to sound pessimistic; the reality is that for many people in Colombia, this regime is a blessing, especially for those who have no other option.

The Role of EPSs in Prevention and Health Promotion

One of the lesser known aspects of EPSs, and one that I have personally experienced, is their role in prevention and health promotion. Many EPSs offer vaccination programs, chronic disease control and promotion of healthy lifestyles.

For example, in my experience, I attended several hypertension control programs that helped me keep my health under control. Although sometimes these programs are not publicized enough, they are worthwhile and are a resource that many do not use simply because they do not know they exist.

The Challenge of Timely Care

Perhaps one of the biggest problems I have experienced with EPSs is timely care. While Law 100 of 1993, which regulates the health care system in Colombia, states that we all have the right to dignified and timely care, the reality is that this is not always met. I remember one occasion when I had to wait more than a month for an appointment with a specialist. The system was saturated, and although the EPS offered me other alternatives, none were viable for me at that time. These types of situations are common and something that any EPS user should be aware of.

How to Choose the Best EPS?

Now, if you are thinking of changing EPS, do your homework! Not all EPSs are the same. Some have better reputations in terms of user service, others in terms of the speed of their procedures. My advice is to do your research, ask other users and compare.

Here are my tips:

• Geographic coverage: Make sure the EPS covers the area where you live well.
• Provider network: Check if it has agreements with good hospitals and clinics near you.
• Customer service: Don't underestimate the importance of good customer service. I have had experiences where a good operator made all the difference.

The Importance of Knowing Your Rights

Finally, and perhaps most important of all, is to know your rights as a user of an EPS. For example, you have the right to receive quality care and to be treated with dignity and respect. And if you ever feel that these rights are being violated, do not hesitate to raise your voice.