Innovative Health Care Solutions and Insurance Programs
Discover a comprehensive health care system structure involving government, insurance companies, administrators, and suppliers. Explore insurance options, benefits, and ambulatory services provided by leading consultancy firm Marsh Risk Consulting. Learn about SURA's health plans, network accessibility, and copayment details for various medical services.
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HEALTH CARE SYSTEM STRUCTURE GOVERNMENT INSURANCE COMPANIES POS EPS ADMINISTRATORS IPS SUPPLIERS 1 MARSH RISK CONSULTING 12 April 2025
INSURANCE PRE PAID PAC EPS SISBEN 2 MARSH RISK CONSULTING 12 April 2025
POS Basic Attention POS Catastrophic Events Benefits PAS Professional Risk Car Accidents 3 MARSH RISK CONSULTING 12 April 2025
SURA health plan and the benefits of an insurance program. SURA gives you the benefits of a pre-paid WIDE OUT WIDE COVERAGE OUT- -OF COVERAGE WITHOUT OF- -POCKET WITHOUT EXPENSIVE POCKET COSTS EXPENSIVE COSTS With an excellent administrative support, inside the company and among its providers. 4 MARSH RISK CONSULTING 12 April 2025
NETWORK NETWORK Directory Web page www.sura.com Su l nea You can also use services outside the network asking for reimbursement 5 MARSH RISK CONSULTING 12 April 2025
Ambulatory Services Copayment: Illness Emergencies and Doctor Visits (Specialists): For these services you should approach any of the institutions inside the network with your Policy ID and Personal ID. Once the service is authorized a copayment is required. Doctor Visits: $29.000, Illness Emergencies: $48.000. In case the emergency turns into an hospitalization or a surgery no copayment needs to be paid Lab Tests (Basic Tests): You should show Doctor s prescription, Personal ID and Policy ID. Copayment: $28.500 Diagnosis Examination: Doctor s Prescription and Medical Record, and send to: Sura: solisaludcal@suramericana.com.co Sura Platforms located inside Clinics, Fundaci n Cl nica Valle del Lili and Centro M dico Imbanaco. Once the information is sent, SURA will give an answer in 72 working hours Copayment: Basic Tests Lab $28.500 Special tests of Diagnostics $35.000. If you have problem with the process, you can contact: Delima Marsh Diana S nchez_ email: solicitudesmmbcali@marsh.com Phone: 6083100 Ext. 2726 6 MARSH RISK CONSULTING 12 April 2025
Ambulatory Services LABORATORIO DIN MICA NO COPAYMENT IN BASIC TESTS LAB Tequendama: Cl nica Vida: Cl 5c # 41 25 Cl 5D # 38 - 35 Phone: 5533387 Phone: 6857777 Services: Services: Lab Tests. TAC Echography MRI Mammogram Mammogram Colposcopy Echography Endoscopy and Colonoscopy X - Rays X - Rays Copaymen: Special tests of Diagnostics $35.000. 7 MARSH RISK CONSULTING 12 April 2025
Reimbursement 1. Reimbursement will be paid up to the value established for Doctor Visits: $100.300 Salud Sura and $105.500 Salud Global, the $29.000 copayment will be deducted. 2. In order to receive the reimbursement you should send the original copy of the invoice to: - Delima Marsh Diana S nchez e-mail. solicitudesmmbcali@marsh.com 6083100 2726 - Plataforms located in clinics Fundaci n Cl nica Valle del Lili and Centro M dico Imbanaco, Note: If reimbursements are requested to Delima Marsh, these will be deposited into your accounts. Other wise you have to pick up the check at Bogota Bank 8 MARSH RISK CONSULTING 12 April 2025
Priority Medical Home Care EMI and On Line Doctor On Line Doctor : This is a service provided by SURA to all Policy Holders through which you can consult over the phone any need related to your health. FREE OF CHARGE EMI: You can also have a priority medical home care EMI for any emergency that won t require transportation to any clinic or hospital. Copayment of $32.000 directly paid to EMI service at the time of the emergency. This service is subject to EMIs coverage nation wide. Where to call? Toll free 018000518888 From Bogot , Cali and Medell n, dialing 437 8888 From any cellphone #888 (free of charge) EMI 24 hours - Phone 6531313 9 MARSH RISK CONSULTING 12 April 2025
Copayments 2017 2018 COVERAGE COPAYMENT Therapy $12.700 per session Lab Tests, Obstetrical Echography, Infiltrations $28.500 Emergencies $48.000 Special tests of Diagnostics $35.000 Doctor s Visits (Specialists) $29.000 10 MARSH RISK CONSULTING 12 April 2025
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CALL CENTER - CENTRAL DE AUTORIZACIONES SULINEA NATIONAL: 01 800 051 8888 Bogota, Medell n y Cali: 437 88 88 Cel Phone : #888 PLATFORM Medell n Cl nica Las Am ricas Cl nica Las Vegas Cl nica El Rosario, El Tesoro Bogot Cl nica del Country Fundaci n Santaf de Bogot Cali Centro M dico Imbanaco Fundaci n Valle del Lili. 14 MARSH RISK CONSULTING 12 April 2025
Who do I call if I need assistance? To Assist-Card central offices in BOGOT There is an exclusive line for Suramericana, the phone call must be made as a collect call. Phone Numbers: 57-1-6237809 from abroad 018000910684 toll free from Colombia requires precertification 15 MARSH RISK CONSULTING 12 April 2025
How do I make the call? From abroad: So that the phone call is charged to ASSIST-CARD, you will have to ask for a collect call to the hotel operator or phone company operator; in case this is not possible, ASSIST- CARD will reimburse the cost of the phone call by showing the invoice. From any city inside Colombia: Just dial the toll free number. 16 MARSH RISK CONSULTING 12 April 2025
What do I say? Express clearly: Full name ID number Policy number Date of birth Explain your situation Address and phone number where you are located If you are in USA, area code or zip code (Assist-Card, will proceed to give you instructions to follow) 17 MARSH RISK CONSULTING 12 April 2025
How long my coverage will last? For a maximum of 90 days per trip. Right after day 91 you will have to purchase a new Assist-Card. If you have Salud Global for 2 or more years, SURA will study the possibility of an extension up to a maximum of 6 additional months (90 initial days + 180 additional days) (This only applies for working exchanges or international students) 18 MARSH RISK CONSULTING 12 April 2025
Assistance to travelers around the world Assistance outside Colombian territory Medical assistance, illness or accident, (4.000 smldv - US$34,368) Medical assistance in case of preexistent illness (2.000 smldv US$17.184) Medicine: 260 smldv (US$2,234) Odontology Emergency: 130 smldv (US$1.116) per piece 40 smdlv (US$344) Sanitary transfer and repatriation Transfer of a relative: maximum 25 smldv (US$215), no more than 10 days Hotel expenses due to convalescence, maximum 25 smldv (US$215), no more than 5 days Repatriation of remains Early return due to serious disaster at home Assistance in the event of lost or stolen passport, tickets, etc Transmission of urgent messages Assistance inside Colombian territory Medical transfer Transport of a relative in case policy holder is hospitalized Hotel expenses for a relative to a maximum 13 smldv (US$112), no more than 10 days Exchange rate: 2.862 19 MARSH RISK CONSULTING 12 April 2025
What services can I use in Colombia? Assistance inside Colombian territory only includes medical transportation, transfer of a relative in case of hospitalization and hotel expenses of the relative, maximum 13 SMDLV (US$112) o more than 10 days. (After evaluation and medical authorization) Exchange rate: 2.862 20 MARSH RISK CONSULTING 12 April 2025
What does it exclude? In addition to the policy exclusions, it also apply the following: Services that the insured had agreed on its own without previously and expressly had been authorized by Suramericana or by the ASSIST CARD Medical Department. Unless something out of hand stops you from communicating with them. Trips due to programmed treatments and programmed medical checkups. Services required by the insured as a consequence of a suicide or the injuries caused by a suicide attempt. Services required by the insured as a consequence of deceitful activities. 21 MARSH RISK CONSULTING 12 April 2025
What s the limit of the coverage provided by Assist-Card? The services provided by Assist-Card go up to the maximum amount agreed or up to the patient stabilization subsequent to the emergency. Subsequent events derived from the initial assistance, wont be authorized by Assist-Card. 22 MARSH RISK CONSULTING 12 April 2025
What is the coverage for ambulatory medicine? Medicine will be reimbursed 260 SMDLV (US$2,234) And you need to show the original invoices and a passport photocopy. (Policy holder information and passport stamps with dates of entry and departure) Exchange rate: 2.862 23 MARSH RISK CONSULTING 12 April 2025
What about if the purpose of my trip is because of a programmed medical treatment? ASSIST-CARD does not cover programmed events. The studies and/or treatments related to chronic pr pre-existing or congenital recurrent conditions. In case you need a medical treatment abroad, you have to require an authorization from SURA (PRE-CERTIFICATION) This has deductibles according to your destination a. 15% in USA and 25% in the rest of the world, of total billed, with a maximum of US$15.000 only if there is a pre certification b. 40% of total billed for cases where there is no pre certification. 24 MARSH RISK CONSULTING 12 April 2025
Rates 25 MARSH RISK CONSULTING 12 April 2025
Rates without taxes 2017 2018 MONTHLY PREMIUM VALUE SURAMERICANA 2017 2018 SIN IVA GLOBAL HEALTH HEALTH SURA HEALTH SURA 70 - 30 GRUPO ASEGURADO WITHOUT EPS WITH EPS WITHOUT EPS WITH EPS WITHOUT EPS WITH EPS 205.322 193.848 179.450 167.976 105.055 Insured under 60 years of age No aplica Insured ages 60 or more 428.738 417.264 368.738 357.264 229.130 No aplica Rate Frozen > 60 years 296.806 285.332 EPS DISCOUNT 11.474 11.474 Las anteriores tarifas no incluyen el valor del IVA del 5%. 26 MARSH RISK CONSULTING 12 April 2025
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