They are monetary contributions that must be made exclusively by Affiliates who are beneficiaries of the Mandatory Health Plan POS, in accordance with the Contributing Affiliate's Base Contribution Income. The values of the Copayments correspond to a part of the value of the demanded service and are intended to help finance the system.

The services to which Copayments will apply are:

  • Hospitalization and Surgery.
  • Outpatient Procedures.
  • Diagnostic tests other than clinical laboratory and simple imaging.
  • Therapeutic Complementation.
  • Dental treatment.

And all other services contained in the Compulsory Health Plan, with the exception of:

  • Promotion and prevention services.
  • Control programs in maternal and child care.
  • Control programs in care of communicable diseases.
  • Catastrophic or high-cost diseases.
  • Initial emergency care and those services subject to the collection of Moderating Fees.

2020 Copays
Amount of copayments per beneficiary affiliate: The value per calendar year allowed for copayments will be determined for each beneficiary based on the income of the contributing affiliate, expressed in legal monthly minimum wages in force as follows:

COPAYMENTS – Contributory Regime Year 2020
TOP IN THE SAME EVENT MAXIMUM CAP YEAR
Stratum Maximum stop in % Maximum limit in pesos Maximum stop in % Maximum limit in pesos
Stratum 1 (Less than 2 SMLMV) 28,7% $251.929 57,50% $504.737
Stratum 2 (Between 2 and 5 SMLMV) 115,00% $1.009.473 230,00% $2.018.947
Stratum 3 (Greater than 5 SMLMV) 230,00% $2.018.947 460,00% $ 4.037.894

*The rate applies according to the rate agreed by the EPS with the IPS

COPAYMENTS – Subsidized Regime Year 2020
Sisben levelTop in the same eventMaximum cap per year
Maximum stop in %Maximum limit in pesosMaximum stop in %Maximum limit in pesos
LEVEL 0Does not applyDoes not applyDoes not applyDoes not apply
LEVEL 1Does not applyDoes not applyDoes not applyDoes not apply
LEVEL 250%$ 439.902100%$ 877.803

*The value applies according to the rate agreed by the EPS and the IPS.

Note. As established in Agreement 260 of 2004, it is important to take into account that:

  • The moderator fees will be applicable to contributing affiliates and their beneficiaries, while co-payments will be applied solely and exclusively to beneficiary affiliates.
  • In accordance with the third numeral of article 160 of Law 100 of 1993, it is the duty of the contributing affiliate and the beneficiaries to pay the moderator fees and the corresponding co-payments.
  • In no case may co-payments and moderator fees be applied simultaneously for the same service.

When the percentage of the total value of the service exceeds the stipulated limits, the user will only pay the maximum values per event or per year, as the case may be.

The Ministry of Health and Social Protection, in accordance with the special laws on Health, has defined specific population groups that are exempted from payment of moderator fees and co-payments and the conditions for application of said exceptions, information that can be consulted at the annexed document Circular 0016 of March 22, 2014 issued by the Ministry, valid at the national level. Only for the Subsidized Regime in the city of Bogotá DC, Decree 345 of 2008 issued by the Mayor's Office of Bogotá also applies (see information in attached documents)

ON 08012020
Comfenalco Valle Delagente
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