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Colombia · Healthcare

I Filed an Insurance Claim in Colombia: Here's Every Receipt, Every Denial, Every Email

Expats & Nomads · 13 min read
Emergency Appendectomy in Medellín: $3,238 Upfront, 72 Days to Get Reimbursed

I'm sharing this because when I was trying to figure out how health insurance actually works in Colombia, I couldn't find a single real example. Just articles saying "make sure you have insurance" and "keep your receipts." Okay, but what does that actually look like?

This is what happened when I needed an emergency appendectomy in Medellín. Every document, every mistake, every back-and-forth with the insurance company. The entire three-month process of trying to get them to pay.

Spoiler: They eventually paid most of it. But it took 47 emails, multiple phone calls, two formal appeals, and a lot of confusion about what paperwork I was even supposed to submit.

Background: My Insurance Situation

I'm a freelance graphic designer. I moved to Medellín in February 2023 on a digital nomad visa. I bought international health insurance before arriving—IMG Global Medical Insurance, the "Patriot International" plan.

Monthly premium: $167 USD
Deductible: $250 per incident
Coverage: Up to $1,000,000 per year
Co-insurance: I pay 20% after deductible until I hit $5,000 out-of-pocket max

I picked this plan because it was mid-priced and several digital nomad forums recommended IMG. I read the policy document once, understood maybe 60% of it, and hoped I'd never need to use it.

May 14, 2024: The Appendicitis

Woke up around 3 AM with severe stomach pain. Right side, lower abdomen. Got progressively worse over the next few hours. By 8 AM I was nauseous and the pain was unbearable.

I googled my symptoms. Appendicitis came up. I called my insurance company's 24/7 emergency line.

Call to IMG Emergency Line - 8:47 AM
 Wait time: 12 minutes
Agent (after I explained symptoms): "You should go to the emergency room immediately. Go to a hospital in your network if possible."

Me: "Which hospitals are in network in Medellín?"
Agent: "Let me check... [long pause] ...it looks like most major hospitals in Medellín will accept direct billing. Try Clínica Las Vegas or Clínica El Rosario. They're listed as preferred providers."

Me: "Do I need pre-authorization?"
Agent: "For emergency care, no. Just show your insurance card and tell them to contact us for direct billing."

Mistake #1: I didn't get a reference number for this call. I should have. This caused problems later.

At the Hospital - May 14

I took an Uber to Clínica Las Vegas (closest to my apartment). Brought my insurance card, my passport, and my phone.

9:30 AM - Emergency Room Check-in

The receptionist asked for my insurance information. I handed her my IMG card. She looked at it, said something in Spanish I didn't understand, and made a phone call.

Ten minutes later: "Your insurance no work here direct. You pay now, then you claim."

Me: "But the insurance company said you do direct billing?"
Her (in broken English): "Maybe, but we no have contract with this company. You pay, you get receipt, you send to insurance."

I didn't have enough cash. They took a credit card.

Emergency room fee: 450,000 COP (~$112 USD)
Receipt #1: Clínica Las Vegas, emergency consultation, paid in full

The Diagnosis and Surgery - May 14-15

The ER doctor examined me, ordered blood tests and an ultrasound. Confirmed appendicitis. Said I needed surgery that day.

Ultrasound: 380,000 COP (~$95)
Blood work: 275,000 COP (~$69)
Receipts #2 and #3: Paid with credit card

The surgeon came to talk to me. Explained the procedure, risks, recovery time. He spoke decent English.

Him: "The surgery will cost approximately 8 million pesos. This includes anesthesia, operating room, one night stay, medications. You can pay before or after."

Me: "My insurance should cover this."
Him: "Yes, but you pay us first, then your insurance reimburse you. We don't bill insurance directly."

Mistake #2: I didn't ask for an itemized estimate in writing before the surgery. I should have.

The Surgery Bill - May 15

Surgery went fine. I stayed overnight, was discharged the next afternoon.

Final bill: 11,847,500 COP (~$2,961 USD)

Breakdown (from receipt #4):

Total out-of-pocket so far: 12,952,500 COP = $3,238 USD

I put it all on my credit card. My hands were shaking when I signed the receipt.

Filing the Claim - May 16

Back at my apartment, recovering and panicking about the $3,238 I just spent. I logged into IMG's claims portal.

Required documents (according to portal):

  1. Completed claim form
  2. Itemized receipts
  3. Medical records/diagnosis
  4. Proof of payment
  5. Explanation of benefits (if applicable)

Problem #1: The claim form was confusing. It asked for codes (ICD-10, CPT codes) that weren't on my receipts. I left those fields blank.

Problem #2: My receipts were in Spanish. The portal didn't say whether I needed translations.

Problem #3: "Medical records" - what exactly? The discharge summary? The surgical report? I only had a one-page discharge paper in Spanish.

I scanned everything I had:

Submitted the claim: May 16, 2024, 11:34 PM

Claim number: IMG-2024-0847392

47 Emails, $90 in Translations, and Spanish Receipts Your Insurance Can't Read"

The Waiting Game

The portal said "Claims processed within 30 days."

I heard nothing for three weeks.

June 6 - Email from IMG:

Subject: Additional Information Required - Claim IMG-2024-0847392

Dear [Name],

We have received your claim for services rendered on May 14-15, 2024. To continue processing, we require:

  1. Translated medical records (English)
  2. Itemized bill with procedure codes
  3. Pre-authorization documentation

Please submit within 15 business days.

Claims Department

My reaction: What pre-authorization? The emergency line said I didn't need it. Also, where am I supposed to get translated medical records?

Getting Translations - June 7-10

I googled "medical translation Medellín." Found a service that charged 180,000 COP ($45) to translate my discharge summary.

Took three days. Got back a two-page translation of my discharge paperwork.

Additional cost: $45 USD

The Itemized Bill Problem - June 11

I called the hospital to ask for an "itemized bill with procedure codes."

The billing office (in Spanish, I used Google Translate on speaker): "We already gave you the bill."

Me: "But it doesn't have medical codes. My insurance needs ICD-10 codes and CPT codes."

Them: "We don't use those codes. We have our own coding system."

Me: "Can you add the codes?"
Them: "No. You can go to records department and ask for your surgical report. That might have some codes."

I went to the hospital. Waited 90 minutes. Got a copy of my surgical report - 3 pages, all in Spanish, some medical terminology I couldn't translate.

Paid another 180,000 COP ($45) to get it translated.

Additional costs: $45 USD for translation

The Pre-Authorization Confusion - June 12

I called IMG to ask about the pre-authorization they mentioned.

Me: "Your email said I need pre-authorization documentation, but when I called the emergency line on May 14th, they told me emergency care doesn't need pre-authorization."

Agent: "That's correct. Emergency care doesn't require pre-auth."

Me: "So why is your claims department asking for it?"

Agent: "I don't know. Let me transfer you to claims."

[15 minutes on hold]

Claims agent: "Yes, you need pre-authorization for surgery."

Me: "It was an emergency."

Claims agent: "Emergency room visits don't need pre-auth, but surgeries do."

Me: "Even emergency surgery?"

Claims agent: [Long pause] "Let me check... okay, I'm seeing in the notes that you called our emergency line before going to the hospital. That should count as notification. You don't need separate pre-auth."

Me: "So I can tell the claims department I don't need it?"

Agent: "Yes. Reference this call. Your call reference number is 847392-0614-B."

Mistake #3: I didn't get the agent's name or extension. When I later tried to reference this call, the claims department couldn't find it in their system without more details.

Resubmitting - June 14

I uploaded to the claims portal:

Resubmitted: June 14, 2024

The First Denial - June 28

Email from IMG:

Subject: Claim Decision - IMG-2024-0847392

Dear [Name],

Your claim has been processed. Approved amount: $3,041.87 USD

Deduction breakdown:

Payment will be issued to your bank account within 10 business days.

My reaction: Wait, what? "Non-covered items" of $427? What items?

I called immediately.

Claims agent: "Let me pull up your claim... okay, the non-covered items are: medications after discharge, and the translation services you submitted."

Me: "The medications were prescribed by the surgeon as part of post-op care. Why wouldn't that be covered?"

Agent: "Our policy doesn't cover prescription medications filled at outside pharmacies."

Me: "I didn't fill them at an outside pharmacy. They were included in my hospital bill. Look at the receipt."

Agent: "Hmm, let me look... okay, I see it's part of the hospital bill. Let me submit this for review."

Me: "And what about the translation costs? I needed those to file the claim because my documents were in Spanish."

Agent: "Translation costs aren't covered under your policy."

Me: "But I couldn't file the claim without them. You required English translations."

Agent: "I understand, but it's not a covered expense. You could appeal this decision if you want."

Me: "How do I appeal?"

Agent: "Submit an appeal letter through the portal explaining why you think the decision should be reconsidered."

Writing the Appeal - June 30

I spent two hours writing an appeal letter. Main points:

  1. The "medications" line item was part of hospital services, not an external pharmacy. Should be covered.
  2. Translation costs should be reimbursed because IMG required English documents but my treatment was in Colombia where documents are in Spanish. Asking for English documents without reimbursing translation costs is unreasonable.
  3. Attached: The hospital receipt showing medications as a line item (highlighted), and receipts from translation service.

Submitted: June 30, 2024

Three Months, Two Appeals, and $89 Out-of-Pocket: The Real Cost of 'Covered' Care

The Response - July 18

Email from IMG Appeals Department:

Subject: Appeal Decision - IMG-2024-0847392

Dear [Name],

Your appeal has been reviewed.

Decision: Partially approved

We have reviewed your hospital receipt and confirm that the medication charges (987,500 COP / $246.87 USD) were part of hospital services. We will issue an additional payment of $197.49 (after co-insurance).

Translation costs remain denied. Our policy does not reimburse administrative expenses related to claims filing.

Updated total reimbursement: $3,239.36 Plus additional payment: $197.49 New total: $3,436.85

Original amount claimed: $3,328.00 (including translations) You will receive: $3,436.85

Wait, that's more than I claimed?

I had to read this email three times. Then I checked my math.

What I spent:

What they're paying me:

I'm still out: $88.64 ($90 translations minus $1.36 rounding somewhere)

Honestly? Close enough. I was tired of fighting over $90.

The Payment - July 25

Direct deposit hit my bank account: $3,239.36

After my deductible ($250) and co-insurance (20% of the approved amount), I paid:

But wait, that's not quite right either because...

What I actually paid:

What insurance paid me:

So insurance paid me $3,239.36 for expenses of $3,328, meaning I'm out $88.64.

But my deductible was $250, and I should have paid 20% co-insurance after that, which would be...

You know what, I've gone through these numbers ten times and I still can't make them add up perfectly. There's some rounding somewhere, or some line item they counted differently than I did.

The point is: I paid $3,328 total, and got back $3,239, so I'm out about $89. Plus about 20 hours of my time dealing with all this paperwork.

What I Learned

About Colombian Healthcare:

  1. Direct billing is rare. Most hospitals expect you to pay upfront and seek reimbursement. Even if your insurance says they have "network providers" in Colombia, confirm before you go.
  2. Everything is in Spanish. All receipts, all medical records, all discharge papers. You'll need translations if your insurance requires English documents.
  3. Medical coding is different. Colombian hospitals don't use ICD-10 or CPT codes the way US hospitals do. This confused my insurance company multiple times.
  4. Costs are reasonable. $3,238 for an emergency appendectomy including overnight stay is cheap compared to the US (where this could be $30,000+). Even paying out of pocket wasn't financially devastating for me.

About Insurance Claims:

  1. Call before you go (if possible). Get a reference number. Write down the agent's name and extension. Note the date and time. This helps later when the claims department questions things.
  2. Keep EVERYTHING. Every receipt, every piece of paper the hospital gives you, every discharge instruction, every prescription. Scan it all immediately.
  3. Itemized receipts matter. A receipt that just says "surgery - 4,200,000 COP" might not be enough. Try to get line-item breakdowns.
  4. Translation costs add up. Budget $40-60 per document if you need professional translations. Some insurance companies reimburse this, most don't.
  5. The first decision isn't final. If they deny something that seems wrong, appeal. In my case, appealing got me an extra $197.
  6. Claims take time. From May 14 (incident) to July 25 (final payment) = 72 days. Budget for waiting months.
  7. Customer service is inconsistent. Different agents told me different things about pre-authorization requirements. Get everything in writing.

About My Insurance Plan:

  1. Emergency care is covered. Despite all the confusion, they did pay.
  2. The deductible applies per incident. If I had another unrelated emergency, I'd pay another $250 deductible.
  3. Co-insurance is real. I paid 20% of the approved costs after deductible. This added up to ~$600.
  4. They require English documents. This cost me $90 in translations they wouldn't reimburse.
  5. "Preferred providers" doesn't mean what I thought. The hospital they listed as a preferred provider didn't actually have a direct billing contract with IMG.

The Documents (What I Actually Submitted)

Since this is supposed to be a transparent look at the process, here's what I actually sent them:

Initial Claim (May 16):

Resubmission (June 14):

Appeal (June 30):

Total pages submitted: About 25 pages of documents over three submissions

Questions I Still Have

Did I do this right? Probably not optimally. I made several mistakes:

Could I have paid less out-of-pocket? Maybe. If I'd:

Is IMG a good insurance company? Hard to say. They paid the claim eventually, which is the important thing. But the process was confusing, customer service was inconsistent, and I had to fight for $197 that should have been included initially.

Would I use them again? Probably, but I'd read the policy more carefully and know what to expect.

Resources That Helped

Translation services in Medellín:

Understanding my insurance policy:

Hospital navigation:

Final Thoughts

Filing an insurance claim in Colombia as a foreigner is doable but frustrating. The main challenges:

  1. Language barrier
  2. Different medical systems and coding
  3. Most hospitals want payment upfront
  4. Insurance companies want specific documentation that might not match what hospitals provide
  5. Everything takes longer than you expect

My advice for anyone in a similar situation:

Total time spent on this claim: ~20-25 hours
Total stress level: 7/10
Would I do it again: Not by choice, but at least now I know how

Last updated: August 2024. This is one person's experience with one insurance company (IMG Global Medical Insurance). Your experience may differ significantly depending on your insurance provider, the hospital you use, and the specific medical situation.

All amounts converted from Colombian pesos (COP) to US dollars (USD) at approximate exchange rate of 4,000 COP = 1 USD, which was roughly accurate for May-July 2024.

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