INSURANCE
See the co-payments for the Sura Health Evolution Plan >>
With Sura's Evoluciona Health Insurance you can
Accessing the benefits of a health insurance policy
Having hospital and outpatient coverage.
Enjoy a wide network of quality providers.
Having health insurance is now easier than ever! With the Evoluciona Health Plan, you can access excellent service affordably and efficiently, thanks to hospital and outpatient coverage, the innovative home care component for emergencies and laboratories, and the extensive network of quality providers this plan offers.
This is complemented by a health risk management approach that aims to support and promote self-care.
Don't wait any longer, and start enjoying the health services that only Donau Seguros and SURA can offer you.
Furthermore, with SURA's Evoluciona Health Insurance, you'll have access to the SURA app. In the SURA Insurance app, you can:
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Schedule medical appointments at SURA Health centers.
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Request reimbursements.
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Consult the medical directory.
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Review your Health Insurance card.
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Request Virtual Assistance
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Access the Help Button
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Access the Rewards Plan
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Manage procedures with EPS Sura.
This Plan will expire if you decide to permanently reside abroad.
What does Sura's Evoluciona Health Insurance cover?
In our Health Evoluciona Plan, we offer a wide range of care and assistance services, including both inpatient and outpatient coverage, as well as emergency medical care.
Hospital and surgical expenses required for your treatment
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Private room with a bed for a companion
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Intensive Care Unit (ICU)
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Inpatient medical expenses
Fees for healthcare personnel for:
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Hospital visits
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Surgeon and anesthesiologist
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Registered nurse or nursing assistant
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Other
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Prostheses and supplies
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Maternity
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Protection for the unborn child
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Organ donation
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Imaging or radiological exams with co-payment
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Unlimited clinical laboratory tests with co-payment
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Dental Treatments for Accidents
Treatments for:
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Cancer
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Leukemia
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HIV/AIDS
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Kidney Disease (no waiting period)
Other outpatient medical treatments with co-payment:
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Scheduled outpatient surgeries, paying the co-payment amount indicated on the cover sheet.
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Treatments for fractures, dislocations, sprains, burns, bites, and sutures.
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Orthotics directly related to accidents treated in the emergency room within 30 days of the event. (No co-payment).
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Orthopedic corticosteroid injections, intratympanic and dermatological injections, excluding keloids or those considered purely cosmetic.
The following therapies will be covered upon payment of the co-payment amount indicated on the policy card:
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Physical, muscular and skeletal, speech, respiratory, cardiac, orthoptic, lymphatic, pleoptic, pelvic, occupational, and vestibular therapies.
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Swallowing therapies, limited to 20 sessions per year.
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Nebulizations.
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Puva therapy will be covered without co-payment through the network of affiliated providers.
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Home hospital medical care.
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Unlimited outpatient consultations with co-payment.
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Unlimited emergency medical care with co-payment.
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Unlimited home emergency medical care with co-payment.
Sura's Evoluciona Health Insurance does NOT cover you in the following events
In the following cases or for the following illnesses, SURA will not cover services, consultations, medical and surgical treatments, medications, laboratory tests and diagnostic aids or any other costs related to the coverages described in the insurance:
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Rehabilitation for alcoholism or drug addiction.
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Rehabilitation for eating disorders.
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Cosmetic surgery and plastic surgery are covered even if you have congenital diseases, except for functional reconstructive surgery as a result of an accident covered by insurance.
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Rhinoplasty
See the full insurance terms and conditions here .
Conditions for admission and continued coverage under the Evoluciona Health Insurance
This insurance is available to residents of Colombia under 70 years of age, and members can remain covered regardless of age. However, in group policies, dependent children and unmarried siblings of the policyholder can only remain covered until they turn 35. If you move abroad, this insurance will automatically terminate, except in cases where you accept in writing the exclusion of coverage abroad proposed by SURA.
Obligations of the policyholder and the insured
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You must fully complete the insurance application, truthfully declaring your health status and that of your family group, and answering all other questions asked.
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You must be affiliated and active with a Health Promoting Entity (EPS) under the Contributory Health Regime. SURA may request proof of your affiliation at any time to comply with the law, as your insurance will automatically terminate if you are not affiliated.
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Cancel to the doctors and institutions under agreement, the value of the co-payment or deductible indicated on the cover sheet, for the coverages that so stipulate.
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Treat medical and hospital staff and company officials with respect.
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Refrain from submitting fraudulent reimbursement requests or requests for medical services or care not received.
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Do not engage in illegal or unlawful activities.
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Make the policy premium payment within the agreed terms.
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Read and understand the general conditions and cover page of the contracted health plan.
Please note that in accordance with the provisions of Law 1438, Article 41, SURA may revoke the contract if you fail to comply with any of these obligations.
Termination of Health Insurance Evolves
This insurance will terminate for the following reasons:
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Failure to pay the corresponding insurance premium.
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Failure to fulfill your obligations.
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Identity theft of the policyholder or the insured.
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Involvement in illegal activities.
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Cancellation by submitting a duly signed written notice. Your cancellation will be effective from the date SURA receives this notice, as it will not be retroactive.
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Failure to truthfully and accurately declare your health status when applying for the insurance.
How to make a complaint?
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By calling SURA's customer service line in Bogotá, Cali or Medellín at 437 88 88 or in the rest of the country at 01 8000 0518 888
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By going to www.sura.com.co and selecting the "Log in to your account" option.
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Contact us directly via WhatsApp at +57 313 493 7761
Deadlines and terms
The premium is what you must pay for your health insurance, and you must pay it no later than one month after the date the policy or certificate was issued.
We remind you that failure to pay premiums on time as a breach of contract are grounds for denial of clinical or medical services, and cancellation of your insurance.
If your payments are up to date, we give you the option to renew the policy automatically.
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Frequently Asked Questions
When a family has 2 children over 2 years old and only the children are being enrolled, is anything required or are they insured without medical exams?
Children can be enrolled on their own and no exams are required, as long as there is no medical history.
Up to what age can optional add-ons for medical visits and emergency care be included?
Up to 60 years of age.
Can a policy be requested without having an EPS?
No, an active EPS is always required. It is also clarified that Sisben is not an EPS.
What requirements must be submitted for a person aged 46 or older?
Medical exam, urine test, glucose, total cholesterol, HDL cholesterol, triglycerides, and EKG.
Additional:
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For women: latest Pap smear result (report transcription) and a copy of a mammogram result not older than 1 year.
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For men: prostate-specific antigen (PSA) test result not older than 1 year.
If a pregnant woman wants to enroll in the policy, what are the requirements and coverage?
A medical exam, urine test, and prenatal medical history are required.
They will only be granted the outpatient consultation add-on, provided they accept a temporary 20% extra premium for the first year.
Paying this extra premium gives the insured the right to use the emergency add-on for illness (if purchased) for outpatient emergencies related to pregnancy complications.
What should be considered when requesting continuity (seniority recognition)?
Each policy must be reviewed before canceling the current contract or policy.
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A properly completed insurability declaration must be attached. If continuity is granted, it will be based on what the applicant declares.
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A certificate of seniority, usage, and pre-existing conditions from the previous insurer must be attached.
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Applicants must be under 60 years old.
What should be considered when transferring from prepaid medicine (MP) to a family health policy?
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Must be under 60 years old (only for Global Family Health Plan).
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The policy must be requested for the entire family group currently insured under the prepaid plan.
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Existing exclusions remain.
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The premium cannot be lower than the current prepaid plan.
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If the insured has a condition not covered by MP but covered by the policy, an exclusion or limitation will be applied.
What are EMI and MEC?
EMI (Comprehensive Medical Emergency):
Optional add-on for Global and Salud SURA policies. The user must call the provider directly. No copay applies.
MEC (Doctors at Home):
Urgent home medical care. Requires the emergency illness add-on. Available in Medellín, Cali, and Bogotá, operated by EMI.
Do health policies cover vaccines?
No.
When can an insured add coverage to their policy?
Optional add-ons like outpatient or emergency coverage can only be added at renewal.
Emergency medical add-ons can be requested at any time.
Who can be insured under collective health policies?
People grouped under a legal entity with employment contracts.
Minimum number of insured persons in a collective policy?
At least 10 members (employees) or heads of household.
Can I freeze the policy? For how long?
Yes, up to two times. Each freeze costs 20% of the premium and can last up to 2 years.
How long must a mother be insured to obtain automatic newborn and congenital coverage?
At least 300 days.
How long must a woman be insured to have maternity coverage?
Two cases:
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Alone: pregnancy after day one of the second year.
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With family: pregnancy after day one of year one plus two months.
If maternity applies, newborn and congenital coverage also apply.
What are the authorization channels?
Authorization line and CAS Salud.
Which channel authorizes scheduled events?
CAS Salud.
What documents are required for authorization?
Claim form, medical order, and clinical history if needed.
What documents are required for reimbursement?
Original invoices, medical order, test results, and clinical history if needed.
Difference between line and CAS authorizations?
Line: emergencies.
CAS: scheduled and complex events.
Can authorization be sent by fax or email?
Yes.
Coverage for sports medicine and ergometric evaluation?
Direct coverage in specific SURA locations; elsewhere via reimbursement.
Where to request reimbursement?
At CAS Salud or any branch with claim form and original invoices.
When does the policy cover dental care?
Only in case of accidents.
Travel assistance coverage?
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Economic community countries: up to €3,000
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Rest of the world: up to COP 54 million or equivalent
Can a monthly-paid annual policy be canceled anytime?
Yes, as long as payments are up to date.
How to change payment method?
Signed request; if switching to monthly, include bank authorization.
Can you switch to Global plan anytime?
No, only at renewal.
How are renewals handled in collective policies?
Based on previous claims ratio.
What is the care team?
Assigned group of healthcare professionals.
Composition of care team:
General practitioner, internist, and pediatrician.
How is the care team assigned?
Depends on age:
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Internist: over 16
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Pediatrician: 16 or under
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General practitioner: all ages
What does the new product cover?
Hospital and outpatient coverage.
Are outpatient and emergency services optional add-ons?
No, they are part of the base coverage.
Can the insured go directly to any specialist?
No, must first see the care team.
Specialties with direct access:
Ophthalmology and Gynecology.
Does this policy allow reimbursement?
No, closed network. Only emergencies may be reimbursed.
Does it include POS discount?
Yes.
Are outpatient services limited?
No, unlimited.
Maternity coverage conditions:
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Collective: pregnancy after 30 days
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Family: depends on insured group and time
Does the baby have automatic coverage?
Yes, if the mother has at least 27 weeks of continuous coverage.
Copay values:
(Values maintained as listed in original text.)
What to do if authorization is denied due to missing referral?
The insured must first see their care team doctor.
New claim types:
161, 157, 159.
Key product changes:
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Obstetric ultrasound is diagnostic
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Infiltrations are outpatient care
Is the initial consultation copay-free?
Yes.
Is referral required for diagnostics?
Yes.
Ultrasound limit:
3 per year.
Therapy limit:
45 per year per type.
Can the insured change care team?
Yes, unlimited times.
What is the Personalized Health Plan?
A health insurance integrating hospital and outpatient coverage with a personalized care model.
Where is coverage valid?
Only in Colombia.
Reimbursement processing time:
8 business days.
