EN 
ES I have reached the age of majority and I am still not going to study. I was a beneficiary of one of my parents' EPS and I have been receiving treatment for HIV/AIDS. Is it possible that they will stop if I don't go to school?
No, incluso en caso de desvinculación de la EPS, aún se conserva el derecho a recibir el servicio iniciado antes de la desvinculación a la entidad de salud. Además, actualmente ya no se exige que se estudie para seguir siendo beneficiario de la EPS de los padres si se es menor de 24 años. En […]
Is it true that I must have the authorisation of the Technical Scientific Committee of the EPS in order to undergo a procedure or be given the medicines ordered by my treating doctor?
The concept of the attending physician is sufficient to access medication, as it is the doctor who, in addition to possessing qualified medical knowledge, is familiar with the patient’s state of health and is in a position to determine the medication or procedure most suitable for recovery (Judgment T-053/04, T-190/07).
My doctor prescribed a medicine or treatment excluded from the POS, it is very expensive and I cannot afford it. Can the EPS refuse to provide it?
Si el medicamento o el tratamiento no se pueden reemplazar por otros igual de efectivos que sí estén en el POS y si el no recibir el tratamiento causa un dolor muy grande o pone en peligro la vida, la EPS debe suministrarlo. Es importante recordar que el médico que formuló el medicamento o tratamiento […]
What can I do when it is not a medicine or treatment? For example, would it be acceptable for the EPS to refuse to provide the nutritional supplement I require as a result of my HIV/AIDS treatment?
Although it is true that nutritional supplements are not medicines and are excluded from the POS, it is considered that they are part of the treatment to which people living with HIV are entitled and, therefore, the EPS have the duty to provide them (Decision T-159/06).
If I have HIV/AIDS but my child does not, can I demand that the EPS provide formula?
Milk formula is included in the POS (Obligatory Health Plan) only for children of HIV-positive women under 6 months of age, as ordered by the treating physician (Decision T-681/14).
If I have lipoatrophy due to retroviral drugs, can I ask the EPS to perform a facial filler with hyaluronic acid?
El tratamiento de los pacientes que viven con VIH/SIDA debe ser integral y garantizar todos aquellos servicios que les permitan llevar el más alto nivel posible de bienestar físico, psicológico, emocional y social. Por lo tanto, si este es el caso, puede entenderse como derecho el recibir tratamiento aún y cuando no se esté incluido […]
I need a viral load test, can you refuse to test me?
The viral load test is essential for people living with HIV to establish the medical procedure to follow, and is currently included in the POS. Therefore, its performance must be guaranteed to those living in Colombian territory, regardless of whether they are in the subsidised or contributory health regime.
Is it the same with the viral genotyping test?
Yes, this test allows to determine the resistance of the virus to the drugs available for its treatment and is also included in the POS, so it should be provided if required.
Can my EPS require me to comply with a minimum contribution period in order to access treatments or procedures included in the POS that are considered high cost?
In the case of HIV/AIDS, as it is classified as a catastrophic illness, the rules relating to minimum contribution periods must be applied when this type of medical care is required and it is demonstrated that it is not possible to cover the cost. For this reason, the responsible entity cannot oppose to the payment of this [...].
My doctor prescribed a medicine under its generic name, but I don't think it is having the same effect as the medicine under its brand name. I want to take the commercial medicine, but it is not in the POS: can I still ask for it?
It can be ordered only if the doctor prescribes it, as this is one of the requirements for the granting of medicines excluded from the POS. The physician may exceptionally formulate it under a trade name only if it is of better quality, safety, efficacy and convenience. If the generic medicine produces the same effects, it is not necessary to formulate it under the trade name [...].
