Finding Health Insurance

Puerto Rico Insurance

Healthcare in Puerto Rico is similar to what you would find in the United States with some major differences, particularly with how insurance companies on the island work and what you should expect from hospital and doctors’ care. The information below includes tips, links and facts about finding the best healthcare and health insurance in Puerto Rico.

Can I keep my U.S. health insurance plan in Puerto Rico?

If you are traveling to Puerto Rico for a short amount of time, your U.S. health insurance plan will continue to cover you. If you plan on moving to Puerto Rico from the U.S., you will most likely need a new health care company. Puerto Rico provides universal healthcare access to 1.7 million people through its $2.3 billion Mi Salud program, of which 55% is funded through Medicaid.

Compared to U.S. insurance prices, Puerto Rico health insurance can sometimes cost half as much and covers much more. An individual PPO plan for a family of 5 is about $700 per month including medical, RX, dental and vision. A single medical plan including medical, RX, dental and vision is less than $200 per month.

With health insurance plans in Puerto Rico, you aren’t required to cover a certain amount of expenses before your insurance coverage kicks in. You pay a small co-pay (or none) for each medical visit, for medication that’s prepared for you and for every emergency room visit. This is, by and large, the practice and procedure. Of course, a lot may also depend on the kind of health plan you have.

Medicaid is valid on the island and will transfer with you. Check with the providers below for more information.

Four of the main health insurance companies in Puerto Rico:

Triple-S Salud

Humana (Medicaid only)

MCS (Medical Card System)

Mapfre

There are also “expat” health insurance programs available. They are much more expensive, but will cover you should you decide to move anywhere in the world.

Cigna Global

Quality of Health Care in Puerto Rico

Expect both good and bad experiences when dealing with health care providers in Puerto Rico. The city of San Juan offers some of the best hospitals and specialists on the island, so if you live close by, you will have an experience closer to what you would expect in any major U.S. city.

If you live further from San Juan you will still be able to find excellent health care. Just don’t expect much from the outside appearance of some of the offices. Your local family doctor, chiropractor or pediatrician office may be a run-down converted home on a pot-holed street without parking.

Inside, you will (for the most part) find a clean office with professional doctors and assistants who provide great one-on-one care. Your best bet is to get a referral from a friend, bring someone with you who speaks Spanish,  and get GPS coordinates. Many doctors lack websites or addresses that appear in Google maps and it may be difficult to communicate with office staff because many do not speak English.

Expect to wait

Health care in Puerto Rico is often a waiting game. You will almost always need to wait weeks or months for an appointment. You will spend several hours in the waiting room for every appointment. Exams and tests may require multiple appointments and multiple offices. Emergency rooms can be crowded and require very long waits.

If you need X-Rays or an MRI (and it isn’t an emergency), your doctor with write you a prescription and send you to an imaging center. You will make another appointment, go there and get your procedure done, and then pick up your film on another day. Then you will return the film to your doctor on another day. It’s a long process.

Health Insurance Puerto Rico

For the most part, the health insurance of Puerto Rico is pretty good. Many people who come from the US, in fact, feel it’s much better than in the United States. For one thing, it is significantly more affordable, with low premium rates, especially if your insurance goes through your employer. Also, there’s very little that insurance companies in Puerto Rico won’t cover. Hospital visits are affordable and you won’t get horrendously high bills.

Living Tips about Puerto Rico healthcare:

The advice given below is from my own experiences and from long-time Puerto Rican transplants and locals. Use at your own risk.

  •  In a minor emergency, your best bet may not be to rely on 911 or an ambulance. They may take hours to arrive.
  • If there is an emergency with a possibility of neck or spinal damage, always call 911 and don’t move the patient.
  • It’s recommended to bring a translator to the emergency room with you as most of the staff with be Spanish speaking only.
  • If you need to go to the hospital, bring your own blankets and pillows. It will be very cold and you may not be provided any.

The best urgent care and emergency rooms:

El Presby in Condado (Walk-in and urgent care)

Centro Medico Emergency Care. They have the best MD’s and services on the island, but it is a public hospital and very confusing to navigate and crowded (and cold!).

Healthcare Links:

Administración de Seguros de Salud – PR.government health care administration

MMAPA Medicaid and Medicare Advantage Products and Association of Puerto Rico

Puerto Rico Medicare Coalition for Fairness

 

 

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