Marilú is a 68-year-old retired woman who lives in the town of Arecibo. After working for over 30 years managing a medical office, she has dedicated her retirement to enjoying walks three times a week with her friends, reading, spending time with her grandchildren, and, of course, taking care of her health.
For the past three years, she had relied on her Triple-S Advantage health plan to cover all her needs, from medical checkups to prescription drugs. However, this year, she realized she needed to review her plan to ensure it covered her new needs, based on her current health condition. Her vision was deteriorating, she required new medications, and a different dental procedure was necessary.
It was time to review her Medicare Advantage coverage. Marilú knew that the open enrollment period, which runs from October 15 to December 7, is the perfect time to seek guidance and ensure that Triple-S Advantage would cover all her health needs with the best care in 2025.
Step 1: Understanding the Changes to the Plan for 2025
Marilú decided to sit down with her notebook and jot down how her health had changed since she enrolled in her current health plan. She realized that:
- She now needs new glasses every year.
- She had two new medications prescribed.
- Her visits to the dentist had increased due to a treatment that required regular
That week, she received a book from Triple-S in the mail explaining the changes to her coverage, effective January 1, 2025. She took the time to read the material and evaluate what she needed to consider.
Step 2: Considerations when evaluating your coverage for next year
Marilú recognized that her needs had changed, so she calculated and asked herself the following:
- Have my medications changed? She decided to find a plan with low copayments to save money when visiting the pharmacy
- Which dental procedures does my current plan cover? She spoke with her specialist about her current treatment, and since she only needed routine visits during the year, she could choose simpler coverage and take advantage of other benefits.
- Will I need transportation to my appointments? Marilú has a car and prefers to get to her appointments on her own, so she chose a coverage with a few trips to take advantage of other benefits.
- Will I need financial assistance to make sure I have more of my Social Security check left over? She found that Triple-S Advantage plans offer the benefit of contributing to the Part B premium that allows her to save that money by paying Medicare less.
Step 3: Make an informed decision and make the change
After considering various options, Marilú discovered a plan that provided exactly what she needed for her current healthcare. She was relieved she had chosen a Triple-S plan that fit her health needs and would allow her to receive the best care possible in 2025.
Like Marilú, if you are considering changing your Triple-S Advantage plan, we recommend you:
- Visit our service offices, located throughout the island.
- Call our Member Service Center and receive a full orientation from the comfort of your home. The toll-free phone number is 1-888-620-1919, 1-888-620-2520 TTY (hearing impaired) Monday through Sunday from 8 a.m. to 8 p.m.
Remember, it’s essential to take the time each year, like Marilú, to review your coverage and continue enjoying a healthy retirement.
Triple-S Advantage, Inc. is a Health Maintenance Organization (HMO) and a Preferred Provider Organization (PPO) under contract with Medicare. Enrollment in Triple-S Advantage, Inc. is contingent upon renewal of the contract. Triple-S Advantage, Inc. is an independent licensee of BlueCross BlueShield Association. Triple-S Advantage, Inc. cumple con las leyes federales aplicables de derechos civiles y no discrimina por razón de raza, color, origen de nacionalidad, edad, discapacidad, o sexo. Triple-S Advantage, Inc. Triple-S Advantage, Inc. complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.遵守適用的聯邦民權法律規定, 不因種族、膚色、民族血統、年齡、殘障或性別而歧視任何人ATENCIÓN: Si usted habla español, servicios de asistencia lingüística están disponibles libre de cargo para usted. Llame al: 1-888-620-1919 (TTY: 1-866-620-2520). ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call: 1-888-620-1919 (TTY: 1-866-620-2520).注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 1-888-620-1919 (TTY: 1-866-620-2520).
