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Outpatient Services

Individual ?
Family ?

Preventive Services

General Practitioner / PCP ?
Specialist ?
Subspecialist ?
Nutritionist ?
Chiropractor ?
Outpatient Facility ?
Prescribed Medical Equipment (DME) ?

Laboratory, X-Ray, Specialized and Imaging

Preventive Services ?

Emergency/Urgent Care Services

Laboratories ?
X-Rays ?
Sonogramas, CT, MRI ?

Hospitalization/Inpatient

Urgent Care Services ?
Emergency Services: Accident / Illness ?

Surgical Assistant

Hospitalization/Inpatient Partial (Including Mental Health) ?
Hospitalization/Inpatient Complete (Including Mental Health) ?
Skilled Nursing Facility ?

Emergency Services in the United States or Services in Cases that Require Equipment, Treatment and Facilities That Are Not Available In Puerto Rico.

Surgical Assistant ?

Vision

Emergency Services in the United States or Services in Cases that Require Equipment, Treatment and Facilities That Are Not Available In Puerto Rico. ?
Urgent Care Services in the United States - Sanitas ?

Dental Coverage

Refraction Test
(Vision for Children and Adults) ?
Pediatric Vision (Visual Correction Lenses or Frames for Visual Correction Lenses) ?
Glasses or Contact Lenses for Adults ?

Pharmacy Coverage

Preventive and Diagnostic ?

Other Services

Drug List ?
Annual Deductible ?
First Level of Coverage ?
Generics ?
Preferred Brand ?
Non-preferred Brand ?
Preferred Specialty ?
Non-preferred Specialty ?
Over The Counter Drugs (OTC) ?
Coinsurance After First Level of Coverage ?