This functionality is implemented using Javascript. It cannot work without it, etc...

We are loading the information...

Skip to main content

Health Plan for Families

Live confidently in knowing that your family is protected by a health plan accepted in 100% of hospitals in Puerto Rico.

Children are wonderful. We want to keep them healthy, but so much love and joy comes hand in hand with an endless concern for their health. From “don’t put your finger in that plug!” to “if your friends jumped from a bridge, would you jump too?” Parenting is a 24/7 job. With so much on your mind you should be able to have peace of mind about the health insurance plan that covers your medical needs and theirs too. You also don’t have to worry about your child being left out of the coverage after college while looking for a job, since he or she can be under your health plan until age 26.

Just like choosing the best school for their future, you must choose a family health plan that has the best network of providers, and that responds in an emergency both here in Puerto Rico and in the United States. Triple-S offers just that. Our network of over 10,000 doctors, hospitals and laboratories of your choice will cover them no matter what kind of care is needed. Also, if someone has an emergency during a family vacation in the United States, they are covered through Blue Card Program (only emergency services and those pre-certified by Triple-S). Having a good family health insurance plan will give you more peace of mind when your child tells you “I want be a professional skater” or “I want to go backpacking around the world with my friends.”

Sit down with your partner and you will see that having a Triple-S Family Health Plan will take a load off your mind. We have been protecting more than 1.7 million Puerto Ricans for 50 years. Choose the best option for family healthcare plan with Triple-S so you can concentrate on convincing your children that not everything should be posted on social networks. Check the list of necessary documents to apply for your family health insurance.

The family health plan covers

  • Vaccunation services as required by federal law without copayments so your children are safe at school
  • Unlimited visits to pediatricians and other primary care physicians, specialists and subspecialists
  • Dental coverage so your sweet tooth does not turn into tooth decay
  • Physical therapy in case yoga fails you
  • Pharmacy coverage for medication that will make them feel better, faster.

Coverage of this plan

Hospital Services

  • Semi-private room, 365 days a year
  • Hospitalizations for mental conditions and substance abuse
  • Skilled Nursing Facility (SNF) unit

Hospital Medical & Surgical Services

  • Visits from physicians to hospitalized patients; specialist consultations and diagnostic services
  • Skin, bone, and cornea transplants
  • Surgery and anesthesia
  • Extracorporeal Shock Wave Lithotripsy (ESWL) procedure
  • Invasive cardiovascular tests and gastrointestinal endoscopies

Medical-Outpatient Services

  • Unlimited visits to primary care physicians (PCP), specialists, and subspecialists
  • Visits to podiatrists, optometrists, audiologists, and chiropractors
  • Visits to the psychiatrist and psychologist; including group therapy and collateral visits for mental conditions and substance abuse
  • Visits to a nutritionist, up to six per policy year
  • Clinical laboratories and X-rays
  • Outpatient surgery at the doctor’s office
  • Home Health Care
  • Emergency Room Services
  • Ground ambulance services, up to $80 per case
  • Preventive services and vaccines, as required by federal law

Specialized Diagnostic Tests

  • Cardiovascular and vascular non-invasive tests
  • Neurological tests
  • Nuclear medicine tests
  • Computed tomography and MRI, one test per anatomical region, per policy year
  • Sonograms and SPECT
  • Echocardiograms and electroencephalograms
  • PET CT and PET Scan, one per year

Maternity

  • Pre and Post-Natal visits
  • Hospitalization costs for natural childbirth or cesarean section
  • Biophysical profile, one per pregnancy, 50% coinsurance
  • Production and interpretation of fetal monitoring
  • Visits for preventive newborn care

Services in the United States

The Blue Card Program offers coverage for emergency care and for services that have been pre-certified by Triple-S Salud. You are responsible for the coinsurance corresponding to the benefit in the United States, according to the coverage you select.

Pharmacy

Brand and generic drugs as the first option from a list of medications. Except when there is no generic drug available in the market for a brand-named drug. If the insured chooses, or the physician prescribes, a brand-name drug when the generic drug is available in the market, the insured will pay the brand-name drug copayment / coinsurance and the difference between the brand-name drug and the generic.

Dental Services

You’re 100% covered with any of our dental plans, which offer diagnostic and preventive services. $0 copay for the following services:

  • Initial comprehensive exam by generalist or specialist
  • Routine periodic exams
  • Emergency exam
  • Individual periapical x-rays
  • Bitewings x-rays
  • Dental Prophylaxis (cleanings)
  • Fluoride (topical) varnish application to children under age 5
  • Topical Fluoride applications to children under age19
  • Topical fluoride applications only for adults with special conditions

Additional Benefits

  • Triple-S Natural: Enjoy the benefits of alternative therapies, such as acupuncture, aromatherapy and naturopathic medicine, among others, for up to six visits
  • Glasses: One pair per policy year for those insured, until age 21
  • Durable Medical Equipment

Health Plan for Couples

Whether you’re just starting a life together, planning on having kids or ready to live life to the fullest, Triple-S Directo offers peace of mind with our Couples healthcare plan.

What side of the bed do you prefer? Who gets what chore around the house? Who takes the dog out? Will we have children? How many? When you live as a couple there are many decisions to take into account, among these, which health insurance plan is best for your lifestyle.

Let’s be honest, living with a partner means adjusting yourself to someone else in order to build a life together and that’s what Triple-S health insurance plans for couples do for you. We offer full protection to complement your lifestyle. If your interest lies in building a family, they have maternity coverage that also covers baby appointments during their first year of life.

Now, if what you prefer is traveling to the United States and enjoying life without thinking about kids, you can relax because you are covered by the Blue Card program wherever you go.

As they say, it’s better to be safe than sorry, and a list of preventive diagnostic tests are available to you without copayments. That way, you prevent something now that you may regret later.

Think about how going through an emergency situation without health insurance would cause serious damage to your budget, which could delay your plans. With a Triple-S healthcare plan for couples, you can be sure that you will be covered by the widest provider network of doctors, hospitals and laboratories in Puerto Rico. This means that 100% of hospitals in Puerto Rico accept Triple-S medical plans.

In addition, all our medical plans include pharmacy and dental, so that a toothache and buying medicine don’t turn into a problem for the savings you are gathering for the dining table you so desperately need. Is it the paperwork that discourages you from requesting a healthcare plan? Check the list of necessary documents [link to checklist] to request your couples insurance, and you’ll see how it’s much easier than you think. Apply online; it will be a lot easier than choosing the size of the TV in your room.

The health insurance plan for couples includes:

  • Maternity coverage for when you decide to have children.
  • Visits to podiatrists, optometrists, audiologists and chiropractors to pay attention to those areas of the body that cannot be ignored when they start acting up
  • Dental Plan to help you take care of that smile with which you conquered your partner
  • X-Ray services in case somebody slips in the garage when the floor is wet

Coverage of this plan

Hospital Services

  • Semi-private room, 365 days a year
  • Hospitalizations for mental conditions and substance abuse
  • Skilled Nursing Facility (SNF) unit

Hospital Medical & Surgical Services

  • Visits from physicians to hospitalized patients; specialist consultations and diagnostic services
  • Skin, bone, and cornea transplants
  • Surgery and anesthesia
  • Extracorporeal Shock Wave Lithotripsy (ESWL) procedure
  • Invasive cardiovascular tests and gastrointestinal endoscopies

Medical-Outpatient Services

  • Unlimited visits to primary care physicians (PCP), specialists, and subspecialists
  • Visits to podiatrists, optometrists, audiologists, and chiropractors
  • Visits to the psychiatrist and psychologist; including group therapy and collateral visits for mental conditions and substance abuse
  • Visits to a nutritionist, up to six per policy year
  • Clinical laboratories and X-rays
  • Outpatient surgery at the doctor’s office
  • Home Health Care
  • Emergency Room Services
  • Ground ambulance services, up to $80 per case
  • Preventive and vaccine services, as required by federal law

Specialized Diagnostic Tests

  • Cardiovascular and vascular non-invasive tests
  • Neurological tests
  • Nuclear medicine tests
  • Computed tomography and MRI, one test per anatomical region, per policy year
  • Sonograms and SPECT
  • Echocardiograms and electroencephalograms
  • PET CT and PET Scan, one per year

Maternity

  • Pre and Post-Natal visits
  • Hospitalization costs for natural childbirth or cesarean section
  • Biophysical profile, one per pregnancy, 50% coinsurance
  • Production and interpretation of fetal monitoring
  • Visits for preventive newborn care

Services in the United States

The Blue Card Program offers coverage for emergency care and for services that have been pre-certified by Triple-S Salud. You are responsible for the coinsurance corresponding to the benefit in the United States, according to the coverage you select.

Pharmacy

Brand and generic drugs as the first option from a list of medications. Except when there is no generic drug available in the market for a brand-named drug. If the insured chooses, or the physician prescribes, a brand-name drug when the generic drug is available in the market, the insured will pay the brand-name drug copayment / coinsurance and the difference between the brand-name drug and the generic.

Dental Services

You’re 100% covered with any of our dental plans, which offer diagnostic and preventive services. $0 copay for the following services:

  • Initial comprehensive exam by generalist or specialist
  • Routine periodic exams
  • Emergency exam
  • Individual periapical x-rays
  • Bitewings x-rays
  • Dental Prophylaxis (cleanings)
  • Fluoride (topical) varnish application to children under age 5
  • Topical Fluoride applications to children under age19
  • Topical fluoride applications only for adults with special conditions

Additional Benefits

  • Triple-S Natural: Enjoy the benefits of alternative therapies, such as acupuncture, aromatherapy and naturopathic medicine, among others, for up to six visits.
  • Glasses: One pair per policy year for those insured, until age 21
  • Durable Medical Equipment

Health Plan for Singles without Children

Health Plan for Singles without Children Learn about the health plan options Triple-S Directo offers singles, available to protect you at this stage of your life at an affordable price.

Think about what you’re doing these days. Did you just graduate from college? Are you about to start a business because you want to have something of your own? Do you want to go out into the world with no worries? Maybe you have your mind set on living, on doing things you have never done before and that’s great, but you’ll need the protection of a specialized healthcare plan for singles, so it can join you on your adventures.

For you, a new business owner on a tight budget, Triple-S healthcare plans have options at affordable prices. It will cost much less than a visit to a doctor, with X-Ray readings and medications that you will have to pay out of pocket because you hammered your finger. For those of you who are saving up to go on that adventure, there’s an available travel insurance that protects you while you go around the world. Here in Puerto Rico, you will be protected by a network of over 10,000 hospitals, doctors and laboratories. As part of Triple-S you will have over-the-phone access to professional nurses, available 24/7 through TeleConsulta, who will help you identify your symptoms, since that pain in your hand is not necessarily cancer, contrary to what you read on the Internet. You’ll also be covered during any trip to the United States (through reimbursments), so go swim with those dolphins in peace.

Applying for a medical plan doesn’t have to be a headache either. You can complete your application for a Triple-S healthcare plan online, which is convenient for someone like you, who wants it done quickly. Speaking of quick, with Triple-S medical plans there’s no waiting time to start using your plan. Emergencies are not planned, and we believe that you should always have free access to our network of over 10,000 doctors, hospitals and laboratories.

Getting sick without a medical plan may delay your plans enough, you’ll see that having a health insurance plan is a good investment. Check the list of necessary documents [link to checklist] to apply for your health insurance. To make it even easier, you can apply online.

The medical plan for Singles without children includes:

  • On-the-phone assistance through TeleConsulta from professional nurses, available 24/7 to answer your medical questions
  • Visits to optometrists so you can get a better view of the world
  • Visits to the audiologist to determine if you have to lower the volume of your headphones
  • Dental care so you can keep that smile going
  • Preventive tests without copayments so you can monitor your health

Coverage of this plan

Hospital Services

  • Semi-private room, 365 days a year
  • Hospitalizations for mental conditions and substance abuse
  • Skilled Nursing Facility (SNF) unit

Hospital Medical & Surgical Services

  • Visits from physicians to hospitalized patients; specialist consultations and diagnostic services
  • Skin, bone, and cornea transplants
  • Surgery and anesthesia
  • Extracorporeal Shock Wave Lithotripsy (ESWL) procedure
  • Invasive cardiovascular tests and gastrointestinal endoscopies

Medical-Outpatient Services

  • Unlimited visits to primary care physicians (PCP), specialists, and subspecialists
  • Visits to podiatrists, optometrists, audiologists, and chiropractors
  • Visits to the psychiatrist and psychologist; including group therapy and collateral visits for mental conditions and substance abuse
  • Visits to a nutritionist, up to six per policy year
  • Clinical laboratories and X-rays
  • Outpatient surgery at the doctor’s office
  • Home Health Care
  • Emergency Room Services
  • Ground ambulance services, up to $80 per case
  • Preventive and vaccine services, as required by federal law

Specialized Diagnostic Tests

  • Cardiovascular and vascular non-invasive tests
  • Neurological tests
  • Nuclear medicine tests
  • Computed tomography and MRI, one test per anatomical region, per policy year
  • Sonograms and SPECT
  • Echocardiograms and electroencephalograms
  • PET CT and PET Scan, one per year

Maternity

  • Pre and Post-Natal visits
  • Hospitalization costs for natural childbirth or cesarean section
  • Biophysical profile, one per pregnancy, 50% coinsurance
  • Production and interpretation of fetal monitoring
  • Visits for preventive newborn care

Services in the United States

The Blue Card Program offers coverage for emergency care and for services that have been pre-certified by Triple-S Salud. You are responsible for the coinsurance corresponding to the benefit in the United States, according to the coverage you select.

Pharmacy

Brand and generic drugs as the first option from a list of medications. Except when there is no generic drug available in the market for a brand-named drug. If the insured chooses, or the physician prescribes, a brand-name drug when the generic drug is available in the market, the insured will pay the brand-name drug copayment / coinsurance and the difference between the brand-name drug and the generic.

Dental Services

You’re 100% covered with any of our dental plans, which offer diagnostic and preventive services. $0 copay for the following services:

  • Initial comprehensive exam by generalist or specialist
  • Routine periodic exams
  • Emergency exam
  • Individual periapical x-rays
  • Bitewings x-rays
  • Dental Prophylaxis (cleanings)
  • Fluoride (topical) varnish application to children under age 5
  • Topical Fluoride applications to children under age19
  • Topical fluoride applications only for adults with special conditions

Additional Benefits

  • Triple-S Natural: Enjoy the benefits of alternative therapies, such as acupuncture, aromatherapy and naturopathic medicine, among others, for up to six visits.
  • Glasses: One pair per policy year for those insured, until age 21
  • Durable Medical Equipment

Health Plan for Singles with Children

The most important thing is that you and your children are protected and have an insurance plan for any situation.

Now that you’re starting a new life, you may be interested in following your adventurous spirit or making a reality out of that business idea that has long been in your mind, and having a medical plan is important. Emergencies can arise at any given moment and you must be protected at all times, which is why Triple-S healthcare plans have no waiting time. As soon as your plan is approved, you’re instantly covered. You won’t be rejected for any preexisting condition either. It’s that easy.

You also want your children to be well-protected at all times; it doesn’t matter if they live with you around the clock or only during weekends. Having a specialized health plan for single parents is something less to worry about when you are planning what you will do while on vacation with them and in your daily life. You can rest assured in knowing that no matter where you are in Puerto Rico, you have over 10,000 doctors, hospitals and laboratories ready to serve you. For a fact, 100% of hospitals in Puerto Rico accept Triple-S. In addition, all our plans include pharmacy coverage, because you know that young children tend to get sick a lot and medicine can be expensive. Eyeglasses are also covered (up to 21 years old) and vaccines required by federal law are covered too.

Being sick is complicated enough, and not having a medical plan could make it much worse. Review the necessary documents to apply for a healthcare plan for you and your children. It is much easier than you think and you can apply online.

The Health Insurance Plan for Singles with Children covers:

  • Dental Plan to keep your candy-loving children’s teeth healthy
  • Visits to pediatricians and other primary care physicians, specialists and subspecialists without medical referrals
  • Cardiovascular care for when your daughter brings her first boyfriend home
  • Physical therapy in case you end up injured after playing basketball with your son
  • Preventive tests without copayments to prevent a treatable condition from becoming a major problem

Coverage of this plan

Hospital Services

  • Semi-private room, 365 days a year
  • Hospitalizations for mental conditions and substance abuse
  • Skilled Nursing Facility (SNF) unit

Hospital Medical & Surgical Services

  • Visits from physicians to hospitalized patients; specialist consultations and diagnostic services
  • Skin, bone, and cornea transplants
  • Surgery and anesthesia
  • Extracorporeal Shock Wave Lithotripsy (ESWL) procedure
  • Invasive cardiovascular tests and gastrointestinal endoscopies

Medical-Outpatient Services

  • Unlimited visits to primary care physicians (PCP), specialists, and subspecialists
  • Visits to podiatrists, optometrists, audiologists, and chiropractors
  • Visits to the psychiatrist and psychologist; including group therapy and collateral visits for mental conditions and substance abuse
  • Visits to a nutritionist, up to six per policy year
  • Clinical laboratories and X-rays
  • Outpatient surgery at the doctor’s office
  • Home Health Care
  • Emergency Room Services
  • Ground ambulance services, up to $80 per case
  • Preventive and vaccine services, as required by federal law

Specialized Diagnostic Tests

  • Cardiovascular and vascular non-invasive tests
  • Neurological tests
  • Nuclear medicine tests
  • Computed tomography and MRI, one test per anatomical region, per policy year
  • Sonograms and SPECT
  • Echocardiograms and electroencephalograms
  • PET CT and PET Scan, one per year

Maternity

  • Pre and Post-Natal visits
  • Hospitalization costs for natural childbirth or cesarean section
  • Biophysical profile, one per pregnancy, 50% coinsurance
  • Production and interpretation of fetal monitoring
  • Visits for preventive newborn care

Services in the United States

The Blue Card Program offers coverage for emergency care and for services that have been pre-certified by Triple-S Salud. You are responsible for the coinsurance corresponding to the benefit in the United States, according to the coverage you select.

Pharmacy

Brand and generic drugs as the first option from a list of medications. Except when there is no generic drug available in the market for a brand-named drug. If the insured chooses, or the physician prescribes, a brand-name drug when the generic drug is available in the market, the insured will pay the brand-name drug copayment / coinsurance and the difference between the brand-name drug and the generic.

Dental Services

You’re 100% covered with any of our dental plans, which offer diagnostic and preventive services. $0 copay for the following services:

  • Initial comprehensive exam by generalist or specialist
  • Routine periodic exams
  • Emergency exam
  • Individual periapical x-rays
  • Bitewings x-rays
  • Dental Prophylaxis (cleanings)
  • Fluoride (topical) varnish application to children under age 5
  • Topical Fluoride applications to children under age19
  • Topical fluoride applications only for adults with special conditions

Additional Benefits

  • Triple-S Natural: Enjoy the benefits of alternative therapies, such as acupuncture, aromatherapy and naturopathic medicine, among others, for up to six visits.
  • Glasses: One pair per policy year for those insured, until age 21
  • Durable Medical Equipment

Health Plan for Students

It’s never too early to think about a healthcare plan that suits your needs.

There is nothing more awful than being short on cash, especially when you couldn’t go to Rincón this weekend because you got sick, you have no health insurance and you had to spend all your money in a doctor’s appointment. Your priority right now is to study, but also hang out with friends, have a great time and party. Unexpected expenses don’t fit into these plans.

That’s why it is important for you to have a healthcare plan with prices that fit the lifestyle and money you have. With a Triple-S healthcare plan you get access to over 10,000 doctors, hospitals and laboratories in Puerto Rico that you can go to without needing medical referrals with your free choice plan. You also have prescription drug coverage, which is super important because buying medicine out of pocket can empty your wallet quickly.

If during the summer you decide to go on vacation or visit family in the United States, you are also protected with doctors, hospitals and laboratories you can visit in case of emergency, and you can submit the reimbursements online, making everything easier. As an additional benefit, once your healthcare plan is approved you can start using it, without unnecessary waiting time.

Are you in your dorm and something is hurting but you don’t want to get out of bed? With Triple-S healthcare plan you have access to over-the-phone assistance through TeleConsulta with professional nurses available 24/7, in order to help you determine if that ankle you twisted while playing basketball is actually broken.

75% of college students in Puerto Rico have their health insurance with Triple-S, so join the group! Applying is super easy. Check out the list of required documents [link to checklist] and fill out the online application.

Student Healthcare Plan Covers:

  • Emergency room visits in case something goes wrong in that one game of truth or dare
  • Over-the-phone assistance with professional nurses 24/7, for when your mom doesn’t know how to answer that medical question
  • Glasses covered until you turn 21, so you can finally understand what’s on the calculus class blackboard

Coverage of this plan

Hospital Services

  • Semi-private room, 365 days a year
  • Hospitalizations for mental conditions and substance abuse
  • Skilled Nursing Facility (SNF) unit

Hospital Medical & Surgical Services

  • Visits from physicians to hospitalized patients; specialist consultations and diagnostic services
  • Skin, bone, and cornea transplants
  • Surgery and anesthesia
  • Extracorporeal Shock Wave Lithotripsy (ESWL) procedure
  • Invasive cardiovascular tests and gastrointestinal endoscopies

Medical-Outpatient Services

  • Unlimited visits to primary care physicians (PCP), specialists, and subspecialists
  • Visits to podiatrists, optometrists, audiologists, and chiropractors
  • Visits to the psychiatrist and psychologist; including group therapy and collateral visits for mental conditions and substance abuse
  • Visits to a nutritionist, up to six per policy year
  • Clinical laboratories and X-rays
  • Outpatient surgery at the doctor’s office
  • Home Health Care
  • Emergency Room Services
  • Ground ambulance services, up to $80 per case
  • Preventive and vaccine services, as required by federal law

Specialized Diagnostic Tests

  • Cardiovascular and vascular non-invasive tests
  • Neurological tests
  • Nuclear medicine tests
  • Computed tomography and MRI, one test per anatomical region, per policy year
  • Sonograms and SPECT
  • Echocardiograms and electroencephalograms
  • PET CT and PET Scan, one per year

Maternity

  • Pre and Post-Natal visits
  • Hospitalization costs for natural childbirth or cesarean section
  • Biophysical profile, one per pregnancy, 50% coinsurance
  • Production and interpretation of fetal monitoring
  • Visits for preventive newborn care

Services in the United States

The Blue Card Program offers coverage for emergency care and for services that have been pre-certified by Triple-S Salud. You are responsible for the coinsurance corresponding to the benefit in the United States, according to the coverage you select.

Pharmacy

Brand and generic drugs as the first option from a list of medications. Except when there is no generic drug available in the market for a brand-named drug. If the insured chooses, or the physician prescribes, a brand-name drug when the generic drug is available in the market, the insured will pay the brand-name drug copayment / coinsurance and the difference between the brand-name drug and the generic.

Dental Services

You’re 100% covered with any of our dental plans, which offer diagnostic and preventive services. $0 copay for the following services:

  • Initial comprehensive exam by generalist or specialist
  • Routine periodic exams
  • Emergency exam
  • Individual periapical x-rays
  • Bitewings x-rays
  • Dental Prophylaxis (cleanings)
  • Fluoride (topical) varnish application to children under age 5
  • Topical Fluoride applications to children under age19
  • Topical fluoride applications only for adults with special conditions

Additional Benefits

  • Triple-S Natural: Enjoy the benefits of alternative therapies, such as acupuncture, aromatherapy and naturopathic medicine, among others, for up to six visits.
  • Glasses: One pair per policy year for those insured, until age 21
  • Durable Medical Equipment

Health Plan Family Guardian

We have family health insurance plans to help you protect your family at affordable prices.

Grandchildren, godchildren and nieces and nephews are for loving and spoiling continuously. That’s why you wait for them every time they come home from school with their favorite snack in hand and give them ground beef because they don’t like meatballs. It’s important to protect these special little people you love so much and a health plan like Triple-S can do this. With this plan, they will be protected even when their mischievous and explorer spirits take over, which happens all the time when you have small children. Having a Triple S health plan gives you the peace of mind of knowing that they are protected when there’s unusual silence in the house and you think they’re hiding something or up to something naughty.

With an individual Triple-S health plan, you guarantee them access to a network of over 10,000 doctors, hospitals and laboratories and you can also count on the TeleConsulta over-the-phone service with professional nurses available 24/7 to help you clarify your questions. It’s very useful when there are children in the house, and even more so when they’re really young and can’t yet communicate well what bothers them. All our plans include pharmacy coverage since children get sick very easily and since elderly people have to take certain medications consistently, and medicine can be expensive. We also cover vaccinations required by federal law to keep children healthy always.

In addition, for those responsible for seniors, our medical plans offer preventive tests with no copayments to make sure they are healthy for as long as possible.

Triple-S has been protecting more than 1.7 million Puerto Ricans for over 50 years. Check the list of necessary documents [link to checklist] to apply for their health insurance. You can also apply online to save time.

The family guardian plan covers:

  • Professional Nurses available 24/7 through an over-the-phone service to clarify your medical questions
  • Emergency room services in case that odd silence turns into a problem
  • Pharmacy coverage for when they get sick
  • Glasses (until they turn 21) for when you see them squinting their eyes while watching TV
  • Vaccines as required by federal law to get them ready for school

Coverage of this plan

Hospital Services

  • Semi-private room, 365 days a year
  • Hospitalizations for mental conditions and substance abuse
  • Skilled Nursing Facility (SNF) unit

Hospital Medical & Surgical Services

  • Visits from physicians to hospitalized patients; specialist consultations and diagnostic services
  • Skin, bone, and cornea transplants
  • Surgery and anesthesia
  • Extracorporeal Shock Wave Lithotripsy (ESWL) procedure
  • Invasive cardiovascular tests and gastrointestinal endoscopies

Medical-Outpatient Services

  • Unlimited visits to primary care physicians (PCP), specialists, and subspecialists
  • Visits to podiatrists, optometrists, audiologists, and chiropractors
  • Visits to the psychiatrist and psychologist; including group therapy and collateral visits for mental conditions and substance abuse
  • Visits to a nutritionist, up to six per policy year
  • Clinical laboratories and X-rays
  • Outpatient surgery at the doctor’s office
  • Home Health Care
  • Emergency Room Services
  • Ground ambulance services, up to $80 per case
  • Preventive services and vaccines, as required by federal law

Specialized Diagnostic Tests

  • Cardiovascular and vascular non-invasive tests
  • Neurological tests
  • Nuclear medicine tests
  • Computed tomography and MRI, one test per anatomical region, per year
  • Sonograms and SPECT
  • Echocardiograms and electroencephalograms
  • PET CT and PET Scan, one per year

Maternity

  • Pre and Post-Natal visits
  • Hospitalization costs for natural childbirth or cesarean section
  • Biophysical profile, one per pregnancy, 50% coinsurance
  • Production and interpretation of fetal monitoring
  • Visits for preventive newborn care

Services in the United States

The Blue Card Program offers coverage for emergency care and for services that have been pre-certified by Triple-S Salud. You are responsible for the coinsurance corresponding to the benefit in the United States, according to the coverage you select.

Pharmacy

Brand and generic drugs as the first option from a list of medications. Except when there is no generic drug available in the market for a brand-named drug. If the insured chooses, or the physician prescribes, a brand-name drug when the generic drug is available in the market, the insured will pay the brand-name drug copayment / coinsurance and the difference between the brand-name drug and the generic.

Dental Services

You’re 100% covered with any of our dental plans, which offer diagnostic and preventive services. $0 copay for the following services:

  • Initial comprehensive exam by generalist or specialist
  • Routine periodic exams
  • Emergency exam
  • Individual periapical x-rays
  • Bitewings x-rays
  • Dental Prophylaxis (cleanings)
  • Fluoride (topical) varnish application to children under age 5
  • Topical Fluoride applications to children under age 19
  • Topical fluoride applications only for adults with special conditions

Additional Benefits

  • Triple-S Natural: Enjoy the benefits of alternative therapies, such as acupuncture, aromatherapy and naturopathic medicine, among others, for up to six visits.
  • Glasses: One pair per policy year for those insured, until age 21
  • Durable Medical Equipment

787-277-6653 787-474-6326