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
Youre 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
