Your well-being is everything to us.
Learn how your plan worksYour plan pays 100% of preventive services1 that will help you stay healthy. Plus it will share part of the costs you have as a member when getting health care services.
Learn these terms to better understand your coverage, plus everything that has to do with paying for the medical services received.
Fixed amount (e.g., $15) you pay for covered medical services, usually upon getting them. The amount may change by type of service.
The amount you pay for covered services. Example: If your health plan says you need to pay 25% for clinical laboratory tests, you would pay $12.50 (25%) for a lab test that costs $50.
The initial fixed amount you must pay for eligible medical and/or pharmacy services before your plan begins to pay the cost of covered services. No deductible applies for preventive services or vaccines.
An established maximum amount that the person must pay during the policy year. Prior to reaching the established maximum out-of-pocket amount, the insured person pays deductibles, copayments or coinsurance for essential medical-hospital care, drugs and dental services. Once the insured person reaches the maximum out-of-pocket amount established, the plan pays one hundred percent (100%) of the expenses for essential health benefits.
Your plan does not have additional costs to those mentioned in your policy such as the payment of the monthly premium amount, deductibles, copayments and coinsurance. You are responsible for payment of non-covered and excluded services. Please read the policy to familiarize yourself with your covered medical, hospital, dental and pharmacy services.
These are your coverage key features:
You should always visit pharmacies in this network to make sure your plan covers your pharmacy benefits.
DOWNLOAD THE PROVIDERS DIRECTORYYour Pharmacy Coverage also gives access to these programs:
This formulary has the available selection of generic and brand-name drugs. Share it with your doctor before they issue any prescriptions to avoid extra costs.
DOWNLOAD THE DRUG FORMULARYGeneric drugs are the first treatment option, except when there are no substitutes in the market for the brand-name medications in your drug formulary.
For some conditions, we ask that you use one medication before trying another for your treatment. For example:
Check your drug formulary for more information about the Step-Therapy medications that apply in your coverage.
There are many reasons to smile! Our plans have 100% dental coverage for diagnostic and preventive services, including:
For only $6.79
a month per member, you get more benefits to take care of your smile. Just ask for the Optional Dental Coverage in any of our individual plans.
This optional extended coverage offers you:
Call us and get your Extended Dental Coverage.
We want to offer you what you need to be healthy. If you need one of these, please call us so we can help.
Your doctor must ask for the pre-authorization by fax to these numbers:
Pre-authorizations for medical equipment, services in the US and home health care:
(787) 774-4824For only $1.75
We don't know what may happen tomorrow. If you die, your chosen beneficiary will get a $10,000 benefit to cover funeral costs, pay certain debts, medical expenses for long term health issues, and others.
This life insurance can be purchased only by the main insured.
Download the summary of benefits for your plan, the covered drug formulary, and the Triple-S Salud provider directory
hospital stays, medications, and current conditions for you and your underage dependents, as well as how to access educational programs.
Available for Android* and iPhone.
All Triple-S Salud members can download the app. Only the plan's primary policyholder can log in to find the health plan cards and coverage information.
Your health plan features benefits and innovative solutions to take care of your health. This is one of the many advantages of joining Triple-S.
Check our provider directory and find the health care provider you need.
ACCESS THE DIRECTORYYou can also see the directory through our Triple-S Salud mobile app.
Before calling a provider, make sure they belong to our network and that your visit is covered under your plan.
If you have questions about a specific provider, call us.
Primary health care services with more than 40 specialists, all under a single electronic health record for added ease.
We offer health care services:
Come visit us in:
Make health care consultations using your mobile phone or computer.
Save time and skip the long waiting times at the Emergency Room:
Triple-S Salud is part of BlueCross BlueShield Association. This is why your plan covers emergency services in Puerto Rico and the US, based on your type of coverage.
What should you do?
Free service provided by highly skilled nursing professionals with over 5 years of experience. They also have the support of the most advanced technology. If you feel ill, are injured, or need some health care advice, they will offer you assistance to settle whether you should:
Get medications and OTC anywhere you want with no delivery fee.
We're here to take care of your health. Call us for anything you need.
Request ID cards, reimbursements, preauthorizations, and more, with just one phone call.
Set up your appointment at any of our Salus clinic network locations.
See our office addresses and business hours.
We recommend you follow the suggestions detailed below so you can enjoy your plan benefits to the max. That way, you will be up to date with your health and your plan account.
Enter your information to create an account and have access to all your coverage information.
We offer these applications for your convenience. This way, you can access your health care information, talk to a doctor, and get your prescription and OTC3 medicines at home.
Become familiar with the documents relevant to your health plan, such as your summary of benefits, the covered drug formulary, and the Triple-S Salud provider directory.
Complete the Health Risk Assessment (HRA). Get to know the risk factors that could affect your health.
Evaluate your overall health, check whether you need vaccines, and talk to your doctor about which areas need the most attention, based on your medical history. You can get these services at our Preventive Centers, in a single visit and without long wait times.
Automatically pay your health insurance premium from your checking account, savings account, or credit card.
Call us and sign up.
Your smile deserves special care. If you haven't yet, extend your Dental Coverage for a very small additional fee.
Call us and get your Extended Dental Coverage
We don't know what may happen tomorrow. A Life Insurance gives you peace of mind knowing that your loved ones will be covered in case one day you miss.
Call us and get a Life Insurance.
You have only 30 days from the effective date of the policy to purchase life insurance.
1The services required and defined by the Federal Reform.
2According to the Drug List, recommended by the US Preventive Services Task Force (USPSTF).
3Limited OTC product supply.
4According to the Drug List.
5Check your Drug List for more information about the Step-Therapy medications that apply in your coverage.