Monday, May 20, 2024

Is Medicare Accepted In Puerto Rico

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How Can I Make Sure Im Covered While Abroad Or Away

Medicare anuncia nueva plataforma para ayuda a pacientes

Since Medicare coverage and international travel do not necessarily go hand in hand, those who plan to leave the country should check their private insurance plan to determine what kind of services they could receive abroadand at what expense.

Travel health insurance may be a worthwhile investment if you expect to be outside the U.S. often during your retirement years, especially if you have health conditions that could require continual care and services, specific medical supplies, prescription drugs or treatments.4

In some instances, Humanas Medicare Advantage or prescription drug plans give members a vacation override that allows them to refill a prescription early in advance of a trip. Most Humana members may use 2 of these vacation overrides in a rolling 12-month period, although some medications require additional approvals for early refills due to federal and state regulations.

In some cases, Humana offers Medicare Part D, Medicaid and Medicare plan members coverage for prescription refills at out-of-network pharmacies. But remember: these pharmacies must be located within the United States to qualify for coverage.

This material is provided for informational use only and should not be construed as medical advice or used in place of consulting a licensed medical professional. You should consult your doctor to determine what is right for you.


Money & Currency Exchange

Since Puerto Rico is an unincorporated territory of the United States, the currency used is the United States Dollar . Travelers should note that Puerto Ricans often refer to the U.S. Dollar as the “peso” or “dolar.” The dollar breaks down into 100 cents, which Puerto Ricans call “centavos” or “chavitos.” Nickels are known by locals as “ficha” or “vellons.” while quarters are called “pesetas.”

Some tourist spots and businesses will accept Canadian dollars but travelers from Canada are encouraged to exchange CAD for local currency since most locations require USD. Currency can be exchanged at larger airports and banks. ATMs also provide a good option for withdrawals while abroad. However, travelers should research any fees associated with withdrawals and currency exchanges.

One additional note to keep in mind when visiting Puerto Rico is that hotels typically charge a 9% tax on rooms, specialty casino hotels charge 11%, and inns charge 7%. These additional hospitality taxes can be surprising, so make sure to budget for them when planning your vacation or business trip.

Tipping is common in Puerto Rico and is usually about 15% of the bill. This is another reason it’s a good idea to keep at least some cash in USD with you.

Accept Medicare Drug Rehab Facilities In Bayamon Puerto Rico United States

When people think of addiction, they tend to think of it as something that only affects younger people. In reality, addiction knows no age. In fact, seniors are among the fastest-growing age group experiencing rates of substance use disorder, according to data from the Substance Abuse and Mental Health Services Administration . Fifteen percent of the nation’s population relies on Medicare for health security. As baby boomers turn 65, enrollment has reached 64 million in 2020 and will reach 80 million in 2030. These two overlapping realities mean that Medicare must cover some level of substance use disorder for its patients.

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Start Exploring Medicare Rehabs

You or your loved one can start the process of looking for rehabs that accept Medicare by calling our representatives. We will navigate our extensive database of treatment centers and find the facility that works best for you or the person you care about who is struggling with addiction. Dont let addiction rob you of your health dignity. Call now.

One Kind Of Substance Use Services Does Medicare Cover

Guia Definitiva de Puerto Rico Medicare

While Medicare doesnt specifically have a category of coverage for substance use treatment, these services are covered when deemed reasonable and necessary.

Some of the Addiction treatment services Medicare covers include, but are not limited to:

  • Inpatient treatment would be covered if reasonable and necessary, including behavioral rehab, medically supervised detoxification and withdrawal management, and medication-assisted treatment.
  • Outpatient treatment, including behavioral rehab and counseling. Just like inpatient treatment, coverage of outpatient treatment would depend on the provider of the services.
  • Partial Hospitalization Programs treatment, including Individual or group psychotherapy with physicians, psychologists, or other mental health professionals, as well as occupational and activity-based therapies.

The scope of Medicare coverage for substance use depends on a variety of factors, including what type of plan you have, the state you live in, and others.

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Learn About Our Supplemental Care Plus Plan

Care Plus Medigap is the name of our Triple-S Salud Original Medicare supplement policy. Medicare establishes 10 types of supplementary plans and each plan is identified with a letter that corresponds to a certain basic level of benefits. Of these 10 models Triple-S Salud offers Model A, B, C and D.

Covers the coinsurance and deductibles that apply to benefits covered by Original Medicare. The Model benefits do not vary by insurance company, so what you should consider is the premium and the quality of service they provide.

With your Supplemental Care Plus plan from Triple-S Salud you have:

  • Our Service Centers conveniently found throughout the island
  • Hospital and medical care without prior approval
  • You can get care with Medicare in Puerto Rico and United States
  • Freedom to choose doctors and hospitals
  • Hospital care up to 365 days and the first three pints of blood.

As established by the MACRA law, starting January 1, 2020, the Plan C can only be purchased by people whose eligibility for Medicare is before December 31 of the year 2019.

Other Than Medicare What Coverage Should I Consider When I’m Traveling

For added peace of mind, many Medicare beneficiaries choose to purchase travel medical insurance prior to a trip. Travel medical plans are widely available, but be aware that in many cases, they restrict the amount of coverage available to seniors.

Although travel plans are frequently available with medical benefit maximums as high as seven figures, that limit is often reduced to $50,000 or less for applicants over 70 years old. Travel medical insurance can be used in conjunction with Medigap coverage or other health insurance.

Many travel medical insurance plans include separate medevac coverage, but it can also be purchased on a stand-alone basis from private carriers. Medevac return to the United States is not included in the foreign travel emergency coverage provided by Medigap plans. So beneficiaries with Original Medicare plus Medigap coverage might want to consider purchasing Medevac coverage prior to a trip abroad.

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Which Medicare Advantages Plans Cover International Travel

Some Medicare Part C plans include a benefit covering 80% of medically necessary urgent care received abroad. The care must begin during the first 60 days of each trip, after paying a $250 annual deductible. These plans carry a lifetime maximum benefit of $50,000. Cigna and Aetna are two companies that do have plans that cover international travel.

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How Does Medicare Cover Me If I’m Traveling Within The Us

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For Medicare beneficiaries who see endless travel opportunities right here in the U.S., Original Medicare plus a Medigap plan will provide coverage border to border and coast to coast, including the U.S. territories.

Ninety-three percent of all U.S. doctors who provide Medicare-covered services are participating providers with Original Medicare. And only about 1% of all non-pediatric physicians in the U.S. have opted out of Medicare entirely.

Its also important to understand that Medicare Part D plans can require members to use in-network pharmacies, and some have localized networks rather than nationwide networks. Check with your Part D plan before traveling, and see if youll need to make arrangements to purchase medication in advance or use a mail-order pharmacy.

Medicare Advantage plans cover emergency care anywhere in the United States or its territories, but for routine care, plans typically require enrollees to use a local provider network. With most Medicare Advantage plans, if you travel outside of your plans service area for more than six months, youll be disenrolled from the Medicare Advantage plan and switched to Original Medicare instead.

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Medicare For Expats: What You Need To Know

If you are considering relocating to another country as a senior ex-pat, you may be concerned about Medicare for expats, whether coverage is available. Knowing this is an integral part of learning how to become an expat in your senior years.

If you are looking for a more general guide to Medicare, see our article on Medicare covered services.

Get Answers To Your Medicare Questions

If you want more information about where you can use your Medicare plan and how to ensure you have the coverage you need when moving or traveling to another state, speak with a licensed insurance agent who can help answer your questions.

Explore Medicare Advantage plan benefits in your area

Or call 1-800-557-6059TTY Users: 711 to speak with a licensed insurance agent. We accept calls 24/7!

About the author

Christian Worstell is a licensed insurance agent and a Senior Staff Writer for He is passionate about helping people navigate the complexities of Medicare and understand their coverage options.

His work has been featured in outlets such as Vox, MSN, and The Washington Post, and he is a frequent contributor to health care and finance blogs.

Christian is a graduate of Shippensburg University with a bachelors degree in journalism. He currently lives in Raleigh, NC.

Where you’ve seen coverage of Christian’s research and reports: is a website owned and operated by TZ Insurance Solutions LLC. TZ Insurance Solutions LLC and TruBridge, Inc. represent Medicare Advantage Organizations and Prescription Drug Plans having Medicare contracts enrollment in any plan depends upon contract renewal.

Plan availability varies by region and state. For a complete list of available plans, please contact 1-800-MEDICARE , 24 hours a day/7 days a week or consult

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How To Change Your Address With Medicare

If you are a Medicare beneficiary and move to another state, you can change your address that’s on file with Medicare by contacting the Social Security Administration .

Here are some ways you can contact the SSA:

How Much Is Travel Insurance For Puerto Rico

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If you’re wondering how much travel insurance for Puerto Rico will cost, you’re not alone. This is one of the most common questions from our customers. The cost of a travel insurance plan varies based on several important factors. These include the number of travelers in your group, their ages, the length of the trip, and the specific type of coverage.

In general, the lower the risk, the lower the premium and vice versa. Simply put, coverage for a one-week trip will usually cost less than coverage for a month-long trip. Similarly, older travelers, especially those with medical issues and pre-existing conditions, may pay a little more for coverage than younger travelers. In some instances, travelers can also opt to insure their trip cost, which can also influence the final price of the travel protection plan.

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Should I Have Medicare Coverage If I Retire Abroad

For coverage in your new country, youd need to purchase private health insurance or buy into the countrys public health plan, if that option is available. If youre willing and able to return to the United States for hospital care, youll still have access to Medicare Part A .

But youd need to purchase Medicare Part B in order to have outpatient coverage, and theres a 10% premium increase for each year that you were eligible for Part B but not enrolled . Advocacy groups have pushed for Medicare coverage to be portable for retirees who choose to live overseas, but so far, its not.

Medicare For Expats Conclusion

Medicare coverage is not generally accepted outside the United States and its territories. Depending on your personal situation, you may wish to continue your enrollment of certain parts while living abroad.

Want to read more about expat life in other countries, specifically regarding elder care? Read the articles we wrote on being an expat in:

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Does Medicare Cover Care Outside Of The United States

There are some limited situations when original Medicare may cover you when youre traveling outside the United States, including if:

  • you live in the United States, have a medical emergency, and a foreign hospital is closer to you than the nearest U.S. hospital
  • youre in Canada, have a medical emergency while traveling on a direct route between Alaska and another U.S. state, and the closest hospital that can treat you is in Canada
  • youre on a cruise ship, need medically necessary care, and the ship is in U.S. waters, a U.S. port, or within 6 hours of arrival or departure from a U.S. port

Medicare Part C / Medicare Advantage

MEDICARE: ¿Es obligatorio afiliarse al Medicare Advantage?

If you have Medicare Advantage, you should stop paying premiums and unenroll before moving abroad because you must live within a specific service area to receive benefits. However, if you plan on being a snowbird or sunbird, you might find it advantageous to continue your coverage under Medicare Advantage, provided you maintain a permanent residence in the U.S. A snowbird is a term for someone who migrates to a sunnier location during the winter. A sunbird is a person who relocates to a milder climate during the summer.

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Does Medicare Cover Me While I Travel

Many older adults look forward to fulfilling their travel bucket list during retirement, but Medicare may not be along for the ride.

If you have Medicare coverage, you wont receive reimbursement for international medical bills. Healthcare services received beyond U.S. borders are not covered.

In some cases, Medicare may cover inpatient hospital costs, ambulance services or dialysis for the following circumstances:

  • You are in the U.S. when emergency treatment is needed and the closest hospital is in a foreign country .
  • You are traveling through Canada between Alaska and another state when an emergency situation occurs and the closest hospital is in Canada.
  • You are a U.S. resident, but a foreign hospital is closer to your home than the nearest U.S. location that can treat your condition, regardless of whether it is an emergency situation.1
  • In any of these situations, the foreign hospital is not required to file a Medicare claim. If it doesnt, be prepared to submit an itemized bill to Medicare.2

    Your Medicare coverage follows you if you travel to:

    • Another state in the U.S
    • District of Columbia

    Senior Us Citizens Traveling Overseas And Medicare Coverage

    • If you get admitted to a foreign hospital which is closer than a US hospital that can treat your emergency medical condition.
    • If you get admitted to a Canadian hospital which can treat your medical emergency while travelling between Alaska and any other state and you are crossing Canada.
    • If you get admitted to a hospital nearest to where you are staying which can treat you under emergency medical condition.

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    How To Sign Up For Medicare In Puerto Rico

    Signing up for Part B in Puerto Rico is as simple as filling out a form. You can find the CMS-40B form online through the Social Security website. The Centers for Medicare & Medicaid Services offers this form, too you can download it by visiting their website. You may visit your local Social Security office if youre not comfortable with the online options.

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    What Does Medicare Cover While Youre Abroad

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    Medicare may pay for services at a foreign hospital if it is closer to your home than an American hospital. That circumstance could apply to Americans living on the Canadian or Mexican borders. The program will also cover you if you suffer a medical emergency while traveling in the U.S. and treatment at a foreign hospital is closest.

    Medicare also covers medical care on cruise ships that are in U.S. territorial waters, meaning that the vessel is within six hours of an American port.

    But beyond that, you need to plan for coverage in traveling abroad. To ensure emergency medical coverage and peace of mind youll need a policy that falls under one of three categories: Medicare Supplement, Medicare Advantage, or trip-specific travel health insurance.

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    How To Request Medicare In Puerto Rico

    Enrolling in Part B for residents of Puerto Rico is not automatic. Residents who want this coverage must register themselves. Many U.S. seniors are automatically enrolled in Medicare when they turn 65. Automatic enrollment includes Part A and for some, Part B.

    When youre Medicare eligible in Puerto Rico, you may be enrolled in Part A automatically. However, enrollment in Part B is not enrolling in Part B isnt required, but its recommended to enroll when you first become eligible. You also have to have Part A & Part B to enroll in either a Medicare Advantage or Medigap plan.

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