Expat Health Insurance in Puerto Rico

If you spend half the year in San Juan and the rest in San Francisco, you need the only health plan available to any bona fide PR resident that provides comprehensive coverage in PR, the U.S. and worldwide

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Because I spend half the year here and half back in the U.S., I love that my TripDoctor health plan covers me both on and off the island. I was able to keep my U.S. doctor and find one I like here in Puerto Rico.

Nicole Nicole | Puerto Rico
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Health Insurance in Puerto Rico

Local PR health insurers do not provide comprehensive coverage in the U.S. Expensive “Association Plans” require high annual membership fees on top of insurance premiums and do not offer U.S. coverage for cancer care. Only TripDoctor’s plans offer comprehensive care in PR and the U.S. for all PR residents.

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Healthcare in Puerto Rico

Puerto Rico has a doctor shortage because local plans pay well below those in the U.S. Our plans allow you to see any doctor, including those that don’t take local insurers, allowing you to see a doctor today, not 4 weeks from now. Contact us to find out more by clicking the link below!

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Puerto Rico Expat Healthcare FAQs

We have put together some of our most frequently asked questions to help you understand the healthcare landscape in Puerto Rico.

Why Can't a Bona Fide PR Resident Just Buy a U.S. Insurance Plan?
Under the ACA (Affordable Care Act or "Obamacare") health insurance is only available to permanent residents of the state in which it is sold. Under IRS rules, A U.S. citizen or permanent resident cannot be a permanent resident of a U.S. State and a bona-fide resident of Puerto Rico. As part of the ACA, the IRS provides insurance subsidies to qualified taxpayers and all insureds are identified through their SSN. This means the IRS has access to the state health insurance rolls and can match the SSN of an individual claiming PR "bona fide" residency while also claiming residency in a U.S. State when purchasing health insurance in that state.
Why Is It So Hard to Get a Doctor Appointment in Puerto Rico?
Puerto Rico insurers reimburse physician fees at lower rates than the reimbursement levels in the mainland, leading to lower physician salaries. The result is a net migration of qualified doctors from Puerto Rico to the U.S. Mainland. Doctor scarcity means that many doctors listed as "in-network" by local insurers are not taking new patients.

A second issue for Expats is that because many receptionists only speak Spanish, it is very difficult to call, describe your medical issue and make an appointment without Spanish fluency.
Do the Local Carriers Like Triple S, MCS or MMM Cover Treatment in the U.S.?
Only some PR plans may offer limited U.S. coverage for emergencies and care not available on the island. However, they only reimburse at Puerto Rico rates. That means you may have a $300,000 cancer treatment at MD Anderson, but they will only pay for half of it, putting you at real financial risk if you rely solely on these plans.
Does My Concierge Clinic Cover Treatment in the U.S.?
Concierge clinics are great for providing fast and reliable access to a primary care doctor.  However, they are not insurance. They don't cover the costs of hospitalization, surgery, labs, medications or specialist appointments. For this, you need a reliable insurance plan. And for the best healthcare access outside of your concierge clinic, you need a plan that covers healthcare costs in the U.S. for serious medical issues. TripDoctor's Puerto Rico plan meets all these needs, making it a great compliment to your concierge clinic membership.
What Are the Best Hospitals in Puerto Rico?
Unfortunately, Puerto Rico is not known for its great hospitals when compared to those in the U.S. In fact, no Puerto Rico hospitals show up on the major top U.S. hospital lists.  However, within PR our assessment of the best options for expats are:

1. Ashford Presbyterian (San Juan)
2. Doctors' Center Hospital (San Juan)
3. Doctors' Center Hospital (Dorado)
4. Caribbean Medical Center (Fajardo)
5. Bella Vista Hospital (Mayaguez)
What Should I Know About Hospitals in Puerto Rico?
If you or a relative have ever been hospitalized in the U.S., you know it's not supposed to be a 5-star hotel experience. However, there are some things you might consider standard in U.S. hospitals, which are not so in Puerto Rico

1. Nursing: In the US, one nurse typically covers 2-8 patients. In Puerto Rico, this can stretch to 20 or more patients. This is because of the island nurse shortage, which exists for the same reasons as the doctor shortage.
2. Food: Nobody likes hospital food, but how about no food. Hospitals in PR do not always provide food for patients. Instead, they expect the patient's family to bring food for their loved one.
3. Amenities: For the patient, hospitals are always cold and boring.  Puerto Rico facilities typically expect you to bring your own pillow and blankets and don't provide TV in the rooms. So, before you go, pack your favorite pillow, extra blankets and a good book.