Puerto Rico healthcare is somewhat similar to what you would expect in the US. The differences are mainly on how insurance companies work and what you can expect from the care of physicians. I remember that the plans I had in the US were so that I had to pay a certain amount of money before the insurance started to cover the expenses, that’s not the case here, you just have to pay a small co-pay per visit or per medication, and the same goes for emergency room visits, of course that depends on the plan you have.
The truth is that the entire process and differences can become quite frustrating at times due to long wait times and the fact that you have to pay for more things than you should. I’ll explain all that in its appropriate section.
Follow the links below according to the category you are curious about, but in this page I will give you a general overview of how the whole thing works and what to generally expect.
Most popular health insurance companies in Puerto Rico and my experience with the one I have.
-Humana (coming soon)
Official details on how to find healthcare. (Choose Puerto Rico in the drop-down box)
-Insurance companies are generally good, in fact I feel they are MUCH better than what we had in the US when we lived there, not only are they much more affordable (especially if you have your insurance through your employer), but also because there is very little that insurance companies won’t cover, and that whole thing about pre-existing conditions, doesn’t exist here.
-Get ready to wait, and wait, make sure you sit and wait, but then you will receive excellent care. Whenever you see a doctor at his/her office, they schedule you a time, but that means very little because they tend to do first come first serve anyway. So it is very common to wait for over an hour at the doctor’s waiting room (I’ve had to wait upwards of 4 hours, although rare, it is possible).
-Generally, doctors care. Either I have amazing luck, or this is just how it is, but I have not had a bad doctor here, and I actually have the personal cell phone number of some of the doctors (my veterinarian too).
-If you need blood drawn or any sort of laboratory testing, don’t expect to get any of that work done at the doctor’s office or building. You have to go to a specialized laboratory where they do all that testing, oh and expect to wait there too. On top of that, for some reason, the government makes you pay a “sello”, which is really a small fee for every test done. So even if your insurance company covers 100% of all lab work (like mine does), you still may have to pay a few cents (10-15 cents or so) for the “sello”, some labs absorb the small fee though.
-Expect to pay the medical visit BEFORE you visit the doctor, or before any sort of service for that matter. Your co-pay will have to be paid in most cases before you see the doctor, often times only cash is accepted.
-If you go to the emergency room or some sort of urgent care, expect to be called several times and be sent back to the waiting room. First call for paperwork and insurance information (sometimes you pay right there also), then they call you for triage (or to pay at another desk if you didn’t pay the first time), then they call you to go inside and wait in another smaller waiting room, and then you get to see the doctor.
-Expect the doctors to be bilingual, but not the receptionists or assistants. We are lucky that I speak Spanish, but that also means that I have to make every single doctor appointment for anyone in the family.