Puerto Rico Consumer Assistance
Puerto Rico no longer operates Consumer Assistance Program under the Affordable Care Act. The new consumer protections and benefits of the law still apply to you, however.
The agencies listed below can help you take advantage of some of these new protections and benefits. They can answer your questions about different types of coverage.
If you need health insurance, be sure to check out HealthCare.gov’s Plan Finder. It will help you find and compare health care coverage options in your area.
If you have questions about insurance you bought for yourself and/or your family or you have insurance provided by an employer who does business only in Puerto Rico, contact:
Puerto Rico Department of Insurance
Office of the Commissioner of Insurance
B5 Calle Tabonuco Suite 216, PMB 356
Guaynabo, PR 00968-3029
(787) 304-8686
Fax: (787) 273-6082
If you have a hard time affording health coverage and you have questions about eligibility or current Medicaid benefits, go to:
Puerto Rico Medicaid
Calle Eleanor Roosevelt #117
Hato Rey, PR
(787) 765-1230
Fax: (787) 250-0990
TDD: (602) 417-4191
http://www.salud.gov.pr/Programas/ProgramaMedicaid/Pages/default.aspx
Applications for Medicaid can be filled out at the Oficina Local de Programa de Asistencia Médica (Local Office of Medical Assistance) in the town where the person or family resides.
If you are not eligible for Medicaid, your child may still be eligible for the Children’s Health Insurance Program. For questions about eligibility or benefits, go to:
Puerto Rico Medicaid
Calle Eleanor Roosevelt #117
Hato Rey, PR
(787) 765-1230
Fax: (787) 250-0990
TDD: (602) 417-4191
http://www.salud.gov.pr/Programas/ProgramaMedicaid/Pages/default.aspx
Applications for CHIP can be filled out at the Oficina Local de Programa de Asistencia Médica (Local Office of Medical Assistance) in the town where the person or family resides.
If you have a question, complaint, or dispute regarding insurance you get through a “self-insured” employer (typically a large company or one with locations in multiple states or countries), go to:
U.S. Department of Labor
Employee Benefits Security Administration
200 Constitution Ave., NW
Washington, DC 20210
(866) 4-USA-DOL (866-487-2365)
http://www.dol.gov/ebsa/consumer_info_health.html
If you are on Medicare and have a question, or if you have a disability or end stage renal disease and want to enroll or find out if you are eligible for Medicare, contact:
Puerto Rico State Health Insurance Assistance Program
Toll Free: (877) 725-4300
Local: (787) 721-6121
If you are a veteran and have a question or concern about veterans’ health care benefits, go to:
US Department of Veterans Affairs
http://www1.va.gov/health/
(877) 222-VETS (8387)
If you have questions about your health insurance that are not covered by the above resources, call the Health Insurance Assistance Team of the U.S. Center for Consumer Information and Insurance Oversight at (888) 393-2789.