Puerto Rico Consumer Assistance

Puerto Rico's participation in the federal Consumer Assistance Program grant has completed, however, the Puerto Rico Oficina de la Procuradora del Paciente continues to provide assistance to consumers with health insurance questions or problems. You can contact them at (787) 304-8686. 

The agencies listed below can help you take advantage of some of these 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 (Oficina del Comisionado de Seguros)
Physical Address: (Direccion Fisica):
Edificio World Plaza
268 Ave. Muñoz Rivera
Piso 9
San Juan, PR 00918

Mailing Address: (Direccion Postal):
361 Calle Calaf
PO Box 195415
San Juan, PR 00919
(787) 304-8686
http://www.ocs.pr.gov

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:

Medicaid Program (Programa Medicaid)
Departamento de Salud
(787) 765-1230
https://www.medicaid.pr.gov
prmedicaid@salud.pr.gov

Find a local office: https://www.medicaid.pr.gov/Home/OficinasLocales

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) 444-3272
http://www.askebsa.dol.gov

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:

Medicare
1-800-633-4227
TY: 1-877-486-2048
https://www.medicare.gov/

If you are a veteran and have a question or concern about veterans’ health care benefits, go to: 

US Department of Veterans Affairs
(877) 222-VETS (8387)
https:/www.va.gov/health-care/

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.

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