You absolutely can have both Medicare and Medicaid in Puerto Rico! To be eligible, you’ll have to meet the income requirements for PR Medicaid, but also qualify for Medicare by either: Being at least 65 years old Receiving SSDI (Social Security Disability Income) for at least 25 months Being diagnosed with ALS or ESRD
Full Answer
Do I qualify for Medicare if I live in Puerto Rico?
If you live in Puerto Rico, you may be eligible for Medicare Part A and Part B coverage. Puerto Rico is a territory of the United States, and residents of Puerto Rico (as well as other territories, such as the Northern Mariana Islands, Guam, the Virgin Islands, and American Samoa) can qualify for Medicare if they meet eligibility requirements.
Will My Health Insurance Cover Me in Puerto Rico?
If you are traveling to Puerto Rico for a short amount of time, your U.S. health insurance plan will continue to cover you. If you plan on moving to Puerto Rico from the U.S., you will most likely need a new health care company.
How does Medicare enrollment work in Puerto Rico?
Medicare enrollment in Puerto Rico works differently than it does in the United States. Puerto Rico residents who are already receiving Social Security or Railroad Retirement Board benefits when they turn 65 are automatically enrolled in Part A, but they must always sign up manually to get Part B.
When should I enroll in Medicare Part B in Puerto Rico?
When you’re Medicare eligible in Puerto Rico, you may be enrolled in Part A automatically. However, enrollment in Part B is not; enrolling in Part B isn’t required, but it’s recommended to enroll when you first become eligible.
Does Medicare cover me in Puerto Rico?
If you have Original Medicare, you have coverage anywhere in the U.S. and its territories. This includes all 50 states, the District of Columbia, Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands. Most doctors and hospitals take Original Medicare.
Does Medicare pay if you get sick in a foreign country?
In most situations, Medicare won't pay for health care or supplies you get outside the U.S. The term “outside the U.S.” means anywhere other than the 50 states of the U.S., the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands.
Is Medicare the same in Puerto Rico?
Medicare coverage in Puerto Rico is the same as it is everywhere else. The only difference is you will not be automatically enrolled in Part B, you have to request enrollment yourself.
What Medicare coverage is available to a Medicare covered beneficiary traveling outside the US?
Medigap coverage outside the U.S. If you have Medigap Plan C, D, E, F, G, H, I, J, M or N, your plan: Covers foreign travel emergency care if it begins during the first 60 days of your trip, and if Medicare doesn't otherwise cover the care.
Can I use my Medicaid in Puerto Rico?
All 50 states and all U.S. territories (Puerto Rico, American Samoa, Guam, Northern Mariana Islands, U.S. Virgin Islands) have access to the United States Medicare and Medicaid programs, though it may be a little different in each place.
What happens if you have a medical emergency abroad?
The nearest US embassy or consulate can help travelers locate medical services and notify your friends, family, or employer of an emergency. They are available for emergencies 24 hours a day, 7 days a week, overseas and in Washington, DC (888-407-4747 or 202-501-4444).
How does Medicare work if you live overseas?
Medicare does not usually cover care that you receive outside the United States. However, it may be beneficial to enroll in Parts A and B if you live abroad on a temporary basis, or travel back to the U.S. frequently. Most people qualify for premium-free Part A, meaning you will pay nothing for coverage.
What will Medicare not pay for?
In general, Original Medicare does not cover: Long-term care (such as extended nursing home stays or custodial care) Hearing aids. Most vision care, notably eyeglasses and contacts. Most dental care, notably dentures.
Can you get Medicare in the U.S. Virgin Islands?
There are no Medicare Advantage Plans in the U.S. Virgin Islands. Both types of plans are called “Medicare drug plans.” In either case you must live in the service area of the Medicare drug plan you want to join.
Why do doctors not like Medicare Advantage plans?
If they don't say under budget, they end up losing money. Meaning, you may not receive the full extent of care. Thus, many doctors will likely tell you they do not like Medicare Advantage plans because private insurance companies make it difficult for them to get paid for their services.
Which Medigap plans provide foreign travel emergency care?
Medigap Plans C, D, F, G, M and N each provide foreign travel emergency care coverage, which you should keep in mind as you travel overseas.
Can I use Medicare in Canada?
In general, Medicare only covers recipients while in the United States. This means that if you have Medicare and you travel to Canada, your healthcare costs will not be covered, even if the services or medications provided would normally be covered in the United States.
Medicare Coverage in Puerto Rico
Here’s a rundown on your Medicare options. 1. You can choose to stay with the federally administered Medicare program, which is Original Medicare,...
Medicare Eligibility in Puerto Rico
You’re typically eligible for Medicare if you’re either a United States citizen or permanent legal resident of at least five continuous years. In P...
Medicare Enrollment in Puerto Rico
Medicare enrollment in Puerto Rico works differently than it does in the United States. Puerto Rico residents who are already receiving Social Secu...
Medicare Plans in Puerto Rico
Once you’re enrolled in Original Medicare, Part A and Part B, you may have other options as well, including Medicare Advantage plans, Medicare Pres...
How many seniors are in Puerto Rico?
Roughly, 1.3 million of the population are seniors over the age of 60. People that reside in Puerto Rico are United States citizens; however, Medicare healthcare coverage options can vary.
When do seniors enroll in Medicare?
Many U.S. seniors are automatically enrolled in Medicare when they turn 65. Automatic enrollment includes Part A and for some, Part B. When you’re Medicare eligible in Puerto Rico, you may be enrolled in Part A automatically. However, enrollment in Part B is not; enrolling in Part B isn’t required, but it’s recommended to enroll when you first ...
Is Medicare the same as Medicare in Puerto Rico?
Medicare coverage in Puerto Rico is the same as it is everywhere else. The only difference is you will not be automatically enrolled in Part B, you have to request enrollment yourself. Medicare is the United States’ federally funded health care insurance program for individuals age 65 and above; or those qualifying by disability or condition.
Consumer Assistance in Puerto Rico
Contact your state department of insurance to get consumer help with a health insurance problem or question.
Medicaid in Puerto Rico
States and territories have different rules about who qualifies for Medicaid. You can find out if you can get Medicaid in Puerto Rico right now.
CHIP in Puerto Rico
The Children’s Health Insurance Program (CHIP) covers uninsured children in families with moderate incomes that are too high to qualify for Medicaid. You can find out whether your children qualify for CHIP right now. Learn more about CHIP in Puerto Rico.
Who is the Secretary of Health and Human Services?
Secretary Burwell and the U.S. Department of Health and Human Services (HHS) are a core part of the Administration’s team working closely with Puerto Rico and other key stakeholders to address the fiscal crisis in the Commonwealth. HHS has taken a number of steps to provide residents of Puerto Rico with access to quality and affordable health care and a more sustainable future.
Is Puerto Rico a full benefit?
All of the dually eligible beneficiaries in Puerto Rico are in the full benefit category, due to the lack of a Medicare Savings Program. As such, plans enrolling dually eligible beneficiaries – including Dual Special Needs Plans – will likely see a significant increase in risk scores. Incorporating Increased Hospital Payments.
How many people are on Medicare in Puerto Rico?
Nowhere is Medicare Advantage more popular than in Puerto Rico, where 70 percent of eligible Medicare beneficiaries – nearly 600,000 people – are enrolled. This amounts to approximately 20 percent of our population, making it a vital source of health care coverage for the island’s seniors and people with disabilities.
What percentage of Puerto Rico's population is below poverty line?
Emphasis is placed on preventive care including vaccinations, checkups for diabetes, colon cancer and other critical screening tests. With 41 percent of the population in Puerto Rico living below the poverty line, many residents struggle to afford basics like adequate housing, let alone medicines and other health care needs.
Is Puerto Rico a dual eligible state for medicaid?
In addition, approximately half of people enrolled in Medicare Advantage plans in Puerto Rico have low incomes that also qualify them for Medicaid, a group known as dual-eligible.
Is Medicare underfunded in Puerto Rico?
Unfortunately the Medicare Advantage program is significantly underfunded in Puerto Rico, creating a downstream affect that has negatively impacted patients, doctors and hospitals. During the last several years, a mass migration of physicians to the mainland has left Puerto Rico with a shortage of specialists. ...