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Benefits

Ahorro Plus (HMO)

Contigo Plus (HMO-SNP)

Enlace Plus (HMO)

Brillante (HMO-POS)

ContigoEnMente (HMO-SNP)

Savings in Part B $65 per month $70 per month $75 per month $20 per month $60 per month
Benefits of purchases and
payment for:

• Purchase of food
• Restaurants and fast foods
• Utilities: Water, electricity, telephone, and internet
• Gasoline
• Propane gas
• Household cleaning supplies
• Professional house cleaning
$90 per month Not covered Not covered Not covered $75 per month
OTC $50 every 3 months Not covered $200 per month $25 every 3 months $150 per month
Comprehensive Dental $2,500 per year
Includes implants
$2,500 per year $3,000 per year $2,000 per year $2,500 per year
Eyeglasses $350 per year $220 per year $400 per year $300 per year $400 per year
Preferred brand prescription drugs $5 copay $0 copay $0 copay $25 copay $0 copay
Hearing aids $500 per year $500 per year $1,500 per year $1,250 per year $1,250 per year
Transportation 14 trips per year Not covered 18 trips per year 20 trips per year 28 trips per year

I wish to receive information about the coverage products and services offered by Triple-S Advantage

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By completing this form, you agree to a meeting with a sales agent to discuss the types of products you check above. Please note, the person who will discuss the products is either employed or contracted by a Medicare plan. They do not work directly for the Federal government. This individual may also be paid based on your enrollment in a plan.

This selection does NOT obligate you to enroll in a plan, it does not affect your current membership, and it will not enroll you in another Medicare plan.

Member Service

1-888-620-1919

TTY/TDD users

1-866-620-2520

Monday thru Sunday,
from 8:00 a.m. to 8:00 p.m.

Service for Providers

1-855-886-7474

Monday thru Friday,
from 8:00 a.m. to 5:00 p.m.

TeleConsulta

1-800-255-4375

Dedicated TeleConsulta for TTY/TDD Callers: 711 | 1-855-209-2639

TeleConsejo

1-877-879-5964

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