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Sales Representative

1-833-779-7999

Your call may be directed and answered by a licensed insurance sales agent.

TTD Users

1-866-620-2520

Monday through Sunday, from 8:00 a.m. to 8.00 p.m.

Documents

Important documents for you

Summary of Benefits (SB)

The Summary of Benefits tells you about some of the characteristics of the plan. It does not include all covered services or all limitations or exclusions. For a complete list of benefits, refer to the Evidence of Coverage.

Click on the plan to download the summary of benefits

Evidence of Coverage (EOC)

The EOC gives you details about your Medicare health care and prescription drug coverage for the calendar year. It also explains how to get coverage for the services and prescription drugs you need. This is an important legal document.

Click on the plan to download the evidence of coverage

Annual Notice of Change (ANOC)

This document is sent to members every fall to inform you about all the changes to benefits, costs, providers, and prescription drugs for the next year. The ANOC helps you compare your current health and prescription drug benefits and costs with those for next year.

Click on the plan to download the annua notice of change

Provider and Pharmacy Directory

Provider Directory

This document provides you with a list of all our contracted health care providers such as primary care physicians, specialists, hospitals, outpatient facilities among other health professionals. This directory contains contracted providers and preferred network providers.

DOWNLOAD PROVIDER DIRECTORY

Pharmacy Directory

The Pharmacy Directory gives you a complete list of pharmacies in our network, which means that all of these pharmacies have agreed to fill covered prescriptions for members of our plan. This directory contains contracted pharmacies and preferred network pharmacies.

DOWNLOAD PHARMACY DIRECTORY

List of Durable Medical Equipment (DME)

The Durable Medical Equipment (DME) list information about brands, equipment manufacturers and medical providers in this plan, as described in your Evidence of Coverage.

DOWNLOAD LIST OF DURABLE MEDICAL EQUIPMENT

Guide for Over the Counter (OTC) Drugs and items

This guide includes over the counter (OTC) medications and health-related items that do not require a prescription to help treat injuries or illnesses. It contains a list of some commonly used drugs, but does not include all the drugs covered by the plan and some items that assist in your health care. This list was selected by a team of health professionals and represents the therapies of medications and non-prescription items that we understand are important to complement your treatment program with prescription drugs.

DOWNLOAD GUIDE FOR OVER THE COUNTER (OTC) DRUGS AND ITEMS

Star Rating Medicare

One of the most important goals for the Centers for Medicare & Medicaid Services (CMS) is to make the quality of Medicare Advantage plans transparent for their beneficiaries. To achieve this goal, Medicare Advantage plans are rated every year on a one- to five-star scale. The Medicare Program rates how well Medicare health and drug plans perform in different categories (for example, detecting and preventing illness, ratings provided by patients, patient safety, drug pricing, and customer service). This score provides an overall measure of a plan’s quality, and is a cumulative indicator of the quality of care, access to care, responsiveness, and plan beneficiary satisfaction. One star represents poor performance, while a five-star rating is considered excellent. The plan ratings are posted on the Medicare website to provide beneficiaries with additional information to help them choose among the Medicare Advantage plans offered in their area. You can visit www.medicare.gov for more information.

If you would like to get additional information on our plan’s performance please call 1-888-620-1919, from Monday through Sunday, from 8:00 a.m. to 8:00 p.m. TTY/TDD users should call 1-866-620-2520.

ID Cards

While you are a member of our plan, you must use the Triple-S Advantage membership card whenever you get any covered services and for prescription drugs obtained at network pharmacies. You must not use your red, white, and blue Medicare card to get covered medical services (except for routine clinical research studies and hospice services). Keep your Medicare card in a safe place in case you need it later. If you obtain covered services using your red, white, and blue Medicare card instead of using the Triple-S Advantage membership card while you are a plan member, you may have to pay the full cost out of pocket.

If your plan membership card is damaged, lost, or stolen, call Customer Service Center immediately, and we will send you a new card.

HMO

HMO with pharmacy

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Atás

HMO without pharmacy

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HMO-POS

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PPO

PPO with pharmacy

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PPO without pharmacy

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Platino

Frente
Atás

I am undecided. Please call me to provide some guidance.

By completing this form, you as a beneficiary or authorized representative agree to have one of our sales representatives contact you to discuss the products Triple-S Advantage offers under Part C. Please be aware that the person calling you is a Medicare employee or subcontractor. They do not work directly with the federal government. This person could receive compensation based on your plan enrollment.

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

Service for Providers

1-855-886-7474

TTY/TDD users

1-866-620-2520

Teleconsejo

1-877-879-5964

Monday thru Friday,
from 8:00 am to 5:00 pm

Teleconsulta

1-800-255-4375

Monday thru Sunday,
from 8:00 am to 8:00 pm

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