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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.

2. What is a grievance?

Grievance: A type of complaint you can file regarding us or one of our participating health care providers or pharmacies, including complaints regarding quality of care. Grievances do not include coverage or payment disputes.


3. What is an appeal?

Appeal: The action you take if you do not agree with our determination to deny coverage or a payment request for health care services or prescription drugs. You may also file an appeal if you do not agree with our determination to cease the services you are receiving. For example, you may file an appeal if we refuse to pay for a prescription drug, item, or service you understand you should receive.


2. How do I file an appeal?

You may print out the following forms to send the information:


1. How do I file a grievance with Medicare?

You may give us feedback about your Medicare health care or prescription drug plan. This information will help the Centers for Medicare & Medicaid Services continuously improve the Medicare program. Medicare


1. How do I file a grievance with my Triple-S Advantage plan?

  • You may call 1-888-620-1919 from Monday thru Sunday, 8:00 am to 8:00 pm. TTY/TDD users may call 1-866-620-2520.
  • You may also:
    • send an email to
    • send a fax to (787) 993-3261
    • mail your grievance to:
      Triple-S Advantage
      Department of Grievances and Appeals
      PO Box 11320
      San Juan, PR 00922

3. What should I do if my physician is not in the Triple-S Advantage healthcare provider network?

As a general rule, if a physician does not belong to your plan network, his/her service would NOT be covered. However, at Triple-S Advantage we have a wide variety of coverages to meet your needs, with available alternatives for such scenarios, such as PPOs and HMO-POS.


2. Which Advantage plan should I choose?

At Triple-S Advantage, we have designed a rapid-response tool to help you find a plan that will meet your health conditions and/or needs. Click here.


1. What is Triple-S Advantage?

It is a Medicare Advantage Plan provided under contract with Medicare and the Health Insurance Plan from the government of Puerto Rico (Medicaid). It provides 100% Medicare coverage, but it extends the Original Medicare benefits and provides coverage for areas not covered by Medicare.


Member Service

1-888-620-1919

TTY/TDD users

1-866-620-2520

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

Service for Providers

1-855-886-7474

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

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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