this site demands javascript Skip to main content
Write your review
Arrow down

Call us

Call us

Sales Representative


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

TTD Users


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

Contigo Plus (HMO-SNP)

Let us guide you

Send us your information and we will contact you as soon as possible.

* May we contact you?

Why choose Contigo Plus (HMO-SNP)?

If you suffer from Diabetes Mellitus, Chronic Heart Failure or Cardiovascular Conditions and are looking for a plan that offers you specialized care without sacrificing the supplementary benefits you are looking for, Contigo Plus (HMO-SNP) is for you. Contigo Plus (HMO-SNP) is a plan specially designed for people who suffer from at least one of the conditions mentioned that seek low copayments and attractive benefits such as eyeglasses, dental, OTC, monthly premium reduction, among others.

Who is elegible for this plan?

  • Beneficiaries with Medicare Parts A and B
  • Residents living in one of Puerto Rico’s 78 municipalities
  • Patients who have been diagnosed with diabetes mellitus, chronic heart failure or cardiovascular disease, and are interested in a specialized coordinated care program for the management of any of these conditions
  • United States citizens or legal residents

For additional information about copayments, coinsurances and details about the benefits and restrictions that apply, please read the Evidence of Coverage and Summary of Benefits.

Some benefits of this plan:

  • $150 every 3 months por food and groceries shopping, housecleaning, purchase of gasoline and payment of utilities restricted to water, electricity, internet, telephone, cable tv/satellite through contracted merchants*
  • $0 Hospital Stay**
  • $0 Primary Care Physicians (PCP)
  • $0 Specialists**
  • $0 Laboratory** Tests and X-Rays
  • $0 Covered Prescription Drugs***
  • Preventive Dental Benefit
  • $1,500 every year for Comprehensive Dental Benefit
  • $100 every 3 months for OTC WITHOUT PRESCRIPTION
  • $600 annually for prescription eyeglasses or contact lenses
  • $1,500 annually for Hearing Aids
  • 36 one-way trips to plan-approved locations, including to non-medical destinations, such church, supermarkets, and financial institutions (e.g., banks)*
  • 3 supplemental nutritionist visits
  • Erectile dysfunction drugs


SSS-A tu Lado
In-Home Support Specialized In-Home Support
Up to 48 hours of care in a calendar year (four [4] hours per day for a maximum of 12 days in the calendar year). Up to 40 hours every 3 months (quarterly) for a maximum of 160 hours in a calendar year.
Benefit eligibility will be based on medical recommendation and meeting certain conditions. Benefit eligibility will be based on certain eligible condition(s) and the requirement to meet with a Care Manager at least once every 3 months (quarterly) in order to have access to the benefit.
See Evidence of Coverage for additional details on these benefits.

  *Restrictions apply.**Copay/coinsurance applies to services in the Preferred Provider Network or services rendered at SALUS facilities. Other providers are available in our network.***Applies to the Preferred Pharmacy Network in Tiers 1, 2 & 6. This information is not a complete description of benefits. Call: 1-888-620-1919 (TTY 1-866-620-2520) for more information. This is a brief summary for informational purposes and it does not replace or modify your Evidence of Coverage (EOC).

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.


Evidence of Coverage (EOC)

The EOC gives you details about your Medicare healthcare 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.


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.


List of Durable Medical Equipment (DME)

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


Provider and Pharmacy Directory 2022

Provider Directory

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


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.



Drug Formulary

The Comprehensive Formulary lists all the drugs covered by our plan. These drugs were selected in consultation with a team of healthcare providers and represent the prescription therapies believed to be necessary for a quality treatment program.


Notice of Changes to Formulary

Our plan is required to provide notice about removals or changes in the preferred or tiered cost-sharing status of any Part D drugs included in the formulary.

Effective Changes at al 2/1/2022

Effective Changes at al 3/1/2022

Effective Changes at al 7/1/2022

Effective Changes at 8/1/2022

Effective Changes at 9/1/2022

Prior Authorization Criteria

Our plan requires you (or your physician) to get prior authorization for certain drugs. This means you will need to get our approval before filling your prescription. If you don’t get approval, we may not cover the drug.

If you need the information contained in this document in Spanish, you may contact Member Services at 1-888-620-1919, Monday through Sunday from 8:00 a.m. to 8:00 p.m. TTY/TDD users should call 1-866-620-2520.


Step Therapy Criteria

In some cases, Triple-S Advantage requires that you first try certain medications to treat your medical condition, before covering other medications for the same medical condition. For example, if medication A and medication B both treat your medical condition, Triple-S Advantage may not cover medication B unless you have tried medication A first. If medication A does not work for you, then Triple-S Advantage will cover medication B.

If you need the information contained in this document in Spanish, you may contact Member Services at 1-888-620-1919, Monday through Sunday from 8:00 a.m. to 8:00 p.m. TTY/TDD users should call 1-866-620-2520.


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 healthcare. 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.


I need more information to choose my plan. Call me!

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.

Last update: 15/10/2022

Member Service


TTY/TDD users


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

Service for Providers


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



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