*Certain restrictions apply. You must be eligible to the benefit. **Copay/coinsurance applies to services rendered at SALUS facilities. Other providers are available in our network. 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. DOWNLOAD SUMMARY OF BENEFITS Evidence of Coverage (EOC)The EOC gives you details about your Medicare healthcare for the calendar year. It also explains how to get coverage for the services you need. This is an important legal document. DOWNLOAD 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 and providers for the next year. The ANOC helps you compare your current health benefits and costs with those for next year. DOWNLOAD ANNUAL NOTICE OF CHANGE List of Durable Equipment (DME)The Durable Equipment (DME) lists information about brands, equipment manufacturers and medical providers in this plan, as described in your Evidence of Coverage. DOWNLOAD LIST OF DURABLE EQUIPMENT Provider Directory 2024 Provider DirectoryThis 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. DOWNLOAD PROVIDER DIRECTORY OTC Items and Drugs Guide for Over-the-Counter (OTC) Drugs and itemsThis 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. DOWNLOAD GUIDE FOR OVER-THE-COUNTER (OTC) DRUGS AND ITEMS You can compare the PPO Plans and know the benefits of each of them. COMPARE THIS PLAN I wish to receive information about the coverage products and services offered by Triple-S Advantage Please fill the required fields: Yes, I wish to receive information about the coverage products and services offered by Triple-S Advantage. Full Name E-mail Home Phone Cell Phone Mailing Address Current Plan (if apply) You have: Medicare Part A Medicare Part B Government Health Plan of Puerto Rico (GHP) ELA Message * May we contact you? Yes No I WANT TO BE CONTACTED 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. 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Home & Lifestyle Do you have your digital Digital Vehicle Tag? Learn where and how to get Triple-S Propiedad as your Compulsory Insurance Read more
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