Providers – triple-s advantage

Triple-S Advantage, Inc. is a Health Maintenance (HMO) and Preferred Provider Organization (PPO) with a Medicare contract, and a contract with the Puerto Rico Government Health Plan (GHP). Enrollment in Triple-S Advantage, Inc. depends on contract renewal. This information is not a complete description of the benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums, deductibles, copayments and coinsurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium. The formulary, pharmacy network, and provider network may change at any time. You will receive notice when necessary. This plan is available to anyone who has both Medical Assistance from the State and Medicare.


Triple-S Advantage, Inc. is an independent licensee of BlueCross BlueShield Association.

To enroll, you must have Medicare Parts A and B, or Medicare Parts A and B and Medicaid, be a U.S. citizen or lawfully present in the United States, have not been diagnosed with End Stage Renal Disease (ESRD) and reside within the 78 municipalities of the Island. Medicare beneficiaries may also enroll in Triple-S Advantage, Inc. through the CMS Medicare Online Enrollment Center located at www.medicare.gov.

Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next. Out-of-network or non-contracted providers are under no obligation to treat Triple-S Advantage, Inc. members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our Customer Service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.

Member Services also has free language interpreter services available for non-English speakers. This information is available for free in other languages. Please call our Member Service Center at 1-888-620-1919 for additional information. Hearing impaired system (TTY) users should call 1-866-620-2520. Our hours of operation are Monday through Sunday from 8:00 am to 8:00 pm. Servicios al Afiliado también tiene servicios de intérprete libre de costo disponible para personas que no hablan español. Esta información está disponible libre de costo en otros idiomas. Por favor, comuníquese con nuestro Centro de Servicio al Afiliado al 1-888-620-1919 para obtener información adicional. Los usuarios del Sistema para audioimpedidos (TTY) deben llamar al 1-866-620-2520. Nuestro horario es de lunes a domingo de 8:00am a 8:00pm.

Triple-S Advantage, Inc. complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Triple-S Advantage, Inc. cumple con las leyes federales aplicables de derechos civiles y no discrimina por razón de raza, color, origen de nacionalidad, edad, discapacidad, o sexo. Triple-S Advantage Inc. 遵守適用的聯邦民權法律規定,不因種族、膚色、民族血統、年齡、殘障或性別而歧視任何人ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call: 1-888-620-1919 (TTY: 1-866-620-2520). ATENCIÓN: Si usted habla español, servicios de asistencia lingüística están disponibles libre de cargo para usted. Llame al: 1-888-620-1919 (TTY: 1-866-620-2520). 注意:如果您使用繁體中文,您可以免費獲得語言援助服務。請致電 1-888-620-1919 (TTY: 1-866-620-2520)。

Triple-S Advantage has a strong commitment to protecting the confidentiality of our members’ sensitive information. We take information privacy very seriously and it is important to us that our members are made fully aware of a potential privacy issue. We have learned that personal information of some of our members, including their name, health plan identification number, date of service in which treatment was provided, and treatment codes describing the service provided was mailed to the wrong address. The Social Security Numbers and date of birth of our members were NOT disclosed as a result of this incident.

Triple-S Advantage has performed an extensive investigation into why and how their personal information was disclosed. We have taken immediate steps to ensure additional notices to our members and your health care providers are sent to the correct address, such as: correction of the mailing process, completion of testings and sending the letters to the correct address of your provider. The members who may have been affected by this incident will receive first-class mail notices.

If you are a Medicare Platino member, you can also contact the Health Insurance Administration of Puerto Rico (ASES) at or Customer and Providers Services Offices (PROBENE) at 1-800-981-2737/1-800-981-ASES from Monday through Friday 8:00 am to 4:30 pm, a Customer Services Representative will assist you. TTY users should call (787) 474- 3389. You can also contact us by email at oficialdeprivacidad@asespr.org.

Please Note: Triple-S Advantage will NOT call or email anyone requesting any personal information as a result of this incident. If you receive an unsolicited call or email that appears to be from Triple-S Advantage, your local hospital or physician office, please do not provide any personal information in response to these calls or emails.

Triple-S Advantage, Inc. complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Triple-S Advantage, Inc. cumple con las leyes federales aplicables de derechos civiles y no discrimina por razón de raza, color, origen de nacionalidad, edad, discapacidad, o sexo. Triple-S Advantage Inc. 遵守適用的聯邦民權法律規定,不因種族、膚色、民族血統、年 齡、殘障或性別而歧視任何人ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call: 1-888-620-1919 (TTY: 1-866-620- 2520). ATENCIÓN: Si usted habla español, servicios de asistencia lingüística están disponibles libre de cargo para usted. Llame al: 1-888-620-1919 (TTY: 1-866-620-2520). 注意:如果您使用繁體中文,您可以免費獲得語言援助服務。請致電 1-888-620-1919 (TTY: 1-866-620-2520)。 ×