What are steps a person from Puerto Rico must take to seek health care?

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M.P. Ossa | College Teacher | (Level 1) Distinguished Educator

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The main question that you are asking, I believe, is how to get health care insurance for a person of Puerto Rican origin currently residing in the continental United States. 

The answer to your question is actually an easy-fix. Puerto Rico's complete official name is Estado Libre Asociado de Puerto Rico, or Free-Associated State of Puerto Rico. This means that the island is an actual territory of the United States. As a result, people born in Puerto Rico are American citizens with the right to enjoy the rights and freedoms of the continental and official 50 states. 

This being said, Puerto Ricans have to go through the same steps as any other American citizen when it comes to getting health care insurance, or health care as it is. In short, you will not be treated differently nor be denied the coverage that you seek to get merely on the basis of having been born in Puerto Rico.

Now, consider exactly what it is that you want to get: If you want publicly-funded health care, the recently passed Affordable Health Care Act (President Obama's health care act) aims to provide every American citizen with affordable health care plans. To be eligible for it, check the website of the US Health department (which is given to you in the links below) and go to your particular state of residency to see what are your qualifications. 

If you are seeking a privately-funded health care plan then all you need to do is to either go directly to an insurance company such as AFLAC, for example, and explore their options. Many people who are self-employed get their medical insurance this way.

If you are employed with a company, or in the public sector, chances are that your organization will have health care insurance as one of your benefits. This is the way that employers entice potential employees to apply to work in their organizations. For this, you get to choose from 

Traditional Health care- Sign up, you may have to pay up front, or pay a deductible for the services. It is a form of "fee-for-service" plan.

Fee for service- Prior to the insurance paying for your expenses (roughly 60-80% depending on your plan, you pay for whatever is left to pay for, sometimes up front, and sometimes after the service is provided. You may or may not have lead-way to choose your health care providers, so read the clauses with LOTS of care. 

Managed Care is basically signing up to pay for an insurance carrier which will have a list of preferred doctors and clinics from which you can choose. You may have to pay more out of pocket expenses if you choose someone from outside their list. 

PPO-This may be one of the most popular types of health care insurance because it is like managed care. However, it is a much bigger umbrella that allows for the insurance carriers to negotiate less fees. This is how some co-pays are higher than others; it all depends on the clauses stated on their PPO plan. 

The other two are the HMOs and the POSs. These plans resemble each other in that the POS allows you to choose your head physician from the list (or rather really encourage you to use their choice). The HMO is the least expensive because they expect you to follow preventive care practices as an incentive. They seem to be good but it all depends on your area. 

Again, a citizen from PR is equally entitled to health care due to their legal citizen status. The rest depends on your choices and where you live. 


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