How does healthcare work in Puerto Rico, and what travel insurance, health insurance or expat insurance do you need?

How does the healthcare system work in Puerto Rico?

Healthcare in Puerto Rico is of good quality. However, it can vary depending on where you are on the island.
The doctors are well-trained and there are both public and private institutions.
There are a great many hospitals, clinics and pharmacies spread throughout the country.
Most medicines are readily available in Puerto Rico. However, it may be wise to bring your own if you are dependent on them.
Call 911 in case of a medical emergency. The answer is usually in Spanish, but you will quickly be transferred to an English-speaking person if you need it.
Private ambulances often require payment in advance. It is important to check whether your insurance covers this.

Public healthcare is arranged through a government program.
Healthcare is not free, but the government does offer a form of insurance for people who qualify for “la Reforma”. These are residents who meet a certain income limit. Check the government website for the latest updates.
The quality of public health care is good, but unfortunately there is a shortage of doctors, which results in long waiting times for care.

Private health care is even better than public health care, and you usually do not have to worry about long waiting times.
In most large health care facilities you can pay with a credit card, but it is still possible that you need cash.
Most good private clinics can be found in San Juan.
The costs for private health care can be quite high, but are usually still lower than in the mainland of the US.

Visiting an internist, general practitioner or family doctor for primary care is normal in Puerto Rico.
It can be useful to ask other foreigners living in Puerto Rico for advice about a good family doctor.
In Puerto Rico you will find several Independent Physician Associations (IPAs). These are a type of health care company to which several independent practices are affiliated.

In Puerto you can get good dental care and the costs are considerably lower than in the rest of the US (about 50-70%!). It is therefore also a popular place for medical tourism.
Dentists are often trained in the US and provide very good care.
Most dentists are certified by the “American Dental Association” (ADA).

Maternity care is not equally available everywhere in Puerto Rico.
Due to natural disasters and low wages, there is a shortage of healthcare workers.
Private hospitals and clinics generally offer the best and most personalized care. Here you have access to all the necessary tests and guidance.
20% of babies are born in areas where care is not available. 100% of women in rural areas live more than 30 minutes drive from a hospital with maternity care, compared to just under 10% in cities.
The number of C-sections has increased significantly in recent years to more than half of all births. It is becoming more the norm than the exception.
It is recommended that you talk to other foreigners living in Puerto Rico about their experiences with support during pregnancy. This way you can find the doctor that suits your needs best.
Abortion is legal in Puerto Rico.

In Puerto Rico you run fewer risks than in most major cities in the US. But it is still useful to be careful.
There is gun crime, drug trafficking and gangs are active. The murder rate is also quite high.
But don't get scared to go and move there. What you are more likely to encounter is theft and pickpocketing.
Be careful in the evenings, especially in San Juan, and make sure you carry your belongings with you in a good, safe bag or money belt.
It is also good to know that hurricanes can occur, which can cause flooding, power outages and damage to infrastructure.

Driving is the best way to explore the island, but traffic can be quite chaotic.
Drivers often drive aggressively and do not always follow the rules, and the roads can have large potholes.
Parking in San Juan is difficult. There are also often heavy traffic jams in the city around nine in the morning and between four and six in the evening.
It can be useful to learn some Spanish words so that you can better understand the road signs.
Driving around can be a lot more dangerous during hurricane season. The roads are especially slippery right after the first rain of the season. Roads can also flood.
Be careful when driving at night. It is best to stay in tourist areas. Gangs can be active in remote areas.
Buses and the “Tren Urbano” are the main means of public transport in San Juan. “Publicos” (shared vans), are mainly used for long-distance travel.

Is the trip to and your return sufficiently covered? Are you sufficiently covered before, during and after your activities? Which insurance best suits your trip and your activity? Read more about insurances for abroad on JoHoinsurances.org.

For Puerto Rico, it is strongly recommended to take out good, international health insurance. Public healthcare is not always easily accessible and the costs for private healthcare can quickly add up. Local health insurance is also an option, but then you are not covered for medical evacuation or repatriation, which is a must for many expats.
Make sure your insurance covers medical evacuation as well as coverage in neighboring countries. Read more about insurances for abroad on Expatinsurances.org.

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