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Puerto Rico · 2026 plan year

Medicare Advantage PPO plans in Puerto Rico

There are 30 Medicare Advantage PPO plans in Puerto Rico from 3 carriers, averaging 3.50 out of 5 stars across the 4 plans CMS has rated. Nearly all charge no monthly plan premium, so what separates them is network, drug coverage and how much you could owe in a bad year.

30
PPO plans
3
Carriers
78
Counties covered
3.5
Avg stars (4 of 30 rated)
Varies
Avg out-of-pocket max
A $0 plan premium is not a free plan. You still pay your Part B premium to Medicare, plus copays and coinsurance as you use care. Star ratings are published by CMS per contract, so every plan a carrier files under the same contract shares one rating — it describes the carrier’s performance, not this specific plan’s benefits. Estimate your real costs.

PPO plans in Puerto Rico rate below the national average.

The 4 rated PPO plans here average 3.50 stars against a national median of 3.81. No plan here reaches 4 stars, so the rating will not separate them for you — compare on network, drug coverage and out-of-pocket limits instead. The score describes the carrier's contract, not any one plan's benefits.

26 of Puerto Rico's PPO plans carry no star rating yet.

CMS rates a contract, not a plan, and does not rate one that is too new or has too little data — so 26 plans here shows no rating at all. Unrated is not the same as badly rated; it usually means a new contract, and those plans have to be judged on benefits and network instead.

Not sure whether Medicare Advantage suits you at all? Medicare Advantage vs Original Medicare covers the trade in plain language.

Highest rated

Top-rated PPO plans in Puerto Rico

PlanStarsOut-of-pocket maxPremium / mo
Óptimo Plus (PPO)Triple-S Advantage3.5★—$0
Óptimo Plus D (PPO)Triple-S Advantage3.5★——
Óptimo Plus E (PPO)Triple-S Advantage3.5★——
Óptimo Plus F (PPO)Triple-S Advantage3.5★——
Humana Medicare Employer (PPO)HumanaNot rated——

Showing 5 of 30. See all Puerto RicoMedicare Advantage plans →

Who sells here

PPO plans by carrier

CarrierPlansAvg starsSNPs
Medicare y Mucho Mas (MMM)Elevance Health, Inc.14——
HumanaHumana Inc.12——
Triple-S AdvantageGuidewell Mutual Holding Corporation43.5—
Other plan types in Puerto Rico

How PPO compares

HMO
4.9★ avg · 3 carriers
146 plans
PPO
3.5★ avg · 3 carriers
30 plans · you are here

All Puerto RicoMedicare Advantage plans →

Nearby on quality

States with similar PPO star ratings

Nebraska
3.50★ average
18 PPO plans
Vermont
3.50★ average
1 PPO plans
Missouri
3.48★ average
23 PPO plans
Common questions

Puerto Rico Medicare Advantage PPO plans, answered

How much do Medicare Advantage PPO plans cost in Puerto Rico?
Of the Puerto Rico PPO plans with a published premium, 100% charge $0 a month. A $0 premium does not mean the plan is free: you still pay your Part B premium to Medicare, plus copays and coinsurance as you use care. The number that actually caps a bad year is the plan's out-of-pocket maximum — check it on each plan, since CMS does not publish it uniformly for PPO plans.
What are the star ratings for Puerto Rico PPO plans?
The 4 rated PPO plans in Puerto Rico average 3.50 out of 5 stars, with 0 rating 4 or better. CMS rates a contract rather than an individual plan, so every plan a carrier files under the same contract shares one score. A contract that is too new or has too little data is not rated at all, which is different from rating badly.
How many Medicare Advantage PPO plans are available in Puerto Rico?
There are 30 PPO plans from 3 carriers, sold across 78 counties. Availability is set by county, so the plans you can actually join depend on where you live — the full list is rarely available in any one place.
Do Puerto Rico PPO plans include prescription drug coverage?
30 of the 30 PPO plans here bundle Part D drug coverage into the plan. That is the usual arrangement for Medicare Advantage and there is no separate drug premium for it — the plan premium covers both. If you join a Medicare Advantage plan without drug coverage, you generally cannot add a standalone Part D plan alongside it.
What is a Special Needs Plan, and are there any in Puerto Rico?
None of the PPO plans in Puerto Rico are Special Needs Plans. SNPs limit enrollment to people who also have Medicaid, live in a nursing home or similar institution, or have a qualifying chronic condition. They often carry richer benefits for that group, but if you do not meet the criteria you cannot join one — so the real number of plans open to you may be lower than the total.

A $0 premium is not the whole cost.
See what a year really looks like.

Simplivera models your actual annual costs across Puerto Rico Medicare Advantage plans.

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