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Puerto Rico · 2027 plan year

Medicare Advantage PPO plans in Puerto Rico

There are 1 Medicare Advantage PPO plans in Puerto Rico from 1 carrier, averaging 4.50 out of 5 stars across the 1 plan CMS has rated. Every one with a published premium charges $0 a month, so what separates them is network, drug coverage and how much you could owe in a bad year.

1
PPO plans
1
Carriers
78
Counties covered
4.5
Average stars
$7,151
Median out-of-pocket max

Across the 1 PPO plans in Puerto Rico that publish one, the in-network out-of-pocket maximum sits at $7,151 for most plans, which is also the highest in the state — the ceiling on what you pay in a year for covered in-network care. The mean is $7,151, which sits below the median — the spread is not symmetric, so the median is the better guide.

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.

One insurer sells every Medicare Advantage PPO plan in Puerto Rico.

All 1 PPO plans here come from Triple-S Advantage. With the field this narrow, the decision is mostly about which plan design inside that network fits your care — so start by confirming your doctors and hospitals are in it.

Puerto Rico has one of the smallest Medicare Advantage PPO markets in the country.

There are 1 PPO plans here from 1 insurer, against an average of about 40 per state. Fewer options makes the comparison quicker, but it also means one plan's network or drug list can decide the whole choice.

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 Advantage4.5★$7,151$0

Showing 1 of 1. See all Puerto RicoMedicare Advantage plans →

Who sells here

PPO plans by carrier

CarrierPlansAvg starsSNPs
Triple-S AdvantageGuidewell Mutual Holding Corporation14.5—
Other plan types in Puerto Rico

How PPO compares

HMO
4.8★ avg · 3 carriers
62 plans
PPO
4.5★ avg · 1 carriers
1 plans · you are here

All Puerto RicoMedicare Advantage plans →

Nearby on quality

States with similar PPO star ratings

Utah
4.30★ average
35 PPO plans
Idaho
4.25★ average
16 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. The monthly premium is what you pay the plan for its medical (Part C) and drug (Part D) coverage together. 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 in-network out-of-pocket maximum, with a median of $7,151 across these plans.
What are the star ratings for Puerto Rico PPO plans?
The 1 rated PPO plans in Puerto Rico average 4.50 out of 5 stars, with 1 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 1 PPO plans from 1 carrier, 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?
1 of the 1 PPO plans here bundle Part D drug coverage into the plan. That is the usual arrangement for Medicare Advantage, and you pay one monthly premium to the plan — but that premium has a medical (Part C) part and a drug (Part D) part, and the drug part is often what makes it more than $0. Each plan's page shows 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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