Puerto Rico Affordable Healthcare Insurance Coverage

Treatment for substance use and/or mental health is not something to be taken lightly. This is an essential step to starting over with a new way of living that puts you more in control of your life. So don’t let worries over paying for a treatment program keep you from entering one.

While the Department of Health and Human Services decided that U.S. territories aren’t obligated to follow the Affordable Care Act mandates, Puerto Rico decided to follow the rules. This means that plans need to cover essential health benefits, which includes mental health and substance use treatment.

Health Insurance Plans In Puerto Rico

You can find a few different insurance companies through the individual healthcare marketplace in Puerto Rico. Once you choose a health insurance plan, find out which health professionals and facilities its network covers to cut down on costs further. Also, check whether you need to get your care authorized in advance by the insurance company as that can often prevent a fee and ensure that the care you want is covered.


One of the insurers that provides coverage in Puerto Rico is Aetna, through its companies First Health Network and Coventry. Both Aetna companies offer PPO plans that allow you to choose from health professionals and facilities that are both in the plan network and outside of it. While you will have out-of-network coverage, you will pay more. Your specific deductible, premiums and copays or co-insurance amounts will vary based on the plan you choose.

When you sign up for one of these Aetna plans, you would have access to MHNet Behavioral Health, a company that sets you up with behavioral health treatment. Its coverage includes a variety of mental health and substance use treatments, including acute rehab, psychotherapy, inpatient care, and outpatient care. Treatment through this network comes from behavioral health professionals, such as qualified psychiatrists.


Humana offers individual insurance plans following the Affordable Care Act guidelines in Puerto Rico. Many Humana plans cover various types of treatment at only $5 copay for each visit. The treatment for these visits includes individual counseling, group counseling, detoxification, medication management, and more. Most care received in an inpatient or outpatient facility would cost you nothing. Under this plan, you need preauthorization for your substance abuse and mental health treatment.

Get Help With Your Care Needs

Contact us to get the help you need.By having an individual health insurance plan, you will have support in paying for your treatment. These plans can help with substance abuse and addiction, as well as for a co-occuring mental disorder if needed. Start on the path towards a sober life by choosing a health insurance plan that fits your needs and using it to enter treatment. It’ll be the most important decision of your life.

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