Sick on vacation in Puerto Rico: a practical guide for visitors

Dr. Diana Nieves Castro, MD, a Puerto Rico-licensed general practice physician with several years of emergency-department experience, sees you by video while you are physically in Puerto Rico, wherever you live. She sees adults and children of all ages, in English or Spanish. We confirm your location at the start of the visit.

We evaluate, diagnose and treat; if needed, we give you a lab order for a lab near you. If appropriate, the doctor prescribes and we send your prescription to your pharmacy. We do not prescribe controlled substances. Everything about the service is on doctor for tourists in Puerto Rico.

• Request your visit. Request a visit online 24/7 — we confirm your time by email or text.
• See the doctor by video. We send you a secure video link; it works on your phone, tablet or computer. There's no office to get to.
• Pick up your medicine. If the doctor prescribes, we send your prescription to the pharmacy you choose on the island.

A doctor visit for visitors is US$79, paid by card when you request it, with no membership. If the visit can't take place, you get a full refund. A doctor's note after your visit is included at no extra charge.

[Travelers' diarrhea](route:condition-travelers-diarrhea) or a stomach bug. According to the CDC, bacterial diarrhea usually lasts 3 to 7 days untreated and viral diarrhea 2 to 3 days. Drink oral rehydration solution or fluids with electrolytes. With bloody stools, fever or severe dehydration, don't take anti-diarrhea medicine on your own; get care. See stomach bug in adults.

Heat. The CDC lists muscle cramps, heavy sweating, dizziness, headache, weakness and nausea as signs of heat illness. Rest somewhere cool and drink water. Confusion or fainting is an emergency.

The beach. For stings see jellyfish stings in Puerto Rico; ear pain after swimming may be swimmer's ear. If you stepped on a sea urchin, see sea urchin sting. According to the CDC, very itchy, winding red tracks after walking barefoot or sitting on sand with dog or cat feces can be cutaneous larva migrans. If you get sick on a boat or an excursion, see seasickness.

Other: a UTI, sore throat, allergies, or medication left at home: see lost or forgotten prescription. For your next trip, read bringing medication to Puerto Rico.

Ashford Presbyterian Community Hospital ("El Presby"), at 1451 Ashford Avenue in Condado, describes itself as the official emergency provider for Luis Muñoz Marín International Airport, San Juan's cruise terminals, the Convention Center and surrounding metro hotels. It has separate adult and pediatric emergency rooms. Phone: (787) 721-2160.

Near Isla Verde and the airport, Hospital UPR Dr. Federico Trilla (Carretera 3 km 8.3, Carolina) runs an emergency room open 24 hours with a pediatric area. Phone: (787) 757-1800.

911 works in Puerto Rico just as on the mainland, for ambulance, police and fire.

In the tourist areas, "24-hour Walgreens" usually means the store, not the pharmacy counter. The Walgreens on Ashford Avenue in Condado is open 24 hours, but its pharmacy is not. On Isla Verde Avenue, the store is open 6am to midnight, and the pharmacy Monday to Friday 9am to 7pm, Saturday 9am to 6pm and Sunday 10am to 6pm.

The nearest 24-hour pharmacy counter we could verify in the metro area is in Guaynabo (2505 Carr 841); it closes from 1:30 to 2am. Hours change, so check the Walgreens locator or call before you go. See the list of 24-hour pharmacies in Puerto Rico.

We don't bill any insurance: you pay by card, and on request we give you an itemized receipt (superbill) to claim from your plan, HSA or FSA.

For ERs and other providers, it depends on your plan. Medicare treats Puerto Rico as part of the United States. Details in does Medicare work in Puerto Rico?. If you get sick and need to cancel or change your trip, see doctor’s note for travel insurance.

The CDC lists dengue as a significant risk for travelers to Puerto Rico. Use a repellent with at least 20% DEET, wear long sleeves and stay in screened or air-conditioned rooms. If you get a fever during or after your trip, read about dengue in Puerto Rico.

We see children of all ages. If the patient is under 21, a parent with patria potestad (parental authority) or a legal guardian signs the consent, stays on the video for the whole visit and shows photo ID. That's Puerto Rico law: a grandparent or aunt traveling with the child cannot take their place.

The doctor's license is a Puerto Rico license, so she sees you while you are here. If you will need follow-up at home, ask during the visit for a summary to take to your own doctor.

Arrived by cruise ship? There is a separate guide for cruise passengers in San Juan.