How to see a doctor without insurance in Puerto Rico

Federally funded community health centers offer primary care, prenatal care, baby shots and referrals to specialists, among other services. What you pay depends on your income, and you don't need insurance.

There are centers in both urban and rural parts of Puerto Rico. Find one with the federal Find a Health Center (opens in a new tab) tool, and call ahead to ask about hours and which income documents to bring.

A federal law, EMTALA, requires hospitals that take part in Medicare and offer emergency services to give a medical screening exam to anyone who asks for care for a possible emergency, regardless of ability to pay, and to stabilize or transfer them if needed. That duty applies to hospital emergency departments.

CDTs (Centros de Diagnóstico y Tratamiento, local diagnostic and treatment centers) are another option for problems that can't wait, but their services, hours and payment rules vary. Call first. See ER vs urgent care in San Juan.

In an emergency, call 911 or go to the nearest emergency room. Don't wait because of cost.

Puerto Rico's Medicaid program, often called Plan Vital or "the government plan", is run through the Puerto Rico Health Insurance Administration (ASES), with the Department of Health as the responsible agency. Eligibility depends mainly on household income.

To find out whether you qualify, apply through the Department of Health's Medicaid program. If you already have the government plan, use its network before paying out of pocket.

You don't need insurance or a membership: you pay only for the visit you choose, by credit or debit card, when you request it. The price is the same for every age.

• Doctor visit, US$79: a new problem, virtual urgent care for non-emergencies, primary care, children, birth control, STIs, skin and visitors.
• Follow-up visit, US$49: a refill of a medicine you already take (anyone can book this) or a review of lab results (existing patients only).
• School and work forms, US$35: school, university or job forms, and the certificado de salud lab order. Not forms that need a vision exam.

If the visit can't take place, you get a full refund. If a US$49 or US$35 visit turns out to need a full doctor visit, the doctor explains why and, only with your consent, you pay the difference. A doctor's note after your visit is included at no extra charge. Details are on pricing; to book, go to the booking page.

You see Dr. Diana Nieves Castro, MD, a Puerto Rico-licensed general practice physician with several years of emergency-department experience, in English or Spanish. The service is run by The Health Initiative, a nonprofit.

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. We care for colds, UTIs, sore throats, chronic conditions and more, for adults and children of all ages: start with an online doctor visit, or a prescription refill if you just need a medicine you already take. If you want a doctor for ongoing care without insurance, see virtual primary care.

You must be in Puerto Rico during the visit. If the patient is under 21, a parent with patria potestad or a legal guardian stays on the video for the whole visit and shows photo ID. Request a visit online 24/7 — we confirm your time by email or text.

Before you rely on a plan here, call the number on your card and ask which Puerto Rico doctors are in network and whether you must choose a primary care physician first. If you moved recently and your coverage hasn't started, a community health center or a self-pay visit can bridge the gap. If you have Medicare or a mainland plan, see does Medicare work in Puerto Rico?. More comfortable in English? See our English-speaking doctor by video.

The visit price doesn't include what others charge: the pharmacy for medicines and the lab for tests. Ask the pharmacy for the generic price and compare pharmacies, since self-pay prices vary a lot. We don't bill insurance, but on request we give you an itemized receipt (superbill); ask your HSA or FSA administrator, or your plan, whether they reimburse a telehealth visit you paid for yourself.