Out of Network Coverage
For Preferred Provider Organization (PPO) plan, with the exception of emergency or urgent care, it will cost you more to get Care from Out-of-Network providers. For Out-of- Network services, First+Plus (PPO) provides reimbursement for all covered benefits as long as they are medically necessary.
For Health Maintenance Organization (HMO) plan, with the exception of an emergency or urgency, generally, you are not covered for services received from a non-contracted provider.
If you receive a bill for services received from a non-contracted provider, you should not pay the bill. You should submit it to First+Plus for processing and determination of liability. Please send the bill to us at:
Attn: Claims Department
PO BOX 195559
San Juan, PR 00919