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Health Insurance: PYMES


Group medical plan for Small Groups

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Products offered by MAPFRE LIFE INSURANCE COMPANY OF PUERTO RICO are designed to meet the highest industry standards and provide peace of mind to our members by having a comprehensive health plan. Our Small Group health plans (PYMES) adapt to groups’ needs and budget.

Among the benefits that this product offers, are the following:


  • Medical Expenses:
    Free selection plans with a wide variety of benefits and an extensive network of providers.
  • Pharmacy:
    Coverage for the cost of prescribed medication.

MAPFRE’s medical plans for the Small Groups allow peace of mind by offering a comprehensive policy that provides coverage to the employees and family, according to the established general terms, conditions and limitations in the policy.

The general terms, conditions and limitations of MAPFRE’s health services inform users which coverage’s they may access, the benefits and additional advantages, as well as the requirements and restrictions established by the Company.

MAPFRE’s health insurance includes a series of requirements and restrictions that users must be aware of in order to know what coverage’s may be accessed according to the general terms and conditions established in the agreement. Some are:

  • Excluded are losses resulting from an insurrection or war, declared or not, any incidental act of said insurrection or war, or participation in any disturbance or civil disobedience.
  • Excluded are losses due to cosmetic surgery, unless reconstructive surgery to restore damaged tissue due to sickness, including the reconstruction of mama after a mastectomy, or corporal accident, lesion or surgery to correct a sickness or congenital anomalies, including oral defect of a newborn.
  • Excluded are those services that exceed the policy limits established in the general conditions and limitations.

MAPFRE recommends that all interested in participating in the health insurance coverage for Small Groups to pay special attention to the policy’s general terms, conditions and limitations to obtain the maximum benefit under their plan.

Recommendations when using the medical plan:

  • It is recommended that members identify the period in which the insurance will remain in force to know when they can access coverage’s under their policy.
  • If someone needs orientation they can contact the specialized phone operators that are available 24/7.
  • Members should know the different processes established by MAPFRE in order to access certain coverage’s in accordance to the policy’s general terms, conditions and limitations.

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