Doctor's note for travel insurance: how it works if you get sick in Puerto Rico

Many airlines, cruise lines and travel insurers ask for a medical document to change a date, refund a ticket or pay a claim when you get sick. Each company decides what it accepts, so ask your airline or insurer first what document they require and bring that to the visit.

We can only see you if you are physically in Puerto Rico during the visit, because the doctor's license is a Puerto Rico license. If you got sick at home in another state before leaving, you need a doctor where you are. Visiting the island? See our care for tourists and visitors.

You see Dr. Diana Nieves Castro, a Puerto Rico-licensed general practice physician with several years of emergency-department experience, in English or Spanish. It is a real doctor visit first: the doctor asks what is wrong, evaluates you and gives you a plan. 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.

If the doctor considers it appropriate that you rest or don't travel, she gives you the note at the end of the visit. It is the same doctor's note we give after any visit, included at no extra charge.

The note reflects what the doctor evaluated during your visit:

We don't bill health plans or travel insurers. You pay for the visit by card and, on request, we give you an itemized receipt (superbill) to file the claim yourself. If your travel insurance reimburses medical costs, that receipt and the note are usually what they ask for; confirm with them.

If you have Medicare: for Medicare, Puerto Rico is not "outside the U.S." What that means for you, and what to ask your plan, is in does Medicare work in Puerto Rico.

Request a visit online 24/7 — we confirm your time by email or text. Book a visit and choose Doctor visit. We send you a secure video link. It works on your phone, tablet or computer.

A doctor visit costs US$79, the same price for every age, with no membership, and the note is included. Your card is charged when you request the visit, and you get a full refund if the visit can't take place. If the patient is under 21, a parent or legal guardian stays on camera for the whole visit and shows photo ID. See prices.

Don't wait for a note: call 911 or go to the nearest emergency room. Travel paperwork can be sorted out later. See when to go to the ER.