Guides
How to see a doctor without insurance in Puerto Rico
To see a doctor without insurance in Puerto Rico, you have real options: community health centers charge based on income, hospital ERs must screen you in an emergency whether or not you can pay, and you can apply for Puerto Rico Medicaid. For telehealth without insurance, you pay directly with no membership: a doctor visit, a follow-up or forms.
Pay now, then choose your time right away. Full refund if you cancel 24 hours or more ahead.
See the cancellation policy
You can cancel for a full refund or change the time up to 24 hours before your visit. Within 24 hours you can't cancel and there's no refund. If you don't join in the first 10 minutes, there's no refund.
If you choose a time less than 24 hours away, it can't be cancelled or changed.
If the clinic can't see you, for example because of a technical problem on our side, we refund you in full.
Community health centers: pay based on income
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.
Hospital ERs and CDTs
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.
Medicaid (Plan Vital) eligibility
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.
A doctor without insurance in Puerto Rico by video: no membership
Telehealth without insurance lets you see a doctor from home. 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: a new problem, virtual urgent care for non-emergencies, primary care, children, birth control, STIs, skin and visitors.
- Follow-up visit: a refill of a non-controlled medicine you already take (anyone can book this) or a review of lab results (existing patients only).
- School and university forms: the medical form your school or university asks for (when the video evaluation supports it), and a medical certificate of an illness or condition the doctor evaluated. Not forms that need a vision exam.
If the clinic can’t see you, you get a full refund. If a follow-up or forms 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.
What the doctor does by video
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 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 non-controlled 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.
Video visits any time, including nights and weekends, except on holidays when the clinic is closed. Every day, any time (Puerto Rico time). Request your visit online and you choose your time when you book.
New to Puerto Rico? How coverage works here
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.
What others charge, and HSA or FSA receipts
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.
How we care for you
We evaluate, diagnose and treat; if needed, we give you a lab order for a lab near you.
We see adults and children of all ages. Patients under 21: a parent with patria potestad (parental authority) or a legal guardian is on camera for the whole visit and shows photo ID.
Real-time video visit. We send you a secure video link. It works on your phone, tablet or computer.
If appropriate, the doctor prescribes and we send your prescription to your pharmacy.
You must be physically in Puerto Rico during the visit (visitors, tourists and cruise passengers are welcome).
In an emergency, call 911.
Frequently asked questions
Can I get telehealth without insurance in Puerto Rico?
Can an ER turn me away if I'm uninsured?
Do I need a membership?
How do I apply for emergency Medicaid?
How much is a doctor visit without insurance?
About this page
Author: The Health Initiative
Medical care provided by Dr. Diana Nieves Castro, MD (PR license 24027)
Disclosure: Founding Executive Director of The Health Initiative
Published: 2026-09-30 · Updated: 2026-10-11
Sources (4)
- Community health centers (HealthCare.gov, CMS) (opens in a new tab) (accessed 2026-09-30)
- Emergency Medical Treatment & Labor Act (EMTALA) (CMS) (opens in a new tab) (accessed 2026-09-30)
- Puerto Rico Medicaid program profile (Medicaid.gov, CMS) (opens in a new tab) (accessed 2026-09-30)
- 42 CFR 440.255: limited services available to certain aliens (LII, Cornell) (opens in a new tab) (accessed 2026-10-02)
