{"id":25,"date":"2018-09-04T20:01:20","date_gmt":"2018-09-05T00:01:20","guid":{"rendered":"http:\/\/localhost\/mi-salud\/?page_id=25"},"modified":"2025-02-25T15:28:41","modified_gmt":"2025-02-25T19:28:41","slug":"services-vital-pays-for","status":"publish","type":"page","link":"https:\/\/sssvital.com\/en\/services-vital-pays-for\/","title":{"rendered":"Services Plan Vital Pays For"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">Plan <\/span><span style=\"font-weight: 400;\">Vital offers services to keep you healthy. Plan Vital works with Triple-S Salud , who coordinate with you and your doctors to help you access services you need.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">You can start getting services as soon as your Medicaid Office says that you are eligible for Plan Vital . You don\u2019t have to wait.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">As a Plan Vital beneficiary , you have a variety of health care benefits and services available to you. Not everyone in Plan Vital has the same benefits. The benefits that are covered for you depend on the group you\u2019re in. Your Plan Vital Member card will tell you what type of coverage you qualify for.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Listed below are the basic services covered by Plan Vital. Some services may have limits. For more information call Triple-S Salud; call\u00a0<\/span><a href=\"tel:1-800-981-1352\"><span style=\"font-weight: 400;\">1-800-981-1352<\/span><\/a><span style=\"font-weight: 400;\">; TTY \/ TDD users should call\u00a0<\/span><a href=\"tel:1-855-295-4040\"><span style=\"font-weight: 400;\">1-855-295-4040<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Routine doctor office visits, checkups, and sick visits<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Well-baby visits, well-child visits, and immunizations<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Tests and studies, laboratory work, and X-rays<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Preventive services, including vaccines, mammogram, colonoscopy, and well visits for adults<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">OB\/GYN exams and annual Pap tests<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services, including periodic preventive health screenings and other necessary diagnostic and treatment services for members ages 21 and under<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Nutritional evaluations and test<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Vision and hearing test<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Prenatal and postpartum care<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Family planning<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Health certificates<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Dental services<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Physical therapy<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Occupational therapy<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Speech therapy<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Physician home visits<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Pharmacy<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Care management and care coordination services<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Emergency services<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Post-stabilization services<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Mental health services<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Visits to specialists<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Community health clinic services<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Hospital: inpatient and\/or outpatient care<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Mental health hospitalization and partial hospitalization<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Ambulatory service center services<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Surgery: inpatient and\/or outpatient<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Ambulance services<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Outpatient rehabilitation services<\/span><\/li>\n<\/ul>\n<h4>DENTAL SERVICES<\/h4>\n<p><span style=\"font-weight: 400;\">Plan Vital offers dental services. You can see any dentist that accepts Plan Vital. You can find information about participating dentists in Triple-S Salud <\/span><a class=\"gtmDirectoriodeProveedores\" href=\"\/en\/provider-directory\/\"><span class=\"gtmDirectoriodeProveedores\" style=\"font-weight: 400;\">Provider Directory<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">When you enroll with Triple-S Salud, you will be mailed the Provider Directory. You can also access the list of providers by visiting the web page at <\/span><a href=\"\/en\/\"><span style=\"font-weight: 400;\">https:\/\/sssvital.com\/en\/<\/span><\/a><span style=\"font-weight: 400;\"> under the Provider Directory section. Your Primary Medical Group and Triple-S Salud Customer Service Offices also have copy of the list.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">For questions about your dental benefits, call Triple-S Salud\u00a0<\/span><a href=\"tel:1-800-981-1352\"><span style=\"font-weight: 400;\">1-800-981-1352<\/span><\/a><span style=\"font-weight: 400;\">; TTY \/ TDD users should call\u00a0<\/span><a href=\"tel:1-855-295-4040\"><span style=\"font-weight: 400;\">1-855-295-4040<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/p>\n<h4>MENTAL HEALTH, ALCOHOL AND DRUG ABUSE SERVICES<\/h4>\n<p><span style=\"font-weight: 400;\">Plan Vital offers mental health, alcohol and substances abuse services. You do not have to see your PCP first to see a doctor or other provider for mental health, alcohol, or substances abuse services. You can ask for these services whenever you feel like you need them.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Plan Vital wants to make it easy for you to get physical and mental health, alcohol, and substance abuse services in the same place. This is called integrated care.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Your Primary Medical Group is one place you can go to get mental health, alcohol or drug abuse services. Your Primary Medical Group must have a psychologist and\/or a social worker available at least from 4 to 16 hours per week during regular business hours.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If you get mental health, alcohol or drug abuse services at another place (like a mental health clinic or a psychiatric hospital), they must have services from a PCP in the office at least part of the time to care for your physical health needs.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If you need help finding mental health, alcohol and substance abuse services, call us at\u00a0<\/span><a href=\"tel:1-800-981-1352\"><span style=\"font-weight: 400;\">1-800-981-1352<\/span><\/a><span style=\"font-weight: 400;\">; TTY \/ TDD users should call\u00a0<\/span><a href=\"tel:1-855-295-4040\"><span style=\"font-weight: 400;\">1-855-295-4040<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/p>\n<h4>PHARMACY SERVICES<\/h4>\n<p><span style=\"font-weight: 400;\">Plan Vital covers prescription drugs . If you need medicine, your provider will write you a prescription to take to a participating pharmacy. You can choose any pharmacy that works with Triple-S Salud. You can find a list of participating pharmacies in Triple-S Salud <\/span><a class=\"gtmDirectoriodeProveedores\" href=\"\/en\/provider-directory\/\"><span class=\"gtmDirectoriodeProveedores\" style=\"font-weight: 400;\">Provider Directory<\/span><\/a><span style=\"font-weight: 400;\">, or you can call us at\u00a0<\/span><a href=\"tel:1-800-981-1352\"><span style=\"font-weight: 400;\">1-800-981-1352<\/span><\/a><span style=\"font-weight: 400;\">; TTY \/ TDD users should call\u00a0<\/span><a href=\"tel:1-855-295-4040\"><span style=\"font-weight: 400;\">1-855-295-4040<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Prescription drugs are free for children up to the age of 20 and for pregnant women that are Medicaid or CHIP beneficiaries. Other adults will need to pay for prescription drugs. For more information on copayments for prescription drugs, <a href=\"\/en\/copayments\">click here<\/a>.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Your Formulary of Medications Covered (FMC) ) is the list of medicines Vital covers. This list helps your doctor prescribe medicines for you. Brand-name and generic drugs are on the FMC. A generic version of a drug is the first choice. If a generic version of a drug is available, your doctor must prescribe the generic version.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If you have a chronic condition, your doctor can write a prescription for a 90-day supply of some drugs. This way, you only must pay for the drug once instead of paying three times (1 payment per month). You can access the Plan Vital Covered Drug Formulary at the following electronic address: <a href=\"https:\/\/www.ases.pr.gov\/proveedores?tab=Farmacias&amp;categoria=Formularios+de+Medicamentos#Farmacia\">https:\/\/www.ases.pr.gov\/proveedores?tab=Farmacias&amp;categoria=Formularios+de+Medicamentos#Farmacia<\/a><\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Plan Vital offers services to keep you healthy. Plan Vital works with Triple-S Salud , who coordinate with you and your doctors to help you access services you need. You can start getting services as soon as your Medicaid Office says that you are eligible for Plan Vital . You don\u2019t have to wait. As [&hellip;]<\/p>\n","protected":false},"author":7,"featured_media":908,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"page-templates\/page-tabs-content.php","meta":{"footnotes":""},"class_list":["post-25","page","type-page","status-publish","has-post-thumbnail","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.0 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>What services does Vital cover? | Vital<\/title>\n<meta name=\"description\" content=\"As a Vital enrollee, you have a variety of health care benefits and services available to you. 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