Plan Vital: About 150,000 People Dropped for Not Recertifying - 2026 Guide to Keep Your Coverage

Every month, thousands of families in Puerto Rico find out at the pharmacy or in the emergency room that their Plan Vital coverage is no longer active. And in most cases it is not because they stopped qualifying: it is because they did not complete their recertification on time. ASES has acknowledged that roughly 150,000 patients dropped out of the program during the recertification process, many of them still eligible and unaware they had lost their insurance. ¹²

Plan Vital is the government health plan (Puerto Rico's Medicaid) that covers more than 1.5 million low-income residents. It is currently run by four insurers: First Medical, Plan de Salud Menonita, Triple-S and MMM. ¹ Being a beneficiary is not permanent: you must renew your eligibility periodically by submitting proof of income and residence. During the pandemic, a federal rule barred anyone from being removed from Medicaid, so for years no one had to recertify. When that protection ended (the so-called "unwinding"), the island resumed recertifications and tens of thousands were dropped, largely over paperwork rather than income. ²

The numbers that matter

According to ASES, about 150,000 people lost Plan Vital during the recertification process. ² Some of them still qualified: they did not answer a letter, did not update their address, or missed their appointment. Recertification is not a once-a-year event for everyone; each case comes up in a specific month, so many people never realize their turn has arrived. That is why the first step is to confirm when yours is due. You can do it by calling the Medicaid Program Call Center at 787-641-4224, 8:00 a.m. to 6:00 p.m., or ASES Customer Service at 787-474-3300 (option 1). ¹

What it means for you

If you have Plan Vital, do not wait to be turned away at the pharmacy. Losing coverage over an incomplete form is preventable, but getting it back takes time: meanwhile, you pay out of pocket for medicine, lab work and visits. The most exposed are those who moved and did not update their address, because recertification letters come by mail. Also elders and families with children, who often juggle several dates and documents. The good news: if you lost coverage but still qualify, you can reapply at any time. ¹³

How to do it / Checklist

1. Confirm your recertification month by calling 787-641-4224 (Medicaid) or 787-474-3300 option 1 (ASES). Ask whether your case is active. ¹
2. Update your mailing address and phone number. If you moved, this is the single most important step: without a correct address, you will not get the notices. ³
3. Gather your documents: valid photo ID, proof of residence (a recent water or power bill), proof of income (pay stubs, tax return, or a Social Security or PAN letter) and birth certificates for minors. ⁴
4. Recertify online. Create your account at medicaid.pr.gov, select your case, upload scanned documents, sign electronically and save the confirmation number. ³⁴
5. If you prefer in person, find your nearest Medicaid office at medicaid.pr.gov/#Oficinas and bring copies of everything. ¹
6. Follow up. Check your email and portal account; the system tells you if a document is missing. If you hear nothing, call again. ³
7. If you believe you were dropped unfairly, contact the Patient Ombudsman Office at 1-800-981-0031. ¹

What's next

Recertifications will continue throughout 2026, month by month, and ASES has been expanding digital channels to cut the number of people dropped over paperwork. The authorities' advice is clear: do not leave your recertification for the last day, and keep your contact information current. A form submitted on time can be the difference between getting your medicine and losing your coverage. ¹²