Triple-S Advantage

What Triple-S Advantage does

Triple-S Advantage, Inc. is a private Medicare Advantage insurance company headquartered in San Juan, Puerto Rico, and an independent licensee of the BlueCross BlueShield Association. The company is a subsidiary of Triple-S Management Corporation and operates as an HMO and PPO with direct contracts from CMS (Medicare) and the Puerto Rico Health Insurance Administration (ASES, Medicaid). It serves Medicare-eligible individuals aged 65 and older, qualifying disabled beneficiaries, and dual-eligible Medicare-Medicaid members across all 78 municipalities of Puerto Rico through a network of 13,000+ contracted providers, 16 preferred hospitals, and 9 exclusive Salus Clinics.

The product portfolio comprises ten named health plans spanning Individual HMO (Ahorro Plus, Enlace Plus, Brillante HMO-POS), Special Needs Plans (Contigo Plus, ContigoEnMente, Platino Plus, Platino Advance, Platino Enlace, Platino Blindao), and a PPO (Óptimo Plus). Core technology includes the Mi Triple-S mobile application for member self-service, TeleConsulta MD for virtual specialist consultations across seven specialties at $0 copay, Triple-S en casa for prescription home delivery integrated with Alivia Home Delivery Pharmacy, TeleConsejo for 24/7 emotional health counseling, and the SSS Contigo clinical program suite for chronic disease management.

The business model is built on CMS capitation payments (Medicare Part C and Part D premiums) and member cost-sharing, distributed through licensed independent insurance agents, dedicated phone sales representatives, the CMS Medicare Online Enrollment Center, and paper-based mail and fax enrollment. The company achieved a 4.5-star CMS Medicare rating for its HMO contract in 2025, placing it among the highest-rated Medicare Advantage plans in the United States. Revenue is not publicly disclosed at the Triple-S Advantage entity level, and the company does not report funding rounds, M&A activity, or leadership changes in the available data.

Name

Triple-S Advantage

Legal name

Triple-S Advantage, Inc.

Website

https://advantage.grupotriples.com

Company type

Private

Operating status

Operating

Headcount range

101–250 employees

Short description

Triple-S Advantage is a private Medicare Advantage insurer headquartered in San Juan, Puerto Rico, offering HMO, PPO, and Special Needs Plans to Medicare-eligible and dual-eligible beneficiaries across all 78 Puerto Rico municipalities through a 13,000+ provider network and exclusive Salus Clinics, under a BlueCross BlueShield Association license.

Ownership category

akta.pro rank

Headquarters

HQ city

San Juan

HQ country

Puerto Rico

HQ region

Latin America

Offices1 record

Markets served

GTM type

B2C

Offering type

Services

Cost components

Personnel, Operations, Supply Chain, Marketing or Sales, Technology or R&D, Infrastructure

Revenue model

1. Medicare Advantage Premiums: Triple-S Advantage generates revenue primarily through Medicare Advantage plan premiums paid by the federal government (Part C) and member cost-sharing. The company is an HMO and PPO organization with contracts with Medicare and the Puerto Rico Medicaid Program.
2. Medicare Part D Pharmacy Benefits: Revenue from pharmacy benefit management including prescription drug coverage through Medicare Part D, with drug formulary management and pharmacy network operations.

Pricing tiers

Go-to-market motion2 records

Distribution channels5 records

Marketing channels6 records

Core offering

Triple-S Advantage is a Medicare Advantage health insurance company that sells HMO, PPO, HMO-POS, and HMO-Special Needs Plans (SNPs) to Medicare-eligible seniors and dual-eligible Medicare/Medicaid beneficiaries throughout Puerto Rico. Its offering bundles medical, hospital, and Medicare Part D prescription drug coverage with digital health tools (Mi Triple-S app, TeleConsulta MD virtual specialty visits, Triple-S en casa home pharmacy delivery), the Salus exclusive clinic network, and care management programs such as SSS Contigo and TeleConsejo.

Product overview

Triple-S Advantage is a Medicare Advantage insurance company offering a comprehensive portfolio of health plans (HMO, PPO, and Special Needs Plans) and digital health tools for seniors in Puerto Rico. The product portfolio includes ten named health plans (Ahorro Plus, Contigo Plus, Enlace Plus, Brillante, ContigoEnMente, Platino Plus, Platino Advance, Platino Enlace, Platino Blindao, and Optimo Plus) complemented by digital tools (Mi Triple-S App, Triple-S en casa, TeleConsulta MD), clinical programs (SSS Contigo, SSS a tu lado), telehealth services (TeleConsulta, TeleConsejo), pharmacy programs (Blue Rx90, ComboCard), and an integrated provider network including Salus Clinics. The offering operates as a unified platform connecting health plan administration with clinical care coordination, medication management, and virtual healthcare access.

Differentiator

Problem solved

Functional benefit

Brands

• Mi Triple-S: Mobile application providing 24/7 access to health information including digital insurance cards, authorization status, medication lists, lab results, and clinical alerts
• Triple-S en casa
• TeleConsulta MD
• Salus Clinics
• ComboCard
• SSS Contigo
• SSS a tu lado
• Blue Rx90
• Programa Bienestar
• TeleConsejo

Products and services

• Medicare Advantage Individual HMO and HMO-POS Plans HMO and HMO-POS Medicare Advantage plans (Ahorro Plus, Brillante, Enlace Plus) offering comprehensive medical and hospital coverage with in-network provider access for Medicare-eligible individuals in Puerto Rico.
• Medicare Platino Dual-Eligible Special Needs Plans (HMO-SNP) Special Needs Plans (Platino Plus, Platino Advance, Platino Enlace, Platino Blindao) that integrate Medicare and Puerto Rico Medicaid benefits for dual-eligible beneficiaries through a contract with ASES, with potential $0 premiums.
• Medicare Special Needs Plans for Chronic and Behavioral Health Conditions (HMO-SNP) Condition-targeted HMO-SNP plans (Contigo Plus for chronic conditions, ContigoEnMente for behavioral health) providing care coordination and specialized benefits for Medicare beneficiaries with qualifying conditions.
• Óptimo Plus (PPO) Medicare Advantage Plan Preferred Provider Organization plan offering flexibility to use in-network or out-of-network providers with broader network access and higher premium options compared to HMO plans.
• Mi Triple-S Mobile Application Member mobile app available on iOS and Android that provides 24/7 digital insurance cards, preauthorization status, medication lists, lab results, clinical alerts, and live chat with TeleConsulta.
• Triple-S en casa Prescription Home Delivery Prescription medication delivery service operated in partnership with Alivia Home Delivery Pharmacy (NCPDP 4030235 | NPI 1396391280), enabling members to send prescription photos, order medications, and receive home, office, or preferred-location delivery at the same copay as retail pharmacy.
• TeleConsulta MD Virtual Specialist Platform Virtual specialist consultation platform providing unlimited visits with nephrologists, pulmonologists, cardiologists, endocrinologists, gynecologists, psychologists, and neurologists via smartphone or computer, with $0 copay.
• Salus Clinics Network of nine exclusive Triple-S member care clinics (Metro Pavia Clinic Arecibo, Clinica Yaguez, Metro Pavia Healthcare Center, and Salus clinics in Guaynabo, Hato Rey, Carolina, and Ponce) offering laboratory services, X-rays, CT scans, MRI, mammograms, urgent care, and consolidated medical records with some services at $0 copay.
• TeleConsulta 24/7 Nurse Hotline 24/7 nurse hotline providing health guidance and referrals to appropriate care levels for members, available by phone.
• TeleConsejo Emotional Health Counseling 24/7 emotional health counseling service for anxiety, depression, grief, and other events affecting emotional wellbeing, available to members, family, and caregivers.
• Triple-S Contigo (SSS Contigo) Clinical Care Program Clinical care coordination programs supporting members in prevention and management of chronic conditions through health education and ongoing support.
• SSS a tu lado Personal Assistance Service Expert personal assistance service for daily living tasks made difficult by health conditions or events, available to members.
• ComboCard Member Benefit Card Member benefit card program providing savings and additional health-related benefits accessible to Triple-S Advantage plan members.
• Blue Rx90 Prescription Savings Program Prescription savings program enabling members to obtain a 3-month supply of eligible medications for the price of 2 months with a single prescription.
• Preferred Hospital and Provider Network Contracted network of more than 13,000 healthcare providers including 16 preferred hospitals (Ashford Hospital, Doctors' Center Hospital network, Hospital Pavia network, Manati Medical Center, Mayaguez Medical Center, Hospital Metropolitano Dr. Pila, Hospital San Lucas, Hospital Dr. Susoni, Hospital Perea) and 9 clinics (Metro Pavia Clinics and Salus Clinics).

Quantifiable outcome

• 4.5-star Medicare rating from CMS for HMO contract, placing among highest-rated Medicare Advantage plans nationally
• +2 more outcomes

Segments3 records

Ideal customer profiles3 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature4 records

Partnerships

Three partnerships are on record, tiered core.

• Alivia Home Delivery PharmacycoreTechnology or IntegrationAlivia Home Delivery Pharmacy provides prescription medication delivery services to Triple-S Advantage members with pharmacy coverage. The pharmacy is duly licensed in Puerto Rico (NCPDP 4030235 | NPI 1396391280) and enables members to receive medications at home, office, or preferred locations. Supports electronic prescription processing and manages home delivery logistics including courier delivery with signature requirements.
• BlueCross BlueShield AssociationcoreOEM/ Whitelabel/ Licensing PartnerTriple-S Advantage, Inc. is an independent licensee of the BlueCross BlueShield Association, operating in Puerto Rico. This licensing relationship provides brand recognition, operational frameworks, and access to BCBSA resources while allowing local operational autonomy.
• Health Insurance Administration of Puerto Rico (ASES)coreStrategic or Co-development PartnerASES is the government agency overseeing Puerto Rico's Medicaid program. Triple-S Advantage holds a contract with the Puerto Rico Medicaid Program through ASES, enabling the company to offer Platino SNP (Special Needs Plan) coverage to dual-eligible Medicare and Medicaid beneficiaries. ASES PROBENE office provides support for Platino members.

Scale indicators4 records

Recent moves6 records

Expansion highlights4 records

Direct peers

• MMM Healthcare: One of the largest Puerto Rico-based Medicare Advantage carriers offering HMO, PPO, and D-SNP products. Directly competes with Triple-S Advantage across the same 78-municipality service area and the same dual-eligible (Platino-equivalent) and individual MA segments.
• MCS Advantage: Puerto Rico-based Medicare Advantage plan offered by MCS (Mutual Care Services), competing in the same MA and D-SNP segments as Triple-S Advantage with overlapping provider networks and the same ASES Medicaid contracting footprint.
• First Medical Health Plan: Puerto Rico-based health plan with Medicare Advantage and Medicaid offerings, directly competing with Triple-S Advantage in the individual MA and dual-eligible markets across the island.

Broad incumbents

• Humana: One of the largest U.S. Medicare Advantage carriers with a national footprint and growing Puerto Rico presence. Competes in MA, SNPs, and Part D with broader scale, deeper PBM leverage, and larger broker budgets than Triple-S Advantage.
• UnitedHealthcare: The largest U.S. Medicare Advantage carrier by enrollment, part of UnitedHealth Group. Operates MA, D-SNP, and Part D products with national scale advantages and is an active competitor in Puerto Rico's individual MA market.
• Elevance Health (Anthem BlueCross BlueShield): Major BlueCross BlueShield licensee and one of the largest U.S. MA carriers. Operates MA and D-SNP plans through affiliated BCBS plans and represents the broader BCBSA peer set for Triple-S Advantage, which itself is a BCBSA licensee.
• CVS Health / Aetna: Aetna is a top-five U.S. MA carrier bundled with CVS Health's retail, PBM (Caremark), and clinic (Oak Street, MinuteClinic) assets. Competes in MA, SNPs, and Part D with integrated pharmacy and primary care capabilities comparable in spirit to Triple-S Advantage's Salus and TeleConsulta stack.
• Molina Healthcare: Government-sponsored healthcare insurer with significant Medicare Advantage and dual-eligible SNP exposure. Overlaps with Triple-S Advantage's D-SNP-heavy product mix and Medicaid contracting orientation.
• Cigna: Major U.S. health insurer expanding its Medicare Advantage footprint and competing in D-SNP and individual MA markets. Operates as a broad incumbent with national scale, comparable to Humana and UnitedHealthcare in competing with regional carriers like Triple-S Advantage.

Others

• Triple-S Management Corporation (GTS): Parent company of Triple-S Advantage and a publicly traded holding company that also owns Triple-S Salud, Triple-S Propiedad, and Triple-S Vida. Most relevant as the corporate parent and source of cross-entity financial comparisons rather than a direct MA competitor.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat4 records

Key risks6 records

Key highlights7 records

Customer concentration

• YouTubeyoutube.com/user/GrupoTripleS
• Facebookfacebook.com/TripleSAdvantage
• LinkedInlinkedin.com/company/grupo-triple-s
• Instagraminstagram.com/grupotriples

Revenue estimate

Valuation estimate

Number of profiles

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Triple-S Advantage