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MMM Supremo (HMO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for MMM Supremo (HMO C-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on MMM Supremo (HMO C-SNP) in 2025, please refer to our full plan details page.
MMM Supremo (HMO C-SNP) is a HMO C-SNP plan offered by Elevance Health, Inc. available for enrollment in 2025 to people living in Puerto Rico. This plan received an overall rating of 4.5 out of 5 stars in 2025.
It's important to know that MMM Supremo (HMO C-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
MMM Supremo (HMO C-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about MMM Supremo (HMO C-SNP).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For MMM Supremo (HMO C-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $25.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $3250.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The MMM Supremo (HMO C-SNP) plan has a $0 deductible for prescription drugs. During the initial coverage phase, you will pay no copay for generic drugs, a $20 copay for preferred brand drugs, and coinsurance for non-preferred and specialty drugs. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase where you will pay nothing for covered drugs. If you qualify for the low-income subsidy, you may have your premium reduced.
Additional Benefits
The MMM Supremo (HMO C-SNP) plan offers comprehensive coverage, including no copay for inpatient hospital stays, primary care, preventive services, and home health services. You'll also find coverage for outpatient services, ambulance services, and hearing and vision services, with varying cost-sharing such as copays for specialist visits and emergency services. Additional benefits include coverage for dental services, home infusion, and medical equipment, with specific limitations on some services. The plan also provides transportation to health-related locations, OTC items, and a meal benefit, alongside coverage for cardiac rehabilitation and skilled nursing facilities.
Inpatient Hospital See details
Inpatient Hospital benefits include Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, both requiring prior authorization. Inpatient Hospital-Acute has no copay for Medicare-covered stays, and the plan covers additional days. Inpatient Hospital Psychiatric has a $50 copay per stay, but additional days and non-Medicare stays are not covered.
Outpatient Services See details
Outpatient Services include coverage for outpatient hospital services with a $25 copay, and observation services with a copay between $0 and $50. The plan also covers Ambulatory Surgical Center (ASC) Services and Outpatient Substance Abuse Services, with individual and group sessions having a $7 copay. Outpatient Blood Services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization. There is no information about cost sharing for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with no copay or coinsurance for ambulance services. Transportation Services to a plan-approved health-related location are covered for 16 one-way trips per year via rideshare, bus/subway, van, or medical transport, while transportation to any health-related location is not covered.
Emergency Services See details
Emergency Services are covered by the MMM Supremo (HMO C-SNP) plan with a $50 copay and no coinsurance. Worldwide Emergency Coverage and Worldwide Urgent Coverage have a $100 copay, and no coinsurance, while Worldwide Emergency Transportation is not covered.
Primary Care See details
The MMM Supremo (HMO C-SNP) plan covers primary care physician services, chiropractic services with a $7 copay, occupational therapy services with a $4 copay, physician specialist services, mental health specialty services with a $0-$7 copay, podiatry services, other health care professional services with a $0-$7 copay, psychiatric services with a $0-$7 copay, physical therapy and speech-language pathology services with a $4 copay, additional telehealth benefits, and opioid treatment program services with 10% coinsurance.
Preventive Services See details
Preventive Services are covered, including Medicare-covered services with no copay, additional preventive services, kidney disease education services, and other preventive services like glaucoma screening and barium enemas. However, the plan does not cover annual physical exams, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, therapeutic massage, adult day health services, home-based palliative care, in-home support services, or support for caregivers of enrollees. Some services, such as alternative therapies, fitness benefits, home and bathroom safety devices, and nutritional/dietary benefits, are covered with a maximum plan benefit coverage amount.
Hearing Services See details
Hearing Services include hearing exams, routine hearing exams (1 per year), and fitting/evaluation for hearing aids (1 per year), all of which are covered. Prescription hearing aids are covered up to $1000 every three years, but Prescription Hearing Aids - Inner Ear, Outer Ear, and Over the Ear are not covered, and OTC hearing aids are not covered.
Vision Services See details
The MMM Supremo (HMO C-SNP) plan covers vision services, including routine eye exams, eyewear, and contact lenses. The plan covers one routine eye exam per year, with no copay, and offers a combined maximum of $500 per year for eyewear. Eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
The MMM Supremo (HMO C-SNP) plan covers a variety of dental services, including oral exams, dental x-rays, and other diagnostic, preventive, restorative, and orthodontic services, with varying limits on visits and periodicity. Maxillofacial prosthetics and orthodontics are not covered, and this plan has a maximum benefit of $2,500 per year for orthodontic services.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including insulin and other Medicare Part B drugs. Medicare Part B Insulin Drugs have a $35 copay, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered with prior authorization. You will pay 20% coinsurance for this service.
Medical Equipment See details
Medical Equipment benefits are covered under the MMM Supremo (HMO C-SNP) plan. Durable Medical Equipment (DME) and Prosthetics/Medical Supplies have no copay or coinsurance, but Durable Medical Equipment for use outside the home, Prosthetic Devices, Medical Supplies, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services includes coverage for Lab Services with a coinsurance of at most 20%, and Diagnostic Radiological Services with a copay of at most $25.00. Diagnostic Procedures/Tests, Therapeutic Radiological Services, and Outpatient X-Ray Services are not covered.
Home Health Services See details
Home Health Services are covered by the MMM Supremo (HMO C-SNP) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Prior authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are generally covered, but the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization and a doctor referral are required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are covered, but additional days beyond Medicare-covered and non-Medicare-covered stays are not covered. Prior authorization is required.
Other Services See details
Other Services includes Over-the-Counter (OTC) items and a meal benefit. OTC items are covered with a maximum benefit of $30 every three months, and the meal benefit is for a chronic illness, both of which require a doctor's referral. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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