A non-government entity
MMM Diamante Platino (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for MMM Diamante Platino (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on MMM Diamante Platino (HMO D-SNP) in 2026, please refer to our full plan details page.
MMM Diamante Platino (HMO D-SNP) is a HMO D-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 5 out of 5 stars in 2026.
It's important to know that MMM Diamante Platino (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
MMM Diamante Platino (HMO D-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 Diamante Platino (HMO D-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 Diamante Platino (HMO D-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 $20.00. 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 a $615.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
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:
Sign up for MMM Diamante Platino (HMO D-SNP)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The MMM Diamante Platino (HMO D-SNP) Medicare Advantage plan features an annual prescription drug deductible of $615. This means you must pay $615 out-of-pocket for covered medications before the plan begins to cover its share of your prescription costs. Understanding this deductible is a key step in evaluating your overall healthcare expenses with this plan. Specific drug tier details, including copayments and coinsurance for generic or brand-name medications, are not currently available for this plan. To determine your exact costs for specific prescriptions, you should consult the plan's formulary or contact the provider directly. This will help you verify if your daily medications are covered and what your final out-of-pocket costs will be.
Additional Benefits
The MMM Diamante Platino (HMO D-SNP) plan offers comprehensive coverage for core medical services with no copay and no coinsurance, making healthcare highly affordable. Covered services include inpatient and outpatient hospital care, primary and specialist visits, emergency services, and home health care. While many benefits require prior authorization, members can access essential diagnostics, dialysis, and skilled nursing facility care without any out-of-pocket costs. This plan also includes valuable supplemental benefits such as dental care up to a $3,500 annual limit and vision hardware coverage up to $800 annually, all with no copay. Additionally, members receive hearing aid coverage up to $3,000 every three years, 30 one-way transportation trips per year to plan-approved locations, and acupuncture and over-the-counter benefits. These additional services are designed to support overall wellness while maintaining the plan's signature zero-cost-sharing structure.
Inpatient Hospital See details
MMM Diamante Platino (HMO D-SNP) partially covers inpatient hospital services, including acute and psychiatric stays, with no copay and no coinsurance. Prior authorization is required, and additional days, non-Medicare-covered stays, and room upgrades are not covered.
Outpatient Services See details
Outpatient services for MMM Diamante Platino (HMO D-SNP) are covered with no copay and no coinsurance, including outpatient hospital, ambulatory surgical center, and blood services. Some outpatient substance abuse services are covered with no copay and no coinsurance, but individual and group sessions are not covered.
Partial Hospitalization See details
Partial hospitalization is covered by MMM Diamante Platino (HMO D-SNP) with no copay and no coinsurance. Prior authorization and a referral are required to access these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered by MMM Diamante Platino (HMO D-SNP) with no copay and no coinsurance, requiring prior authorization. Ambulance services are not covered in practice, and transportation is limited to 30 one-way trips per year to plan-approved locations only, as ground ambulance, air ambulance, and transportation to any health-related location are not covered.
Emergency Services See details
MMM Diamante Platino (HMO D-SNP) covers emergency and urgently needed services with no copay and no coinsurance. Worldwide emergency services are partially covered up to a $500 maximum, with a $75 copay and no coinsurance for worldwide emergency and urgent care, while worldwide emergency transportation is not covered.
Primary Care See details
MMM Diamante Platino (HMO D-SNP) offers primary care, specialist, therapy, and podiatry services with no copay and no coinsurance. While routine chiropractic care is covered up to 6 visits annually, other chiropractic services are not covered, and individual or group sessions for mental health and psychiatric services are excluded from coverage.
Preventive Services See details
MMM Diamante Platino (HMO D-SNP) partially covers preventive services with no copay and no coinsurance, although prior authorization is required for several services. Uncovered services include the annual physical exam, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs for hair loss, weight management, therapeutic massage, adult day health, home-based palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, and counseling.
Hearing Services See details
MMM Diamante Platino (HMO D-SNP) provides partial coverage for hearing services with no copay and no coinsurance, though prior authorization is required. Covered services include one annual hearing aid fitting evaluation and prescription hearing aids up to $3,000 every three years, while routine hearing exams, OTC hearing aids, and inner ear, outer ear, or over-the-ear prescription hearing aids are not covered.
Vision Services See details
MMM Diamante Platino (HMO D-SNP) offers vision services with no copay and no coinsurance. While some eye exam services are covered, routine eye exams and other eye exam services are not, and eyewear is partially covered up to $800 annually for contact lenses and eyeglasses while individual eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
MMM Diamante Platino (HMO D-SNP) partially covers dental services with no copay and no coinsurance for covered care, up to a maximum annual benefit of $3,500. Sub-services that are not covered under this plan include oral exams, dental x-rays, diagnostic dental, cleanings, fluoride, preventive dental, endodontics, periodontics, maxillofacial prosthetics, oral and maxillofacial surgery, and orthodontics.
Home Infusion bundled Services See details
MMM Diamante Platino (HMO D-SNP) partially covers Home Infusion bundled Services with no copay and no coinsurance, though prior authorization and step therapy are required. Under this benefit, Medicare Part B insulin is covered with no copay and no coinsurance, while Medicare Part B chemotherapy, radiation, and other Part B drugs are not covered.
Dialysis Services See details
Dialysis Services are covered by MMM Diamante Platino (HMO D-SNP) with no copay and no coinsurance, though prior authorization is required.
Medical Equipment See details
MMM Diamante Platino (HMO D-SNP) covers durable medical equipment with no copay and no coinsurance, though prior authorization is required. For other medical and diabetic equipment, some services are covered but prosthetic devices, medical supplies, diabetic supplies, and therapeutic shoes or inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by MMM Diamante Platino (HMO D-SNP) with no copay and no coinsurance, although prior authorization is required. While some services are covered, diagnostic procedures, lab services, diagnostic and therapeutic radiological services, and outpatient X-rays are not covered.
Home Health Services See details
Home Health Services are covered under the MMM Diamante Platino (HMO D-SNP) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by MMM Diamante Platino (HMO D-SNP) with no copay and no coinsurance, though prior authorization and a referral are required. Only some services are covered under this benefit, as Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered.
Skilled Nursing Facility (SNF) See details
MMM Diamante Platino (HMO D-SNP) covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance, requiring prior authorization but allowing admission without a prior three-day inpatient hospital stay. While Medicare-covered SNF days are covered, additional days beyond the standard Medicare limit are not covered.
Other Services See details
MMM Diamante Platino (HMO D-SNP) offers partially covered other services, providing acupuncture, over-the-counter (OTC) items, and chronic illness meal benefits with no copay and no coinsurance. However, some sub-services, including Naloxone, specific CMS-listed OTC drugs, and other miscellaneous services, are not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved