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MMM Deluxe (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for MMM Deluxe (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on MMM Deluxe (HMO-POS) in 2026, please refer to our full plan details page.
MMM Deluxe (HMO-POS) is a HMO-POS 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 Deluxe (HMO-POS) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about MMM Deluxe (HMO-POS).
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 Deluxe (HMO-POS), 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 $155.00. 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 combined Maximum Out-Of-Pocket cost of $3250.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $3250.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
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 Deluxe (HMO-POS) Medicare plan features a $0 drug deductible, meaning your prescription coverage begins immediately. Under this plan, there is no copay for Tier 1 preferred generics, Tier 2 generics, and Tier 7 select care drugs at standard pharmacies or through standard mail order. This ensures that many common and select medications are available to members at no cost. For brand-name and specialty medications, standard pharmacy copays include $8 for Tier 3 preferred brand drugs and $12 for Tier 4 non-preferred drugs for a one-month supply. Three-month supplies for Tier 3 and Tier 4 drugs are available for a $16 and $24 copay, respectively, at standard pharmacies or through mail order. Specialty medications require coinsurance, with Tier 5 preferred specialty drugs at 25% and Tier 6 specialty drugs at 33% for a one-month supply.
Additional Benefits
The MMM Deluxe (HMO-POS) plan offers strong coverage with no copay for acute inpatient hospital stays, primary care visits, and telehealth services. Outpatient services and specialist visits are highly affordable, featuring no coinsurance and copays ranging from no copay to $25. Emergency care is covered with a $75 copay that is waived upon hospital admission, while urgent care services require no copay. Routine annual hearing and vision exams are covered with no copay, coinsurance, or deductible, though eyewear and hearing aids are not covered under this plan. Preventive dental care, home health services, and skilled nursing facility stays also feature no copays or coinsurance. Additionally, members can access unlimited health-related transportation and chronic illness meals with no copay.
Inpatient Hospital See details
MMM Deluxe (HMO-POS) provides partial coverage for inpatient hospital services, requiring prior authorization but featuring no coinsurance for all stays. Acute inpatient stays have no copay and include unlimited additional days, while psychiatric inpatient stays require a $50 copay per stay, though upgrades and non-Medicare-covered stays are not covered.
Outpatient Services See details
MMM Deluxe (HMO-POS) covers outpatient services with no coinsurance, featuring a $25 copay for outpatient hospital services, a $0 to $50 copay for observation services, and a $5 copay for outpatient substance abuse sessions. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, though prior authorization is required.
Partial Hospitalization See details
Partial hospitalization is covered under the MMM Deluxe (HMO-POS) plan with no copay and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered by MMM Deluxe (HMO-POS), as ground and air ambulance services are not covered under the plan. Covered transportation services feature no copay and no coinsurance for unlimited one-way rides to plan-approved health-related locations, though transportation to any health-related location is not covered.
Emergency Services See details
MMM Deluxe (HMO-POS) covers emergency services with a $75 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours, and urgently needed services are available with no copay or coinsurance. Worldwide emergency and urgent services are partially covered up to a $500 maximum with a $100 copay and no coinsurance, but worldwide emergency transportation is not covered.
Primary Care See details
MMM Deluxe (HMO-POS) covers primary care and telehealth with no copay and no coinsurance, while specialists, therapies, psychiatric, and podiatry services cost between $0 and $10 with no coinsurance. Chiropractic services are partially covered, offering routine care for a $5 copay and no coinsurance while excluding other chiropractic services, and opioid treatment requires a 10% coinsurance with no copay.
Preventive Services See details
MMM Deluxe (HMO-POS) partially covers preventive services with no copay and no coinsurance, though prior authorization is required for some services. Covered benefits include health education, nutritional counseling, and alternative therapies, while annual physical exams, in-home safety assessments, and weight management programs are not covered.
Hearing Services See details
MMM Deluxe (HMO-POS) covers one routine hearing exam every year with no copay, no coinsurance, and no deductible, although prior authorization is required. Fitting and evaluation for hearing aids, prescription hearing aids, and over-the-counter (OTC) hearing aids are not covered.
Vision Services See details
MMM Deluxe (HMO-POS) vision services are partially covered, offering one routine eye exam annually with no copay, no coinsurance, and no deductible, subject to prior authorization. Other eye exam services and eyewear, including contact lenses, eyeglasses, lenses, frames, and upgrades, are not covered.
Dental Services See details
MMM Deluxe (HMO-POS) dental services are partially covered, featuring no copay and 0% to 20% coinsurance for Medicare-covered dental, and no copay and no coinsurance for covered preventive services. Restorative services, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
MMM Deluxe (HMO-POS) covers home infusion bundled services with prior authorization, including Medicare Part B insulin for a $35 copay and no coinsurance. Other covered Part B drugs, including chemotherapy, require no coinsurance to 20% coinsurance and applicable copays, with other Part B drugs ranging from no copay to a $12 copay.
Dialysis Services See details
Dialysis Services are covered by MMM Deluxe (HMO-POS) with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
MMM Deluxe (HMO-POS) covers medical equipment with no copays, featuring 0% (no coinsurance) to 20% coinsurance for durable medical equipment and 5% coinsurance for prosthetics and medical supplies. Diabetic equipment is partially covered with no copay and no coinsurance, though diabetic supplies and therapeutic shoes or inserts are not covered.
Diagnostic and Radiological Services See details
MMM Deluxe (HMO-POS) partially covers diagnostic and radiological services, requiring prior authorization for covered options. Covered lab services and diagnostic radiological services feature no copay and no coinsurance, while diagnostic procedures and tests, therapeutic radiological services, and outpatient X-ray services are not covered.
Home Health Services See details
Home Health Services are covered by MMM Deluxe (HMO-POS) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the MMM Deluxe (HMO-POS) plan, as cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are all excluded from coverage.
Skilled Nursing Facility (SNF) See details
MMM Deluxe (HMO-POS) covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance, though prior authorization is required and additional days beyond Medicare-covered limits are not covered. Beneficiaries can be admitted without a prior three-day inpatient hospital stay, and no cost-sharing is charged on the day of discharge.
Other Services See details
MMM Deluxe (HMO-POS) covers acupuncture with a $10 copay and no coinsurance for up to 10 treatments per year, as well as over-the-counter items and chronic illness meal benefits with no copay and no coinsurance. Prior authorization is required for acupuncture and meals, and certain sub-services like Naloxone are not covered.
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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.
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