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MMM Relax Platino (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for MMM Relax 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 Relax Platino (HMO D-SNP) in 2025, please refer to our full plan details page.
MMM Relax 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 4 out of 5 stars in 2025.
It's important to know that MMM Relax 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 Relax 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 Relax 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 Relax 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 $92.10. 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 $590.00 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:
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Drug Coverage
The MMM Relax Platino (HMO D-SNP) plan has a $590 deductible for prescription drugs. Once you meet the deductible, you will pay the costs for your drugs, as outlined in the plan's formulary, until your total drug costs reach $2,000. If you qualify for the low-income subsidy (LIS), you will pay $0 for Part D drugs. After your yearly out-of-pocket drug costs reach $2,000, you will pay nothing for Medicare Part D covered drugs.
Additional Benefits
The MMM Relax Platino (HMO D-SNP) plan offers a range of benefits including coverage for inpatient and outpatient services, though some require prior authorization. You'll find no copay for ambulance services, emergency services, and many primary care and home health services. Vision and dental are partially covered, with maximum annual benefits for eyeglasses and orthodontic services, respectively. This plan also provides coverage for hearing, medical equipment, and dialysis services. Additional benefits include acupuncture, an over-the-counter allowance, and a meal benefit for chronic illness. However, this plan does not cover many services, including some vision, hearing, dental, and home care services.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, but additional days for both are not covered. Prior authorization is required.
Outpatient Services See details
Outpatient Services are covered under the MMM Relax Platino (HMO D-SNP) plan. Outpatient Hospital Services and Observation Services are covered, as are Ambulatory Surgical Center (ASC) Services, though prior authorization is required for all of these. Outpatient Substance Abuse Services are covered, but require prior authorization and a doctor referral, though individual and group sessions for outpatient substance abuse are not covered. Outpatient Blood Services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization and a doctor's referral. The copay and coinsurance for this benefit are not specified in the provided information.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by MMM Relax Platino (HMO D-SNP), with no copay or coinsurance for all ambulance services. Transportation Services to a plan-approved health-related location are covered, with up to 24 one-way trips per year using rideshare services, bus/subway, van, or medical transport, but ground and air ambulance services, and transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Coverage have no copay or coinsurance. Worldwide Urgent Coverage has a $75 copay, while Worldwide Emergency Transportation is not covered.
Primary Care See details
Primary Care includes coverage for Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Podiatry Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services. Chiropractic Services has a maximum plan benefit coverage amount of $750 per year, with a limit of 6 visits per year. Occupational Therapy Services and Physical Therapy and Speech-Language Pathology Services have no copay or coinsurance, and require authorization. Individual and Group Sessions for Mental Health Specialty Services and Psychiatric Services are not covered.
Preventive Services See details
The MMM Relax Platino (HMO D-SNP) plan covers preventive services, including Medicare-covered services with prior authorization, but doesn't cover annual physical exams. Additional preventive services, such as health education and alternative therapies, are covered, but other services like in-home safety assessments and therapeutic massage are not covered.
Hearing Services See details
Hearing services are covered and include hearing exams, fitting/evaluation for hearing aids, and prescription hearing aids. Routine hearing exams, prescription hearing aids for the inner ear, outer ear, and over the ear, as well as OTC hearing aids are not covered.
Vision Services See details
Vision services are partially covered under the MMM Relax Platino (HMO D-SNP) plan. Eye exams and contact lenses are covered, but routine eye exams are not covered. Eyeglasses (lenses and frames) are covered, and there is a maximum plan benefit coverage amount of $600 per year.
Dental Services See details
The MMM Relax Platino (HMO D-SNP) plan covers Medicare Dental Services, Orthodontic Services, Restorative Services, Prosthodontics (removable and fixed), and Implant Services, but does not cover Adjunctive General Services, Endodontics, Periodontics, Maxillofacial Prosthetics, Oral and Maxillofacial Surgery, or Orthodontics. The plan has a maximum benefit of $2,000 per year for orthodontic services.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the MMM Relax Platino (HMO D-SNP) plan, including Medicare Part B Insulin Drugs, but Medicare Part B Chemotherapy/Radiation Drugs are not covered. Prior authorization is required for this benefit.
Dialysis Services See details
Dialysis Services are covered, but require prior authorization. There is no copay or coinsurance for this benefit.
Medical Equipment See details
Medical Equipment is covered by MMM Relax Platino (HMO D-SNP), with Durable Medical Equipment (DME) subject to coinsurance between 0% and 10%, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Medical Supplies have a 20% coinsurance, and Diabetic Equipment is covered, but Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, but some services are not covered, including Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services. There is no copay for the covered services.
Home Health Services See details
Home Health Services are covered by the MMM Relax Platino (HMO D-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 technically covered, but none of the sub-services, including Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services, are covered. 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 coverage and non-Medicare-covered stays are not covered. Prior authorization is required.
Other Services See details
The MMM Relax Platino (HMO D-SNP) plan covers acupuncture with a limit of 6 treatments per year, and a maximum plan benefit coverage amount of $500.00 per year; it also covers over-the-counter (OTC) items with a maximum of $60.00 every three months, and a meal benefit for chronic illness with no maximum coverage amount. However, this plan does not cover 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.
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