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MMM Plenitud (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for MMM Plenitud (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on MMM Plenitud (HMO-POS) in 2026, please refer to our full plan details page.
MMM Plenitud (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 Plenitud (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 Plenitud (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 Plenitud (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 $44.00. 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 Plenitud (HMO-POS) plan features a $0 drug deductible, meaning your prescription coverage begins immediately. For Tier 1 preferred generics, Tier 2 generics, and Tier 7 select care drugs, there is no copay for a 1-month or 3-month supply at standard pharmacies, as well as no copay for a 3-month supply via standard mail order. This makes managing everyday maintenance medications highly affordable. For brand-name and specialty medications, the plan offers predictable copays and coinsurance rates. Tier 3 preferred brands require a $5 copay for a 1-month supply, while Tier 4 non-preferred drugs have a $7 copay for a 1-month supply at standard pharmacies. Specialty medications in Tier 5 and Tier 6 carry a 25% and 33% coinsurance, respectively, for a 1-month supply.
Additional Benefits
The MMM Plenitud (HMO-POS) plan offers comprehensive medical coverage with many essential services available at no copay and no coinsurance. Key benefits such as primary care, specialist visits, acute inpatient hospital stays, preventive care, and skilled nursing facility stays require no copayments or coinsurance. For other medical needs, patients will find low out-of-pocket costs, including a $25 copay for outpatient hospital services, a $4 copay for physical therapies, and a $75 copay for emergency room visits. This plan also features robust supplemental coverage with no copays or coinsurance for routine dental, vision, and hearing care. Beneficiaries receive valuable allowances, including $500 annually for eyewear, up to $1,250 every three years for prescription hearing aids, and a $2,000 annual maximum for comprehensive dental services. Additionally, the plan covers up to 20 one-way routine transportation trips and select over-the-counter items with no copay or coinsurance.
Inpatient Hospital See details
MMM Plenitud (HMO-POS) partially covers inpatient hospital services, excluding non-Medicare-covered stays, upgrades, and additional psychiatric days. Medicare-covered acute stays have no copay and no coinsurance, while psychiatric stays require a $50 copay per admission and no coinsurance.
Outpatient Services See details
MMM Plenitud (HMO-POS) outpatient services are covered with no coinsurance, featuring a $25 copay for outpatient hospital services and a $0 to $50 copay per stay for observation services. Ambulatory surgical center and outpatient blood services require no copay and no coinsurance, while some outpatient substance abuse services are covered with no copay or coinsurance, but individual and group sessions are not covered.
Partial Hospitalization See details
MMM Plenitud (HMO-POS) covers partial hospitalization services with no copay and no coinsurance, although prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and transportation services are offered by MMM Plenitud (HMO-POS), though ground and air ambulance services are not covered. Transportation services are partially covered with no copay or coinsurance, providing up to 20 one-way trips per year to plan-approved health-related locations with prior authorization, while transport to any health-related location is not covered.
Emergency Services See details
MMM Plenitud (HMO-POS) covers emergency services with a $75 copay and no coinsurance (waived if admitted to the hospital within 24 hours), and urgently needed services with no copay and no coinsurance. Worldwide emergency and urgent care are partially covered up to a $500 maximum with a $100 copay and no coinsurance, though worldwide emergency transportation is not covered.
Primary Care See details
MMM Plenitud (HMO-POS) covers primary care, specialist, telehealth, and podiatry services with no copay and no coinsurance, while physical, occupational, and speech therapies require a $4 copay and no coinsurance. Chiropractic care is partially covered with no copay or coinsurance for routine visits (excluding other chiropractic services), opioid treatment requires a 10% coinsurance with no copay, and psychiatric services are not covered.
Preventive Services See details
MMM Plenitud (HMO-POS) offers partially covered preventive services with no copay and no coinsurance, although prior authorization is required for most services. While Medicare-covered preventive care, health education, and select alternative therapies are covered, other services like annual physical exams, therapeutic massages, and in-home safety assessments are not covered.
Hearing Services See details
Hearing services are partially covered by MMM Plenitud (HMO-POS) with no copay and no coinsurance, though prior authorization is required. The plan covers one routine exam and fitting evaluation annually, and up to $1,250 every three years for prescription hearing aids, but OTC hearing aids and inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Vision services are partially covered under MMM Plenitud (HMO-POS) with no copays, no coinsurance, and no deductibles, though prior authorization is required. The plan covers one routine eye exam per year and provides a $500 annual allowance for contact lenses and eyeglasses, while other eye exams, upgrades, and separate eyeglass lenses or frames are not covered.
Dental Services See details
MMM Plenitud (HMO-POS) partially covers dental services with no copay and no coinsurance for covered services, although prior authorization is required. Maxillofacial prosthetics and orthodontics are not covered under this plan, and select comprehensive services are subject to a $2,000 annual maximum benefit.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by MMM Plenitud (HMO-POS) with prior authorization, offering Medicare Part B insulin for a $35 copay and no coinsurance. Other covered Part B drugs, including chemotherapy, carry a coinsurance of 0% to 20% and copays ranging from no copay up to $7.
Dialysis Services See details
Dialysis Services are covered under the MMM Plenitud (HMO-POS) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
MMM Plenitud (HMO-POS) covers durable medical equipment (DME) with no copay and no coinsurance, and prosthetic devices and medical supplies with no copay and a 5% coinsurance. Diabetic equipment is partially covered with no copay and no coinsurance, but diabetic supplies and therapeutic shoes or inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are partially covered by MMM Plenitud (HMO-POS) with prior authorization required, offering covered lab services and diagnostic radiological services with no copay and no coinsurance. Diagnostic procedures and tests, therapeutic radiological services, and outpatient X-ray services are not covered.
Home Health Services See details
MMM Plenitud (HMO-POS) covers home health services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the MMM Plenitud (HMO-POS) plan, as cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation sub-services are all excluded from coverage.
Skilled Nursing Facility (SNF) See details
MMM Plenitud (HMO-POS) covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance per stay, and does not require a prior three-day hospital stay. Prior authorization is required for these services, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by MMM Plenitud (HMO-POS), including acupuncture, over-the-counter (OTC) items, and meal benefits, while additional categories (Other 1, 2, and 3) and Naloxone are not covered. Acupuncture requires a $10 copay and no coinsurance for up to 10 treatments per year, while chronic illness meals and OTC items are available with no copay and no coinsurance.
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