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MMM Combo Platino (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for MMM Combo 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 Combo Platino (HMO D-SNP) in 2026, please refer to our full plan details page.
MMM Combo 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 Combo 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 Combo 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 Combo 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 Combo 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 $50.00. 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:
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Drug Coverage
The MMM Combo Platino (HMO D-SNP) Medicare plan has an annual prescription drug deductible of $615. This deductible is the amount you must pay out-of-pocket for your medications before your plan coverage begins to pay. Specific drug tier details, including individual copays and coinsurance amounts, are currently not available for this plan. To determine your exact prescription drug costs and coverage, you should consult the plan formulary for a complete list of covered medications.
Additional Benefits
The MMM Combo Platino (HMO D-SNP) plan offers highly affordable coverage, featuring no copay and no coinsurance for the vast majority of its medical services. This includes inpatient and outpatient hospital care, primary and specialist doctor visits, emergency services, and home health care. Additionally, members can access preventive care, diagnostic hearing exams, and up to 12 one-way routine transportation trips per year with no copay or coinsurance. For specialized benefits, the plan covers contact lenses and eyeglasses with no copay or coinsurance up to a $1,000 annual limit. Dental services are partially covered with no copay to a 20% coinsurance up to a $1,000 annual maximum, while durable medical equipment and prosthetics require a 20% coinsurance. Worldwide emergency care is also available with a $75 copay, ensuring predictable out-of-pocket costs for members.
Inpatient Hospital See details
MMM Combo Platino (HMO D-SNP) partially covers inpatient acute and psychiatric hospital stays with no copay and no coinsurance, though prior authorization is required. However, additional days, non-Medicare-covered stays, and room upgrades are not covered.
Outpatient Services See details
MMM Combo Platino (HMO D-SNP) covers outpatient hospital, ambulatory surgical center, and blood services with no copay and no coinsurance. Some outpatient substance abuse services are covered with no copay and no coinsurance, though individual and group sessions are not covered.
Partial Hospitalization See details
Partial hospitalization is covered under the MMM Combo Platino (HMO D-SNP) plan with no copay and no coinsurance. Prior authorization and a referral are required to access these services.
Ambulance and Transportation Services See details
MMM Combo Platino (HMO D-SNP) does not cover ground or air ambulance services, but provides up to 12 one-way transportation trips per year to plan-approved locations with no copay and no coinsurance. Prior authorization is required, and transportation to any health-related location is not covered.
Emergency Services See details
MMM Combo Platino (HMO D-SNP) covers emergency and urgently needed services with no copay and no coinsurance. Worldwide emergency and urgent services are partially covered with a $75 copay and no coinsurance up to a $500 maximum limit, though worldwide emergency transportation is not covered.
Primary Care See details
Primary care benefits under MMM Combo Platino (HMO D-SNP) are covered with no copay and no coinsurance for primary care, specialist, therapy, telehealth, podiatry, and opioid treatment services. Chiropractic care is partially covered, excluding other chiropractic services, while mental health specialty and psychiatric benefits cover some services but exclude individual and group sessions.
Preventive Services See details
MMM Combo Platino (HMO D-SNP) partially covers preventive services with no copay and no coinsurance, though prior authorization is required for many services. Covered benefits include Medicare-covered preventive care, alternative therapies, and nutritional counseling, while annual physical exams, in-home safety assessments, and personal emergency response systems are not covered.
Hearing Services See details
Hearing services are partially covered by MMM Combo Platino (HMO D-SNP), which offers diagnostic hearing exams with no copay, no coinsurance, and no deductible, though prior authorization is required. Routine hearing exams, fitting evaluations, OTC hearing aids, and all prescription hearing aid types—including inner ear, outer ear, and over-the-ear devices—are not covered.
Vision Services See details
Vision services are partially covered by MMM Combo Platino (HMO D-SNP) with no copay and no coinsurance, though prior authorization is required. While contact lenses and eyeglasses are covered up to a $1,000 annual limit, routine eye exams, other eye exam services, eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
MMM Combo Platino (HMO D-SNP) provides partial coverage for dental services, offering covered Medicare dental, restorative, adjunctive, implant, and prosthodontic services with no copay and no coinsurance to 20% coinsurance up to a $1,000 annual maximum. Preventive services (including cleanings, exams, and x-rays), endodontics, periodontics, maxillofacial prosthetics, oral surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
MMM Combo Platino (HMO D-SNP) partially covers home infusion bundled services with no copay and no coinsurance, though prior authorization and step therapy are required. While Medicare Part B insulin drugs are covered with no copay and no coinsurance, Medicare Part B chemotherapy or radiation drugs and other Medicare Part B drugs are not covered under this benefit.
Dialysis Services See details
MMM Combo Platino (HMO D-SNP) covers Dialysis Services with no copay and no coinsurance, though prior authorization is required for these services.
Medical Equipment See details
MMM Combo Platino (HMO D-SNP) partially covers medical equipment, offering durable medical equipment and prosthetics with no copay and a 20% coinsurance. Diabetic equipment is covered with no copay and no coinsurance, but diabetic supplies and diabetic therapeutic shoes or inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by MMM Combo 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-ray services are not covered.
Home Health Services See details
Home Health Services are covered under the MMM Combo Platino (HMO D-SNP) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
MMM Combo Platino (HMO D-SNP) offers coverage for some Cardiac Rehabilitation Services with no copay and no coinsurance, though referral and prior authorization are required. While some services are covered, specific programs including cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by MMM Combo Platino (HMO D-SNP) with no copay and no coinsurance, though prior authorization is required. This benefit does not require a prior three-day inpatient hospital stay, but additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered by MMM Combo Platino (HMO D-SNP), offering acupuncture, over-the-counter (OTC) items, and meal benefits for chronic illnesses with no copay and no coinsurance. However, highly integrated services for dual eligibles and other additional services are not covered.
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