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MMM Flexi Platino (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for MMM Flexi 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 Flexi Platino (HMO D-SNP) in 2026, please refer to our full plan details page.
MMM Flexi 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 Flexi 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 Flexi 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 Flexi 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 Flexi 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.
This plan does not come with a Part B Premium reduction. You must continue to pay your 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 Flexi Platino (HMO D-SNP) prescription drug coverage features an annual drug deductible of $615. You must pay this deductible amount out-of-pocket for your covered medications before the plan begins to pay its share. Specific details regarding prescription drug tiers, copays, and coinsurance are currently unavailable for this plan. To determine your exact out-of-pocket costs, it is best to review the plan's formulary for your specific medications.
Additional Benefits
The MMM Flexi Platino (HMO D-SNP) plan offers robust coverage with no copay and no coinsurance for many essential services, including inpatient hospital care, primary care visits, home health, and skilled nursing facility stays. Local emergency and urgent care services are also covered with no copay, while worldwide emergency care is subject to a seventy-five dollar copay. However, many of these benefits require prior authorization, and routine services for vision, hearing, and dental are not covered. For durable medical equipment and prosthetic devices, members will pay no copay and a twenty percent coinsurance. Additionally, the plan provides up to twelve one-way transportation trips per year with no copay, but it excludes coverage for ambulance services, cardiac rehabilitation, and over-the-counter items. This plan is designed to minimize out-of-pocket costs for major medical needs, though members should be aware of specific coverage exclusions.
Inpatient Hospital See details
MMM Flexi Platino (HMO D-SNP) covers inpatient hospital services, including acute and psychiatric care, with no copay and no coinsurance, though prior authorization is required. This benefit is partially covered because upgrades, additional days, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by MMM Flexi Platino (HMO D-SNP) with no copay and no coinsurance for outpatient hospital, ambulatory surgical center, and blood services. Some outpatient substance abuse services are covered with no copay or coinsurance, but individual and group sessions are not covered.
Partial Hospitalization See details
Partial hospitalization is covered by MMM Flexi Platino (HMO D-SNP) with no copay and no coinsurance. Members are required to obtain a referral and prior authorization for these services.
Ambulance and Transportation Services See details
MMM Flexi Platino (HMO D-SNP) covers transportation services with no copay and no coinsurance for up to 12 one-way trips per year to plan-approved locations, though prior authorization is required. For ambulance benefits, some services are covered but ground and air ambulance services are not covered.
Emergency Services See details
Emergency services are covered by MMM Flexi Platino (HMO D-SNP) with no copay and no coinsurance for local emergency and urgent care. 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
MMM Flexi Platino (HMO D-SNP) covers primary care services with no copay and no coinsurance, including PCP visits, specialists, and physical therapy. Chiropractic care is partially covered because other chiropractic services are not covered, and while mental health and psychiatric benefits are listed, some services are covered but individual and group sessions are not covered.
Preventive Services See details
Preventive Services are partially covered by MMM Flexi Platino (HMO D-SNP) with no copay and no coinsurance, though prior authorization is required for many services. While Medicare-covered preventive care, diabetes training, and select alternative therapies are included, several services like annual physical exams, fitness benefits, therapeutic massages, and in-home safety assessments are not covered.
Hearing Services See details
Hearing services are partially covered by MMM Flexi Platino (HMO D-SNP), which offers diagnostic hearing exams with no copay and no coinsurance, subject to prior authorization. While some prescription hearing aid services are covered, routine exams, fitting evaluations, OTC hearing aids, and all prescription hearing aid types—including inner ear, outer ear, and over the ear—are not covered.
Vision Services See details
Vision Services are covered by MMM Flexi Platino (HMO D-SNP) with no copay and no coinsurance, subject to prior authorization. Although some services are covered, routine eye exams, contact lenses, and eyeglasses are not covered by the plan.
Dental Services See details
MMM Flexi Platino (HMO D-SNP) partially covers dental services, providing coverage solely for Medicare-covered dental services with no copayment and 0% to 20% coinsurance, which requires prior authorization. Routine and preventive dental care, including cleanings, exams, x-rays, and orthodontic services, is not covered by this plan.
Home Infusion bundled Services See details
MMM Flexi 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 drugs are covered, but Medicare Part B chemotherapy, radiation, and other Part B drugs are not covered.
Dialysis Services See details
Dialysis Services are covered under the MMM Flexi Platino (HMO D-SNP) plan with no copay and no coinsurance, although prior authorization is required.
Medical Equipment See details
Medical Equipment benefits under MMM Flexi Platino (HMO D-SNP) are covered with no copay and a 20% coinsurance for durable medical equipment, prosthetic devices, and medical supplies, all requiring prior authorization. Although diabetic equipment is covered with no copay and no coinsurance, diabetic supplies and diabetic therapeutic shoes or inserts are not covered.
Diagnostic and Radiological Services See details
MMM Flexi Platino (HMO D-SNP) covers some diagnostic and radiological services with no copay and no coinsurance, subject to prior authorization. However, diagnostic procedures and tests, lab services, diagnostic radiological services, therapeutic radiological services, and outpatient x-ray services are not covered.
Home Health Services See details
Home Health Services are covered under the MMM Flexi 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 not covered under the MMM Flexi Platino (HMO D-SNP) plan, as cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are all excluded from coverage.
Skilled Nursing Facility (SNF) See details
MMM Flexi Platino (HMO D-SNP) covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance, though prior authorization is required. This benefit allows for admission with less than a three-day prior hospital stay, but does not cover additional days beyond the standard Medicare-covered limit.
Other Services See details
Other services are partially covered by MMM Flexi Platino (HMO D-SNP), featuring acupuncture and chronic illness meal benefits with no copay and no coinsurance. Over-the-counter (OTC) items are not covered under this benefit.
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