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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 2025, 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 4 out of 5 stars in 2025.
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 $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 Flexi Platino (HMO D-SNP) plan has a $590 deductible for prescription drugs. After the deductible is met, you pay the cost-sharing amount for your prescriptions. Once your total drug costs reach $2,000, you enter the next coverage phase. After your yearly out-of-pocket drug costs reach $2,000, you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The MMM Flexi Platino (HMO D-SNP) plan offers a variety of benefits, including coverage for inpatient and outpatient services, with the requirement of prior authorization for many services. Emergency services have no copay, and there are no copays for primary care, physical therapy, speech-language pathology, and home health services. This plan provides coverage for ambulance services and transportation to health-related locations, with limits. Hearing, vision, and dental services are partially covered, and many other services are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits, including Acute and Psychiatric, are covered under the MMM Flexi Platino (HMO D-SNP) plan, but additional days and non-Medicare covered stays are not covered. Prior authorization is required.
Outpatient Services See details
Outpatient Services, including outpatient hospital services, observation services, and ambulatory surgical center services, are covered, but require prior authorization. Outpatient substance abuse services are covered with prior authorization and a doctor referral, but individual and group sessions are not covered. Outpatient blood services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization and a doctor referral.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the MMM Flexi Platino (HMO D-SNP) plan; however, ground and air ambulance services are not covered. Transportation Services to a plan-approved health-related location are covered, with a limit of 12 one-way trips per year.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Coverage have no copay and no coinsurance, but Worldwide Urgent Coverage has a $75 copay, and Worldwide Emergency Transportation is not covered. Worldwide Emergency Services has a maximum plan benefit coverage amount of $500.
Primary Care See details
The MMM Flexi Platino (HMO D-SNP) plan covers primary care physician services, chiropractic services (with a $750 annual maximum and 6 visits per year), occupational therapy services with no copay or coinsurance (but prior authorization and a referral are required), physician specialist services, podiatry services (with 6 visits per year), physical therapy and speech-language pathology services with no copay or coinsurance (but prior authorization is required), additional telehealth benefits, and opioid treatment program services. Mental health and psychiatric services are partially covered, with individual and group sessions not covered.
Preventive Services See details
The MMM Flexi Platino (HMO D-SNP) plan covers preventive services, including Medicare-covered services with prior authorization. Additional preventive services are covered, including health education, alternative therapies (12 visits), nutritional/dietary benefits (6 visits), additional sessions of smoking and tobacco cessation counseling (9 visits), glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following welcome visit. However, annual physical exams, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, therapeutic massage, adult day health services, home-based palliative care, in-home support services, support for caregivers of enrollees, fitness benefits, enhanced disease management, telemonitoring services, home and bathroom safety devices and modifications, and counseling services are not covered.
Hearing Services See details
Hearing services are partially covered by the MMM Flexi Platino (HMO D-SNP) plan, but routine hearing exams, fitting/evaluation for hearing aids, and all types of prescription hearing aids are not covered. The plan has no deductible for hearing exams.
Vision Services See details
Vision services are partially covered by the MMM Flexi Platino (HMO D-SNP) plan. Specifically, routine eye exams, contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental services are partially covered by the MMM Flexi Platino (HMO D-SNP) plan, with Medicare Dental Services covered and a coinsurance between 0% and 20%. Orthodontic Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable), Maxillofacial Prosthetics, Implant Services, Prosthodontics (fixed), Oral and Maxillofacial Surgery, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the MMM Flexi Platino (HMO D-SNP) plan. Medicare Part B Insulin Drugs are covered, while Medicare Part B Chemotherapy/Radiation Drugs are not covered.
Dialysis Services See details
Dialysis Services are covered by the MMM Flexi Platino (HMO D-SNP) plan, but require prior authorization.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance and no copay, Prosthetics/Medical Supplies with coinsurance for Medicare-covered items and no copay, and Diabetic Equipment. Durable Medical Equipment for use outside the home, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the MMM Flexi Platino (HMO D-SNP) plan, but none of the listed services are covered, including Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services. There is no copay for these services.
Home Health Services See details
Home Health Services are covered by the MMM Flexi Platino (HMO D-SNP) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. This benefit requires authorization.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but none of the sub-services are covered. Prior authorization and a doctor referral are required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered. Prior authorization is required.
Other Services See details
The "Other Services" benefit for MMM Flexi Platino (HMO D-SNP) covers acupuncture with a limit of 6 treatments per year, up to $500 per year, but requires prior authorization and a doctor's referral, while over-the-counter items, meal benefits, 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 are not covered.
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