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MCS Classicare Platino Ideal (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for MCS Classicare Platino Ideal (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on MCS Classicare Platino Ideal (HMO D-SNP) in 2025, please refer to our full plan details page.
MCS Classicare Platino Ideal (HMO D-SNP) is a HMO D-SNP plan offered by MHH Healthcare, L.P. available for enrollment in 2025 to people living in Puerto Rico. This plan received an overall rating of 5 out of 5 stars in 2025.
It's important to know that MCS Classicare Platino Ideal (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:
MCS Classicare Platino Ideal (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 MCS Classicare Platino Ideal (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 MCS Classicare Platino Ideal (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 $120.00. 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 $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 $3400.00 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 MCS Classicare Platino Ideal (HMO D-SNP) plan has a deductible of $590.00. If you qualify for the low-income subsidy, you pay $0.00 for your Part D drugs. After the deductible is met, you will pay the costs for your drugs based on the tier and pharmacy you use. Once your total drug costs reach $2000.00, you enter the catastrophic coverage phase, where you pay nothing for your Part D covered drugs.
Additional Benefits
The MCS Classicare Platino Ideal (HMO D-SNP) plan offers a range of healthcare benefits. This plan covers inpatient and outpatient services, including emergency, primary care, and home health services. Many services, like ambulance and transportation, have no copay, while others, such as hearing and vision, offer specific allowances for exams and eyewear. Additional benefits include coverage for dental services, hearing services, and medical equipment. However, certain services like cardiac rehabilitation and some durable medical equipment are not covered. The plan also provides coverage for other services like acupuncture and over-the-counter items.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, but some services like Additional Days for Inpatient Hospital-Acute and Non-Medicare-covered Stay for Inpatient Hospital-Acute are not covered. Prior authorization and a doctor referral are required.
Outpatient Services See details
Outpatient Services are covered, including outpatient hospital services, observation services, ambulatory surgical center services, and outpatient blood services. Outpatient substance abuse services are partially covered; individual and group sessions are not covered.
Partial Hospitalization See details
Partial Hospitalization benefits are covered. This plan offers coverage for partial hospitalization, but the specific costs associated with the benefit are not detailed in the provided information.
Ambulance and Transportation Services See details
The MCS Classicare Platino Ideal (HMO D-SNP) plan covers all ambulance services with no copay or coinsurance, but ground and air ambulance services are not covered. Transportation services to a plan-approved health-related location are covered for up to 32 one-way trips per year with no copay or coinsurance, using taxis, other methods, and a fleet including sedans, minivans, and buses. Transportation services to any health-related location is not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, Worldwide Emergency Services, Worldwide Emergency Coverage, and Worldwide Urgent Coverage are covered by MCS Classicare Platino Ideal (HMO D-SNP) with no copay and no coinsurance. Worldwide Emergency Transportation is not covered.
Primary Care See details
The MCS Classicare Platino Ideal (HMO D-SNP) plan covers primary care physician services, chiropractic services (with prior authorization and referral), occupational therapy services (with authorization), physician specialist services (with referral), podiatry services (with referral, and limited to 1 routine foot care visit every three months), other health care professional services (with referral), psychiatric services, physical therapy and speech-language pathology services (with authorization), additional telehealth benefits, and opioid treatment program services. Mental health specialty services, individual sessions, and group sessions for mental health and psychiatric services are not covered.
Preventive Services See details
The MCS Classicare Platino Ideal (HMO D-SNP) plan covers several preventive services, including glaucoma screening, diabetes self-management training, and more, with no copay. The plan does not cover annual physical exams, in-home safety assessments, personal emergency response systems, or several other services.
Hearing Services See details
Hearing services with the MCS Classicare Platino Ideal (HMO D-SNP) plan include coverage for hearing exams, routine hearing exams (1 per year), and fitting/evaluation for hearing aids (1 per year). Prescription hearing aids are covered with a maximum benefit of $500 per year, but inner ear, outer ear, and over-the-ear prescription hearing aids are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision services include routine eye exams with no copay and no deductible for one visit every year, and eyewear with a combined maximum benefit of $500 every year. Contact lenses, eyeglasses (lenses and frames), and eyeglass lenses and frames are covered, but upgrades are not covered.
Dental Services See details
The MCS Classicare Platino Ideal (HMO D-SNP) plan covers dental services, including Medicare dental services, orthodontic services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), implant services, and oral and maxillofacial surgery. Maxillofacial prosthetics and orthodontics are not covered. The plan has a maximum benefit of $3,500 per year for orthodontic services.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the MCS Classicare Platino Ideal (HMO D-SNP) plan, including Medicare Part B Insulin Drugs, but prior authorization is required, and Medicare Part B Chemotherapy/Radiation Drugs are not covered. This plan does have step therapy.
Dialysis Services See details
Dialysis Services are covered under the plan. There is no copay or coinsurance for this benefit.
Medical Equipment See details
Medical Equipment is covered under the MCS Classicare Platino Ideal (HMO D-SNP) plan, but some services are not covered. Durable Medical Equipment (DME) and Prosthetics/Medical Supplies - Non-Medicare benefits are covered with no copay and no coinsurance, but Durable Medical Equipment for use outside the home, Prosthetic Devices, Medical Supplies, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, but Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services are not covered. There is no copay for covered services.
Home Health Services See details
Home Health Services are covered by MCS Classicare Platino Ideal (HMO D-SNP) with no copay and no coinsurance, but prior authorization and a referral are required. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the MCS Classicare Platino Ideal (HMO D-SNP) plan. Specifically, Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but additional days beyond Medicare-covered and non-Medicare-covered stays are not covered. Prior authorization and a doctor referral are required for SNF services.
Other Services See details
The MCS Classicare Platino Ideal (HMO D-SNP) plan covers acupuncture with a limit of 6 treatments per year, and it covers over-the-counter (OTC) items with a maximum benefit of $93.00 per month. Meal benefit, 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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