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MCS Classicare Patriot (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for MCS Classicare Patriot (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on MCS Classicare Patriot (HMO) in 2026, please refer to our full plan details page.
MCS Classicare Patriot (HMO) is a HMO 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 2026.
It's important to know that MCS Classicare Patriot (HMO) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about MCS Classicare Patriot (HMO).
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 Patriot (HMO), 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.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
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
Prescription drugs are not covered by MCS Classicare Patriot (HMO).
Additional Benefits
The MCS Classicare Patriot (HMO) plan offers robust coverage with no copays and no coinsurance for many essential services, including inpatient hospital stays, outpatient services, primary care, specialist visits, and skilled nursing facility care. Beneficiaries also pay no copay or coinsurance for preventive services, diagnostic tests, home health care, and routine vision, hearing, and dental exams, which includes annual allowances of up to $700 for eyewear, $700 for hearing aids, and $2,500 for dental treatments. For other medical needs, emergency room visits require a $40 copay, while dialysis services and certain medical equipment or prosthetics may require up to a 20% coinsurance. The plan also features valuable extra benefits like up to 68 one-way health-related trips and a $200 monthly over-the-counter reimbursement with no copay, though it does not cover ambulance rides, routine physicals, or cardiac rehabilitation.
Inpatient Hospital See details
MCS Classicare Patriot (HMO) inpatient hospital benefits are covered with no copay and no coinsurance for acute and psychiatric stays, though prior authorization is required. This benefit is partially covered because upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by MCS Classicare Patriot (HMO) with no copay and no coinsurance for outpatient hospital, ambulatory surgical center, and outpatient blood services. For outpatient substance abuse, some services are covered but individual and group sessions are not covered.
Partial Hospitalization See details
Partial hospitalization is covered by MCS Classicare Patriot (HMO) with no copay and no coinsurance required for services.
Ambulance and Transportation Services See details
MCS Classicare Patriot (HMO) covers some ambulance services, but ground and air ambulance services are not covered. Transportation services are partially covered with no copay and no coinsurance for up to 68 annual one-way trips to plan-approved health-related locations, while transportation to any health-related location is not covered.
Emergency Services See details
MCS Classicare Patriot (HMO) covers emergency services with a $40 copay and no coinsurance, which is waived if admitted to the hospital within 24 hours, and urgently needed services with no copay or coinsurance. Worldwide emergency services are partially covered with a $75 copay and no coinsurance for emergency and urgent care, but worldwide emergency transportation is not covered.
Primary Care See details
MCS Classicare Patriot (HMO) primary care, specialist, therapy, telehealth, and opioid treatment services are covered with no copay and no coinsurance. Routine chiropractic care is partially covered for up to 6 visits per year, but podiatry services, other chiropractic services, and individual or group sessions for mental health and psychiatric services are not covered.
Preventive Services See details
Preventive services are partially covered under MCS Classicare Patriot (HMO) with no copay and no coinsurance for covered services like Medicare-covered zero-dollar care, kidney disease education, and alternative therapies. However, the plan does not cover annual physical exams, fitness benefits, weight management, in-home safety assessments, PERS, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, adult day health, palliative care, in-home support, caregiver support, additional smoking cessation, enhanced disease management, telemonitoring, home safety devices, or counseling.
Hearing Services See details
Hearing services are covered by MCS Classicare Patriot (HMO) with no copay and no coinsurance, including one routine exam and one fitting evaluation per year. Prescription hearing aids are covered up to $700 annually with prior authorization, but OTC hearing aids and inner ear, outer ear, or over-the-ear prescription models are not covered.
Vision Services See details
Vision services are covered by MCS Classicare Patriot (HMO) with no copay, no coinsurance, and no deductible, which includes one routine eye exam yearly and eyewear up to a $700 annual limit. The plan's vision benefit is partially covered, as other eye exam services and eyewear upgrades are not covered.
Dental Services See details
MCS Classicare Patriot (HMO) partially covers dental services with no copay and no coinsurance for covered preventive and comprehensive services. While a wide range of treatments are covered up to a $2,500 annual limit, maxillofacial prosthetics and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled services are covered by MCS Classicare Patriot (HMO) with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy and other drugs carry a coinsurance of 0% to 20%, while Medicare Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Dialysis Services are covered under the MCS Classicare Patriot (HMO) with no copay and a 20% coinsurance.
Medical Equipment See details
MCS Classicare Patriot (HMO) covers durable medical equipment and diabetic equipment with no copay and no coinsurance, though diabetic supplies and therapeutic shoes or inserts are not covered. Prosthetic devices are covered with no copay and a 0% to 20% coinsurance, while medical supplies have no copay and a 10% coinsurance.
Diagnostic and Radiological Services See details
MCS Classicare Patriot (HMO) partially covers Diagnostic and Radiological Services, offering covered diagnostic tests, lab services, and therapeutic radiological services with no copay and no coinsurance. Prior authorization is required for covered services, and outpatient X-ray services are not covered.
Home Health Services See details
MCS Classicare Patriot (HMO) covers home health services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
MCS Classicare Patriot (HMO) does not cover Cardiac Rehabilitation Services, including standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by MCS Classicare Patriot (HMO) with no copay and no coinsurance, though prior authorization is required. The plan allows for admission with less than a 3-day prior inpatient hospital stay, but additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services covered by MCS Classicare Patriot (HMO) include acupuncture and over-the-counter (OTC) items with no copay and no coinsurance, while meal benefits are not covered. Acupuncture is limited to 6 treatments per year, and the OTC benefit provides up to $200 monthly via reimbursement, excluding nicotine replacement therapy, naloxone, and certain CMS OTC list drugs.
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