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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 2025, 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 2025.
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 a range of benefits, including inpatient hospital stays with no copay for Medicare-covered days, and outpatient services. The plan also covers emergency services with a $40 copay, and offers transportation services to plan-approved locations with no copay for up to 68 one-way trips per year. Additional benefits include coverage for primary care, preventive services, hearing, vision, and dental services. Hearing aids have a maximum benefit of $1,000 per year, and vision includes routine eye exams and eyewear with a combined $1,000 annual maximum. The plan also covers home infusion, dialysis, medical equipment, diagnostic and radiological services, home health, and cardiac rehabilitation.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute with no copay for Medicare-covered stays and additional days with no copay. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute are not covered, and Inpatient Hospital Psychiatric has no specific cost-sharing information.
Outpatient Services See details
Outpatient Services are covered, including outpatient hospital services, observation services, ambulatory surgical center (ASC) services, and outpatient blood services. Outpatient substance abuse services are partially covered, as individual and group sessions are not covered.
Partial Hospitalization See details
Partial Hospitalization benefits are covered under the MCS Classicare Patriot (HMO) plan. There is no information about the cost of these services.
Ambulance and Transportation Services See details
The MCS Classicare Patriot (HMO) plan covers Ambulance and Transportation Services; however, ground and air ambulance services are not covered. Transportation Services to a Plan Approved Health-related Location are covered for up to 68 one-way trips per year, with no copay or coinsurance.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Coverage are covered by the MCS Classicare Patriot (HMO) plan. Emergency Services has a $40 copay, and Worldwide Emergency Coverage and Worldwide Urgent Coverage each have a $75 copay, while there is no copay for Urgently Needed Services. Worldwide Emergency Transportation is not covered.
Primary Care See details
Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Other Health Care Professional, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services are covered. Chiropractic Services require prior authorization and covers up to 6 visits per year. Mental Health Specialty Services and Psychiatric Services do not cover individual or group sessions, and Podiatry Services are not covered.
Preventive Services See details
The MCS Classicare Patriot (HMO) plan covers preventive services including health education, alternative therapies (6 visits), therapeutic massage (6 sessions), nutritional/dietary benefits (6 visits), glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following Welcome Visit. Annual physical exams, in-home safety assessments, Personal Emergency Response Systems (PERS), medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, adult day health services, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, fitness benefits, enhanced disease management, telemonitoring services, home and bathroom safety devices and modifications, and counseling services are not covered.
Hearing Services See details
The MCS Classicare Patriot (HMO) plan covers hearing exams, routine hearing exams (1 per year), and fitting/evaluation for hearing aids (1 per year). Prescription hearing aids (all types) are covered with a maximum benefit of $1,000 per year, and require prior authorization. Prescription hearing aids for the inner ear, outer ear, and over the ear are not covered, and OTC hearing aids are also not covered.
Vision Services See details
The MCS Classicare Patriot (HMO) plan covers vision services, including routine eye exams once per year, and eyewear with a combined maximum benefit of $1,000 per 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 Patriot (HMO) plan covers a variety of dental services, including oral exams, dental x-rays, and other diagnostic services, with some services requiring prior authorization. Orthodontic services are covered up to a maximum of $2,500 per year. Maxillofacial prosthetics and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%. The coinsurance for the other drugs is between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the MCS Classicare Patriot (HMO) plan. The coinsurance for these services is 20%.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with no copay or coinsurance, but Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices have a coinsurance between 0% and 20%, and Medical Supplies have a 10% coinsurance. Diabetic Equipment benefits are covered, but Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests and Lab Services with a coinsurance of at most 20%, and Diagnostic Radiological Services and Therapeutic Radiological Services with a coinsurance of at most 20%, with no copay for any of the services; however, Outpatient X-Ray Services are not covered.
Home Health Services See details
Home Health Services are covered by the MCS Classicare Patriot (HMO) plan with no copay and no coinsurance, but authorization is required. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization is required for this benefit.
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 is required for SNF services.
Other Services See details
The MCS Classicare Patriot (HMO) plan covers acupuncture, with a limit of 6 treatments per year, and it also covers over-the-counter (OTC) items up to $230.00 per month. Several other "Other Services" are not covered, including meal benefits, and home and community based services.
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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
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