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MCS Classicare Platino Progreso (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for MCS Classicare Platino Progreso (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 Progreso (HMO D-SNP) in 2025, please refer to our full plan details page.
MCS Classicare Platino Progreso (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 Progreso (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 Progreso (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 Progreso (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 Progreso (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 $45.00. 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 Progreso (HMO D-SNP) plan has a $590 deductible for prescription drugs. If you qualify for the low-income subsidy, you will pay $0 for Part D drugs. After the deductible, you will pay the costs for drugs in each tier until your total drug costs reach $2000. Once you reach $2000, you enter the next coverage phase.
Additional Benefits
The MCS Classicare Platino Progreso (HMO D-SNP) plan offers coverage for a wide range of services. This includes no copay for ambulance services, emergency services, and home health services. The plan also provides coverage for hearing, vision, and dental services, including prescription hearing aids, routine eye exams, eyewear, and various dental procedures. Additional benefits include coverage for outpatient services, partial hospitalization, transportation for health-related locations, primary care, preventive services, and medical equipment. There is coverage for diagnostic and radiological services, but certain services are not covered. The plan also covers acupuncture, and over-the-counter (OTC) items, with a monthly allowance.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, which both require prior authorization. However, additional days, non-Medicare stays, and upgrades for both Inpatient Hospital-Acute and Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services are covered, including all outpatient hospital services, observation services, ambulatory surgical center services, and outpatient blood services. Outpatient substance abuse services are partially covered, with individual and group sessions not covered.
Partial Hospitalization See details
Partial Hospitalization is covered by the plan. There is no cost information provided for this benefit.
Ambulance and Transportation Services See details
Ambulance services are covered with no copay or coinsurance, but ground and air ambulance services are not covered. Transportation services to plan-approved health-related locations are covered for up to 45 one-way trips per year via taxi or other modes of transportation, and there is no copay or coinsurance for these services.
Emergency Services See details
Emergency Services, Urgently Needed Services, Worldwide Emergency Services, Worldwide Emergency Coverage, and Worldwide Urgent Coverage are covered with no copay and no coinsurance, but Worldwide Emergency Transportation is not covered.
Primary Care See details
Primary Care, Chiropractic, Occupational Therapy, Physician Specialist, Mental Health Specialty, Psychiatric, Physical Therapy, Speech-Language Pathology, Additional Telehealth, and Opioid Treatment Program Services are covered. Chiropractic services require prior authorization and a doctor referral, and Routine Chiropractic Care is limited to 6 visits per year. Individual and group sessions for Mental Health and Psychiatric services are not covered. Occupational Therapy and Physical Therapy/Speech-Language Pathology services have no copay or coinsurance, but require authorization. Podiatry services are not covered.
Preventive Services See details
The MCS Classicare Platino Progreso (HMO D-SNP) plan covers preventive services, including Medicare-covered services with no copay, and additional preventive services such as 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. 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, weight management programs, adult day health services, home-based palliative care, in-home support services, support for caregivers, additional sessions of smoking cessation counseling, fitness benefits, enhanced disease management, telemonitoring services, home and bathroom safety devices, and counseling services are not covered.
Hearing Services See details
Hearing services, including routine hearing exams and fitting/evaluation for hearing aids, are covered under the MCS Classicare Platino Progreso (HMO D-SNP) plan. Prescription hearing aids are covered up to a maximum of $1,500 per year, while inner ear, outer ear, and over the ear prescription hearing aids, and OTC hearing aids are not covered.
Vision Services See details
Vision services include routine eye exams, eyewear, and upgrades, and are covered by the plan. Routine eye exams are covered once per year. Eyewear has a combined maximum benefit of $1000 every year, and includes coverage for contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames. Upgrades are not covered.
Dental Services See details
The MCS Classicare Platino Progreso (HMO D-SNP) plan covers dental services, including Medicare dental services, restorative services, adjunctive general services, endodontics, periodontics, removable prosthodontics, implant services, fixed prosthodontics, and oral and maxillofacial surgery. Orthodontic services are covered with a maximum plan benefit of $4,500 per year. Maxillofacial prosthetics and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the MCS Classicare Platino Progreso (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 with no copay and no coinsurance.
Medical Equipment See details
Medical Equipment is covered by MCS Classicare Platino Progreso (HMO D-SNP), including Durable Medical Equipment (DME), with no copay or coinsurance, but equipment for use outside the home is not covered. Prosthetics/Medical Supplies are covered with no copay or coinsurance, however, prosthetic devices and medical supplies are not covered. Diabetic Equipment is covered, but diabetic supplies and therapeutic shoes/inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by MCS Classicare Platino Progreso (HMO D-SNP), but Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services are not covered, with no copay. Prior authorization and a doctor referral are required.
Home Health Services See details
Home Health Services are covered by MCS Classicare Platino Progreso (HMO D-SNP) with no copay or coinsurance. However, Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are technically covered, but none of the sub-services, including Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services, are covered. Prior authorization is required for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services require prior authorization and a doctor's referral, but the plan does not cover additional days beyond Medicare-covered SNF stays or non-Medicare-covered SNF stays.
Other Services See details
Other Services include acupuncture and over-the-counter (OTC) items. Acupuncture has a limit of 6 treatments per year. OTC items are covered up to a maximum of $81.00 per month, and the amount carries over if unused. 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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