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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 2026, 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 2026.
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 $615.00 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) prescription drug plan features an annual drug deductible of $615. You will need to pay this deductible amount out-of-pocket before the plan begins to cover its share of your prescription medication costs. Specific drug coverage tier details, including individual copayments and coinsurance rates, are not available for this plan. To determine your exact costs for specific medications, it is best to consult the plan's formulary or contact the plan provider directly.
Additional Benefits
The MCS Classicare Platino Progreso (HMO D-SNP) offers comprehensive medical coverage with no copays and no coinsurance for most essential services. This includes inpatient and outpatient hospital stays, primary and specialist care, emergency services, and dialysis treatments. Members can also access home health care and skilled nursing facility services with zero out-of-pocket costs, though prior authorizations or referrals may be required. This plan also features robust supplemental benefits with no copay, including up to $4,500 annually for comprehensive dental care, $1,000 for eyewear, and $1,500 per ear for prescription hearing aids. Additionally, members benefit from up to 45 health-related one-way transportation trips per year and an $86 monthly allowance for over-the-counter items. While major benefits are covered, notable exclusions include ambulance services and routine preventive dental care.
Inpatient Hospital See details
MCS Classicare Platino Progreso (HMO D-SNP) covers inpatient acute and psychiatric hospital services with no copay and no coinsurance, though prior authorization and referrals are required. This benefit is partially covered, as upgrades, additional days, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by MCS Classicare Platino Progreso (HMO D-SNP) with no copay and no coinsurance for outpatient hospital, ambulatory surgical center, and outpatient blood services. For outpatient substance abuse services, some services are covered but individual and group sessions are not covered.
Partial Hospitalization See details
MCS Classicare Platino Progreso (HMO D-SNP) covers partial hospitalization services with no copay and no coinsurance.
Ambulance and Transportation Services See details
MCS Classicare Platino Progreso (HMO D-SNP) does not cover ambulance services, but transportation services are partially covered with no copay and no coinsurance. This benefit includes up to 45 one-way trips per year to plan-approved health-related locations, while transportation to any health-related location is not covered.
Emergency Services See details
MCS Classicare Platino Progreso (HMO D-SNP) covers emergency and urgently needed services, as well as worldwide emergency and urgent care, with no copay and no coinsurance. However, worldwide emergency transportation is not covered under this benefit.
Primary Care See details
MCS Classicare Platino Progreso (HMO D-SNP) covers primary care, specialist, and therapy services with no copay and no coinsurance. Routine chiropractic care is partially covered with no copay and no coinsurance for up to 6 yearly visits, though podiatry and other chiropractic services are not covered. Some mental health and psychiatric services are covered with no copay and no coinsurance, but individual and group sessions for these specialty services are excluded.
Preventive Services See details
MCS Classicare Platino Progreso (HMO D-SNP) covers preventive services with no copay and no coinsurance, including Medicare-covered zero-dollar services and kidney disease education. This benefit is partially covered, as an annual physical exam, fitness benefit, weight management programs, and in-home safety assessments are not covered.
Hearing Services See details
MCS Classicare Platino Progreso (HMO D-SNP) covers routine hearing exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are partially covered with no copay and no coinsurance up to a maximum benefit of $1,500 per ear annually, although OTC, inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
Vision services are partially covered by MCS Classicare Platino Progreso (HMO D-SNP) with no copay and no coinsurance for covered benefits. The plan includes one routine eye exam per year and up to $1,000 annually for eyewear, though other eye exam services and upgrades are not covered.
Dental Services See details
Dental services are partially covered under MCS Classicare Platino Progreso (HMO D-SNP), featuring no copay and no coinsurance for Medicare dental and comprehensive services like restorative care, endodontics, and implants up to a $4,500 annual limit. Preventive dental services (including oral exams, cleanings, and x-rays), maxillofacial prosthetics, and orthodontics are not covered.
Home Infusion bundled Services See details
MCS Classicare Platino Progreso (HMO D-SNP) partially covers Home Infusion bundled Services with no copay and no coinsurance, though prior authorization and step therapy are required. Under this benefit, Medicare Part B insulin drugs are covered with no copay and no coinsurance, while Medicare Part B chemotherapy/radiation drugs and other Part B drugs are not covered.
Dialysis Services See details
Dialysis services are covered by MCS Classicare Platino Progreso (HMO D-SNP) with no copay and no coinsurance. This ensures you can receive necessary dialysis treatments with zero out-of-pocket costs.
Medical Equipment See details
MCS Classicare Platino Progreso (HMO D-SNP) covers Durable Medical Equipment (DME) with no copay and no coinsurance, though prior authorization and preferred vendors are required. Prosthetic devices, medical supplies, diabetic supplies, and diabetic therapeutic shoes or inserts are not covered under this plan.
Diagnostic and Radiological Services See details
MCS Classicare Platino Progreso (HMO D-SNP) covers diagnostic and radiological services with no copay and no coinsurance, requiring prior authorization and referrals. However, only some services are covered in practice, as diagnostic procedures/tests, lab services, diagnostic radiological services, therapeutic radiological services, and outpatient x-ray services are not covered.
Home Health Services See details
MCS Classicare Platino Progreso (HMO D-SNP) covers Home Health Services with no copay and no coinsurance. Prior authorization and a referral are required to access these services.
Cardiac Rehabilitation Services See details
MCS Classicare Platino Progreso (HMO D-SNP) covers cardiac rehabilitation services with no copay and no coinsurance, although prior authorization is required. While some services are covered, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by MCS Classicare Platino Progreso (HMO D-SNP) with no copay and no coinsurance, although prior authorization and a referral are required. Admission is allowed without a prior three-day inpatient hospital stay, though additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
MCS Classicare Platino Progreso (HMO D-SNP) partially covers other services with no copay and no coinsurance, including acupuncture limited to 6 treatments per year and up to $86 monthly in over-the-counter item reimbursements. Meal benefits, nicotine replacement therapy, and naloxone are not covered.
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* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
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