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MCS Classicare Platino MasCa$h (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for MCS Classicare Platino MasCa$h (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 MasCa$h (HMO D-SNP) in 2025, please refer to our full plan details page.
MCS Classicare Platino MasCa$h (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 MasCa$h (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
MCS Classicare Platino MasCa$h (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 MasCa$h (HMO D-SNP).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For MCS Classicare Platino MasCa$h (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 $174.70. 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 $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The MCS Classicare Platino MasCa$h (HMO D-SNP) plan has a $590 deductible for prescription drugs. After you meet your deductible, you will pay the costs for drugs in each tier until your total drug costs reach $2000. Once your yearly out-of-pocket drug costs reach $2000, you pay nothing for Medicare Part D covered drugs. If you qualify for the low-income subsidy, you will pay no copay for your drugs.
Additional Benefits
The MCS Classicare Platino MasCa$h (HMO D-SNP) plan offers a range of benefits, including coverage for hospital stays, outpatient services, and emergency care with no copay. It also includes coverage for primary care, preventive services, hearing, vision, and dental services. The plan provides additional benefits such as transportation, home health services, and medical equipment, with some services requiring prior authorization or referrals.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, but Additional Days, Non-Medicare-covered Stays, and Upgrades for Inpatient Hospital-Acute, as well as Additional Days and Non-Medicare-covered Stays for Inpatient Hospital Psychiatric are not covered. Prior authorization and a doctor's referral are required for Inpatient Hospital-Acute.
Outpatient Services See details
Outpatient Services are covered, including outpatient hospital services, observation services, ambulatory surgical center (ASC) services, and outpatient blood services, but outpatient substance abuse services are not covered. Outpatient blood services include an enhanced benefit with a three-pint deductible waived.
Partial Hospitalization See details
Partial Hospitalization benefits are covered by the MCS Classicare Platino MasCa$h (HMO D-SNP) plan. There is no information about the cost of services.
Ambulance and Transportation Services See details
Ambulance services are covered with no copay or coinsurance, but ground and air ambulance services are not covered. Transportation services to a plan-approved health-related location are covered for 28 one-way trips per year via taxi, sedan, minivan, or bus with no copay or coinsurance, while transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, Worldwide Emergency Services, Worldwide Emergency Coverage, and Worldwide Urgent Coverage are covered under the MCS Classicare Platino MasCa$h (HMO D-SNP) plan with no copay and no coinsurance, while Worldwide Emergency Transportation is not covered.
Primary Care See details
The Primary Care benefit includes coverage for Primary Care Physician Services, Chiropractic Services (with a limit of 6 visits per year), Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services (excluding individual and group sessions), Podiatry Services, Other Health Care Professional, Psychiatric Services (excluding individual and group sessions), Physical Therapy and Speech-Language Pathology Services and Additional Telehealth Benefits. Occupational Therapy and Physical Therapy have no copay or coinsurance, while Mental Health Specialty Services and Psychiatric Services do not cover individual or group sessions.
Preventive Services See details
Preventive services are covered by MCS Classicare Platino MasCa$h (HMO D-SNP), but 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 related to chemotherapy, weight management programs, 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. Alternative therapies, therapeutic massage, and nutritional/dietary benefits are covered. Alternative therapies are covered for 6 visits per year.
Hearing Services See details
Hearing Services include routine hearing exams, fitting/evaluation for hearing aids, and prescription hearing aids. Routine hearing exams and fitting/evaluation for hearing aids are covered once per year. Prescription hearing aids are covered up to $500 per year, and the plan covers two hearing aids annually. Prescription hearing aids for the inner ear, outer ear, and over the ear are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision services include routine eye exams, with one visit covered every year, and eyewear coverage with a combined maximum benefit of $500 per year. Contact lenses, eyeglasses (lenses and frames), and eyeglass lenses and frames are covered, while upgrades are not covered.
Dental Services See details
Dental services are covered, including Medicare Dental Services, Orthodontic Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable and fixed), Implant Services, and Oral and Maxillofacial Surgery, with a maximum benefit of $2,500 per year. Maxillofacial Prosthetics and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by MCS Classicare Platino MasCa$h (HMO D-SNP). The plan covers Medicare Part B Insulin Drugs, but does not cover Medicare Part B Chemotherapy/Radiation Drugs.
Dialysis Services See details
Dialysis Services are covered with no copay and no coinsurance.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment (DME), is covered with no copay and no coinsurance, but Durable Medical Equipment for use outside the home is not covered. Prosthetics/Medical Supplies - Non-Medicare benefit is covered with no copay and no coinsurance, but Prosthetic Devices and Medical Supplies are not covered. Diabetic Equipment is covered, but 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 the covered services.
Home Health Services See details
Home Health Services are covered by the MCS Classicare Platino MasCa$h (HMO D-SNP) plan with no copay and no coinsurance, but require authorization and a referral. 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 are covered. Prior authorization is required.
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
Under Other Services, this plan covers acupuncture with a limit of 6 treatments per year, and covers over-the-counter (OTC) items with a maximum benefit of $40.00 every month. However, the plan does not cover meal benefits, 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.
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