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MCS Classicare En Tu Hogar (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for MCS Classicare En Tu Hogar (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on MCS Classicare En Tu Hogar (HMO) in 2026, please refer to our full plan details page.
MCS Classicare En Tu Hogar (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 En Tu Hogar (HMO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about MCS Classicare En Tu Hogar (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 En Tu Hogar (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. Additionally, this plan comes with a Part B Premium reduction of $21.00. 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 no drug deductible. Your prescription medication coverage will start immediately.
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 En Tu Hogar (HMO) plan features a $0 drug deductible, meaning your prescription coverage begins immediately. For Tier 1 preferred generic and Tier 2 generic medications, you will pay no copay for one-month, two-month, or three-month supplies at standard pharmacies. Additionally, these generic tiers offer no copay for a three-month supply when filled through standard mail order. Tier 3 preferred brand drugs require a copay of $5 for a one-month supply at standard pharmacies, while Tier 4 non-preferred drugs carry a $15 copay for a one-month supply. For specialty medications in Tier 5, you will pay a 33% coinsurance for a one-month supply at standard pharmacies or through standard mail order. Standard mail order options also provide savings, such as a three-month supply of preferred brands for a $10 copay and non-preferred drugs for a $30 copay.
Additional Benefits
MCS Classicare En Tu Hogar (HMO) offers highly affordable healthcare coverage, featuring no copay and no coinsurance for major services like inpatient hospital stays, primary care visits, and home health services. Emergency room care is accessible with a $40 copay, which is waived upon hospital admission, while urgent care is provided with no copay. Specialized medical needs such as dialysis require a 20% coinsurance, and Part B prescription drugs like chemotherapy range from 0% to 20% coinsurance. In addition to medical care, the plan provides valuable supplemental benefits with no copay, including routine dental care, vision exams with a $500 annual eyewear allowance, and hearing exams with a $500 annual hearing aid allowance. Members also receive up to 36 free one-way trips to plan-approved locations and a $35 monthly reimbursement for over-the-counter health items. Durable medical equipment is also covered with no copay, ensuring comprehensive support for your daily health and mobility needs.
Inpatient Hospital See details
MCS Classicare En Tu Hogar (HMO) offers inpatient hospital coverage for acute and psychiatric stays with no copay and no coinsurance, although prior authorization is required. Some specific services are not covered under this benefit, including upgrades, non-Medicare-covered stays, and additional days for psychiatric care.
Outpatient Services See details
MCS Classicare En Tu Hogar (HMO) covers outpatient hospital, ambulatory surgical center, and blood services with no copay and no coinsurance. While some outpatient substance abuse services are covered with no copay and no coinsurance, individual and group sessions are not covered.
Partial Hospitalization See details
Partial hospitalization is covered by MCS Classicare En Tu Hogar (HMO) with no copay and no coinsurance.
Ambulance and Transportation Services See details
MCS Classicare En Tu Hogar (HMO) offers transportation services with no copay and no coinsurance for up to 36 one-way trips per year to plan-approved locations, though transportation to any health-related location is not covered. For ambulance benefits, some services are covered with no copay or coinsurance, but ground and air ambulance services are not covered.
Emergency Services See details
Emergency services under MCS Classicare En Tu Hogar (HMO) are covered with a $40 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services are fully covered with no copay and no coinsurance, while worldwide emergency and urgent care are partially covered with a $75 copay and no coinsurance, excluding worldwide emergency transportation.
Primary Care See details
MCS Classicare En Tu Hogar (HMO) covers primary care, specialist, therapy, and telehealth services with no copay and no coinsurance. Chiropractic, psychiatric, and mental health specialty services are partially covered, but other chiropractic services and individual or group sessions for psychiatric and mental health services are not covered.
Preventive Services See details
Preventive Services are partially covered by MCS Classicare En Tu Hogar (HMO) with no copay and no coinsurance for covered options like Medicare-covered zero-dollar services, alternative therapies, and select screenings. However, several sub-services are not covered, including annual physical exams, fitness benefits, in-home safety assessments, medical nutrition therapy, and weight management programs.
Hearing Services See details
MCS Classicare En Tu Hogar (HMO) provides partially covered hearing services with no copay and no coinsurance, which includes one routine hearing exam and one fitting evaluation annually. Prescription hearing aids are covered up to a $500 annual maximum with prior authorization, but OTC hearing aids, as well as inner ear, outer ear, and over the ear prescription hearing aids, are not covered.
Vision Services See details
Vision services are partially covered by MCS Classicare En Tu Hogar (HMO) with no copay and no coinsurance, including one routine eye exam per year and up to $500 annually for contacts and eyeglasses. Other eye exam services and eyewear upgrades are not covered.
Dental Services See details
MCS Classicare En Tu Hogar (HMO) offers partially covered dental services with no copay and no coinsurance for covered preventive and comprehensive treatments. While services like cleanings, exams, and implants are covered, orthodontics and maxillofacial prosthetics are not covered under this plan.
Home Infusion bundled Services See details
MCS Classicare En Tu Hogar (HMO) covers home infusion bundled services with no copay, requiring prior authorization and step therapy. Under this benefit, Medicare Part B insulin drugs require a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered by MCS Classicare En Tu Hogar (HMO) with no copay and a 20% coinsurance.
Medical Equipment See details
MCS Classicare En Tu Hogar (HMO) covers durable medical equipment with no copay and no coinsurance, while diabetic equipment is only partially covered since diabetic supplies and therapeutic shoes or inserts are not covered. Prosthetic devices and medical supplies are covered with no copay, but require a 0% to 20% coinsurance for prosthetics and a 10% coinsurance for medical supplies.
Diagnostic and Radiological Services See details
MCS Classicare En Tu Hogar (HMO) partially covers diagnostic and radiological services with prior authorization, offering no copay and no coinsurance for covered diagnostic procedures, lab services, and therapeutic radiological services. Outpatient X-ray services are not covered under this plan.
Home Health Services See details
Home health services are covered by MCS Classicare En Tu Hogar (HMO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
MCS Classicare En Tu Hogar (HMO) covers cardiac rehabilitation services with no copay and no coinsurance, although prior authorization is required. While some services are covered, specific sub-services including cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered.
Skilled Nursing Facility (SNF) See details
MCS Classicare En Tu Hogar (HMO) covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance, though prior authorization is required. The plan allows for SNF admission without a prior three-day inpatient hospital stay, but additional days beyond Medicare-covered limits are not covered.
Other Services See details
MCS Classicare En Tu Hogar (HMO) partially covers other services with no copay and no coinsurance, which includes up to six acupuncture treatments per year and a $35 monthly reimbursement for over-the-counter items. Meal benefits, nicotine replacement therapy, and naloxone are not covered.
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