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MCS Classicare Platino Total (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for MCS Classicare Platino Total (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 Total (HMO D-SNP) in 2026, please refer to our full plan details page.
MCS Classicare Platino Total (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 Total (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 Total (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 Total (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 Total (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.
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.
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 Total (HMO D-SNP) plan features an annual prescription drug deductible of $615. This deductible is the amount you must pay out-of-pocket for your covered medications before the plan begins to pay its share. 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, you should consult the plan's comprehensive formulary or contact the provider directly.
Additional Benefits
The MCS Classicare Platino Total (HMO D-SNP) offers comprehensive coverage with no copays, no deductibles, and no coinsurance for almost all of its covered services. Members can access essential medical care including inpatient and outpatient hospital stays, primary and specialist care, emergency services, and home health care at no cost. Additionally, the plan includes valuable supplemental benefits such as comprehensive dental care up to a $1,200 annual maximum, vision and hearing allowances up to $500 each, and up to 30 one-way transportation trips per year to plan-approved locations. This plan also features a generous $250 monthly reimbursement for over-the-counter items and covers durable medical equipment and dialysis with no copay. However, it is important to note that certain services require prior authorization or referrals, and some benefits like ambulance services and annual physical exams are not covered. Overall, this plan is designed to minimize out-of-pocket expenses while providing robust coverage for key healthcare needs.
Inpatient Hospital See details
MCS Classicare Platino Total (HMO D-SNP) partially covers inpatient hospital services, offering acute and psychiatric stays with no copay and no coinsurance. Prior authorization and referrals are required for these services, and the plan does not cover additional days, non-Medicare-covered stays, or room upgrades.
Outpatient Services See details
MCS Classicare Platino Total (HMO D-SNP) covers outpatient services with no copay and no coinsurance, including outpatient hospital, ambulatory surgical center, and blood services. Some outpatient substance abuse services are covered, but individual and group sessions are not covered.
Partial Hospitalization See details
MCS Classicare Platino Total (HMO D-SNP) covers partial hospitalization services with no copay and no coinsurance.
Ambulance and Transportation Services See details
MCS Classicare Platino Total (HMO D-SNP) offers partially covered transportation services with no copay and no coinsurance for up to 30 one-way trips per year to plan-approved locations, while transportation to any health-related location is not covered. Ambulance services are not covered under this plan, as both ground and air ambulance services are not covered.
Emergency Services See details
MCS Classicare Platino Total (HMO D-SNP) covers emergency and urgently needed services, including worldwide emergency and urgent care, with no copay and no coinsurance. However, worldwide emergency transportation is not covered under this plan.
Primary Care See details
MCS Classicare Platino Total (HMO D-SNP) provides primary care and specialist benefits with no copay and no coinsurance for covered services like physician visits, physical therapy, and telehealth. This benefit is partially covered, as podiatry, other chiropractic services, and individual or group sessions for both mental health and psychiatric services are not covered.
Preventive Services See details
Preventive Services are partially covered by MCS Classicare Platino Total (HMO D-SNP) with no copay and no coinsurance for covered care, including kidney disease education, nutritional sessions, alternative therapies, and therapeutic massage. However, several services are not covered, such as annual physical exams, fitness benefits, in-home safety assessments, and personal emergency response systems.
Hearing Services See details
Hearing services are covered by MCS Classicare Platino Total (HMO D-SNP) with no deductible, no copay, and no coinsurance for annual routine exams and fitting evaluations. Prescription hearing aids are covered up to a $500 annual limit with no copay and no coinsurance, though some services are covered but inner ear, outer ear, over the ear, and OTC hearing aids are not covered.
Vision Services See details
MCS Classicare Platino Total (HMO D-SNP) provides partially covered vision services 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
Dental services are partially covered by MCS Classicare Platino Total (HMO D-SNP) with no copay and no coinsurance, up to a $1,200 annual maximum for comprehensive services. While Medicare dental and various restorative, endodontic, periodontic, prosthodontic, implant, and oral surgery services are covered with prior authorization, preventive and diagnostic services—such as oral exams, cleanings, x-rays, and fluoride—as well as maxillofacial prosthetics and orthodontics are not covered.
Home Infusion bundled Services See details
MCS Classicare Platino Total (HMO D-SNP) partially covers Home Infusion bundled Services with no copay and no coinsurance, although prior authorization and step therapy are required. While home infusion and Medicare Part B insulin drugs are covered with no copay and no coinsurance, Medicare Part B chemotherapy, radiation, and other Part B drugs are not covered.
Dialysis Services See details
Dialysis services are covered under the MCS Classicare Platino Total (HMO D-SNP) plan, allowing members to receive treatment with no copay and no coinsurance.
Medical Equipment See details
MCS Classicare Platino Total (HMO D-SNP) covers durable medical equipment (DME) with no copay and no coinsurance, subject to prior authorization and preferred vendor requirements. For prosthetics, medical supplies, and diabetic equipment, some services are covered with no copay and no coinsurance, but prosthetic devices, medical supplies, diabetic supplies, and therapeutic shoes or inserts are not covered.
Diagnostic and Radiological Services See details
MCS Classicare Platino Total (HMO D-SNP) covers diagnostic and radiological services with no copay and no coinsurance, though prior authorization and referrals are required. While some services are covered, diagnostic procedures or tests, lab services, diagnostic radiological services, therapeutic radiological services, and outpatient x-ray services are not covered.
Home Health Services See details
Home Health Services are covered under the MCS Classicare Platino Total (HMO D-SNP) with no copay and no coinsurance. Beneficiaries will need to obtain a referral and prior authorization to receive these services.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are technically covered under MCS Classicare Platino Total (HMO D-SNP) with no copay and no coinsurance, though in practice only some services are covered as cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are partially covered by MCS Classicare Platino Total (HMO D-SNP) with no copay and no coinsurance, though additional days beyond the Medicare-covered limit are not covered. Prior authorization and a referral are required for these services, which do not require a prior three-day inpatient hospital stay.
Other Services See details
MCS Classicare Platino Total (HMO D-SNP) provides other services with no copay and no coinsurance, including up to six acupuncture treatments per year and a $250 monthly over-the-counter reimbursement benefit. Meal benefits, nicotine replacement therapy, and naloxone are not covered.
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