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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 2025, 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 2025.
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 $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 Total (HMO D-SNP) plan has a $590 deductible for prescription drugs. After the deductible is met, you'll pay the costs for your drugs based on the drug tier. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for your Part D covered drugs. If you qualify for the low-income subsidy, you will pay $0 for Part D drugs.
Additional Benefits
The MCS Classicare Platino Total (HMO D-SNP) plan offers a wide range of benefits, including coverage for inpatient and outpatient services, with no copay for emergency services and transportation to health-related locations. The plan also includes coverage for primary care, preventive services, hearing, vision, and dental care, with specific limits and requirements for some services. Additional benefits include home health services with no copay, coverage for medical equipment, and access to other services like acupuncture and over-the-counter items. However, some services like diagnostic and radiological services, cardiac rehabilitation, and certain types of hearing aids are not covered by this plan.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. However, additional days, non-Medicare covered stays, and upgrades for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services are covered, including outpatient hospital services, observation services, ambulatory surgical center services, and outpatient blood services. Outpatient substance abuse services are partially covered; individual and group sessions for outpatient substance abuse are not covered.
Partial Hospitalization See details
Partial Hospitalization benefits are covered by the MCS Classicare Platino Total (HMO D-SNP) plan. There is no copay or coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, but ground and air ambulance services are not covered. Transportation Services to a plan-approved health-related location are covered for up to 30 one-way trips per year, with no copay or coinsurance.
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; however, Worldwide Emergency Transportation is not covered.
Primary Care See details
Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services are covered. Chiropractic Services require prior authorization and a doctor referral, with coverage limited to 6 visits per year. Individual and Group Sessions for Mental Health Specialty Services and Psychiatric Services are not covered, and Podiatry Services are also not covered.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services with no copay, along with additional preventive services such as Health Education, Alternative Therapies (6 visits), Therapeutic Massage (6 sessions), Nutritional/Dietary Benefit (6 visits), Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, EKG following Welcome Visit, and Remote Access Technologies, while Annual Physical Exams, In-Home Safety Assessments, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Adult Day Health Services, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Fitness Benefit, Enhanced Disease Management, Home and Bathroom Safety Devices and Modifications, Counseling Services, and Telemonitoring Services are not covered.
Hearing Services See details
Hearing services include routine hearing exams, fitting/evaluation for hearing aids, and prescription hearing aids, with prior authorization and a doctor referral required. Routine hearing exams and fitting/evaluation for hearing aids are covered once per year, while prescription hearing aids have a maximum benefit of $600 per year for both ears combined, and are covered for 2 visits per year. Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, and Prescription Hearing Aids - Over the Ear are not covered. OTC hearing aids are not covered.
Vision Services See details
Vision services are covered, including eye exams and eyewear. Routine eye exams are covered once per year. Eyewear has a combined maximum benefit of $600 every year. Contact lenses, eyeglasses (lenses and frames), and eyeglass lenses and frames are also covered, but upgrades are not covered.
Dental Services See details
The MCS Classicare Platino Total (HMO D-SNP) plan covers dental services, including Medicare Dental Services, Orthodontic Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable), Implant Services, Prosthodontics (fixed), and Oral and Maxillofacial Surgery. Maxillofacial Prosthetics and Orthodontics are not covered. There is a $1200 annual maximum plan benefit coverage for orthodontic services.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the MCS Classicare Platino Total (HMO D-SNP) plan, and prior authorization is required. Insulin, including Medicare Part B Insulin Drugs, is covered.
Dialysis Services See details
Dialysis Services are covered by the MCS Classicare Platino Total (HMO D-SNP) plan. The snippet does not include any cost information for this benefit.
Medical Equipment See details
Medical Equipment benefits are covered by the MCS Classicare Platino Total (HMO D-SNP) plan. Durable Medical Equipment (DME) and Prosthetics/Medical Supplies - Non-Medicare benefits are covered with no copay and no coinsurance, while Durable Medical Equipment for use outside the home, Prosthetic Devices, Medical Supplies, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are not covered by the MCS Classicare Platino Total (HMO D-SNP) plan, as no services are covered.
Home Health Services See details
Home Health Services are covered by MCS Classicare Platino Total (HMO D-SNP) with no copay and no coinsurance, though authorization and a referral are required. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are generally covered, but not in practice, as Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. Prior authorization is required for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but additional days beyond Medicare-covered SNF stays and non-Medicare-covered SNF stays are not covered. A doctor referral and prior authorization are required.
Other Services See details
Other Services includes acupuncture and over-the-counter (OTC) items. Acupuncture is covered with a limit of 6 treatments per year, and OTC items are covered up to $250.00 every month. 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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