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MCS Classicare Platino Maximo (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for MCS Classicare Platino Maximo (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 Maximo (HMO D-SNP) in 2025, please refer to our full plan details page.
MCS Classicare Platino Maximo (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 Maximo (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 Maximo (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 Maximo (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 Maximo (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 $100.00. 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 $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 Maximo (HMO D-SNP) plan has a $590 deductible for prescription drugs. If you qualify for the low-income subsidy, your Part D costs will be $0. Once you meet your deductible, you will enter the initial coverage phase. During this phase, you will pay the costs for drugs in each tier until your total drug costs reach $2000, at which point you will enter the next coverage phase.
Additional Benefits
The MCS Classicare Platino Maximo (HMO D-SNP) plan offers a wide range of benefits with no copay, including ambulance services, emergency services, and home health services. The plan also includes coverage for primary care, preventive services, vision, dental, home infusion, dialysis, medical equipment, and diagnostic and radiological services. This plan provides additional coverage for hearing aids up to $750 per year, and covers other services such as acupuncture (6 treatments), and over-the-counter items up to $200 monthly. However, some services are not covered, including additional days for inpatient hospital and skilled nursing facility stays, and cardiac rehabilitation services.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, but additional days, non-Medicare covered stays, and upgrades for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric are not covered. Prior authorization and a doctor referral are required for Inpatient Hospital-Acute, and prior authorization is required for Inpatient Hospital Psychiatric.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, observation services, ambulatory surgical center services, and outpatient blood services, are covered by MCS Classicare Platino Maximo (HMO D-SNP). Outpatient Substance Abuse Services are partially covered, with individual and group sessions not covered.
Partial Hospitalization See details
Partial Hospitalization benefits are covered by the MCS Classicare Platino Maximo (HMO D-SNP) plan. The copay and coinsurance for this benefit are not mentioned in the provided information.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the MCS Classicare Platino Maximo (HMO D-SNP) plan. Ambulance Services have no copay or coinsurance, while Ground and Air Ambulance Services are not covered; Transportation Services to plan-approved health-related locations are covered for 18 one-way trips per year via taxi, or other approved transportation, 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 with no copay and no coinsurance. Worldwide Emergency Transportation is not covered.
Primary Care See details
The Primary Care benefit covers Primary Care Physician Services, Chiropractic Services (with a limit of 6 visits per year), Occupational Therapy Services (with no copay or coinsurance, but authorization is required), Physician Specialist Services (with a doctor referral), Mental Health Specialty Services (but not for individual or group sessions), Other Health Care Professional (with a doctor referral), Psychiatric Services (but not for individual or group sessions), Physical Therapy and Speech-Language Pathology Services (with no copay or coinsurance, but authorization is required), Additional Telehealth Benefits, and Opioid Treatment Program Services. Podiatry Services are not covered.
Preventive Services See details
The MCS Classicare Platino Maximo (HMO D-SNP) plan covers preventive services, including 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, and EKG following Welcome Visit. 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, 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, telemonitoring services, home and bathroom safety devices and modifications, and counseling services are not covered.
Hearing Services See details
Hearing services include routine hearing exams and fitting/evaluation for hearing aids, each covered once per year; prescription hearing aids are covered up to $750 per year, but inner ear, outer ear, and over the ear hearing aids are not covered. OTC hearing aids are not covered.
Vision Services See details
Vision services include routine eye exams with no copay, and eyewear with a combined maximum of $750 per year. Contact lenses, eyeglasses (lenses and frames), and eyeglass lenses and frames are also covered. 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. This plan offers a maximum benefit of $1200 per year for Orthodontic Services. Maxillofacial Prosthetics and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the MCS Classicare Platino Maximo (HMO D-SNP) plan, and require prior authorization. Medicare Part B Insulin Drugs are covered. Medicare Part B Chemotherapy/Radiation Drugs are not covered.
Dialysis Services See details
Dialysis Services are covered with this plan. There is no copay or coinsurance for this benefit.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME) and Prosthetics/Medical Supplies, with no copay or coinsurance, but some services are not covered, including DME for use outside the home, prosthetic devices, medical supplies, diabetic supplies, and diabetic therapeutic shoes/inserts. Diabetic Equipment also requires prior authorization.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the MCS Classicare Platino Maximo (HMO D-SNP) plan, but the plan does not cover Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, or Outpatient X-Ray Services, and there is no copay for the services that are covered. Prior authorization and a doctor referral are required.
Home Health Services See details
Home Health Services are covered by MCS Classicare Platino Maximo (HMO D-SNP) with no copay and no coinsurance, but Additional Hours of Care and Personal Care Services are not covered. Referrals and authorization are required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the MCS Classicare Platino Maximo (HMO D-SNP) plan. Specifically, Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but additional days beyond Medicare coverage and non-Medicare-covered stays are not covered. Prior authorization and a doctor's referral are required for SNF services.
Other Services See details
Other Services includes acupuncture, which is covered with a limit of 6 treatments per year, and over-the-counter (OTC) items, which are covered up to a maximum of $200 per month and carry forward if unused. The plan does not cover a meal benefit, or services such as Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services.
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