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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. After you meet your deductible, you will pay the cost of the drugs in each tier until your total drug costs reach $2000, at which point you enter the next phase of coverage. You will pay nothing for Medicare Part D covered drugs after your yearly out-of-pocket drug costs reach $2000.
Additional Benefits
The MCS Classicare Platino Maximo (HMO D-SNP) plan offers a wide range of benefits with a focus on no-cost services. Many services, including Emergency Services, Ambulance and Transportation Services, Primary Care, Preventive Services, Home Health Services, Dialysis Services, Diagnostic and Radiological Services, and Medical Equipment, come with no copay. The plan also provides coverage for hearing, vision, and dental services, including a yearly maximum for hearing aids and eyewear, and also offers an OTC allowance. The plan covers inpatient and outpatient services, as well as partial hospitalization. Other covered services include acupuncture, and Home Infusion bundled Services. However, it's important to note that some services, such as Cardiac Rehabilitation and certain transportation and vision upgrades, are not covered.
Inpatient Hospital See details
Inpatient Hospital coverage, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, is covered and requires prior authorization. Additional days, non-Medicare-covered stays, and upgrades for both Inpatient Hospital-Acute and Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services are covered, including all outpatient hospital services, observation services, ambulatory surgical center (ASC) services, and outpatient blood services. Outpatient substance abuse services are partially covered, excluding individual and group sessions.
Partial Hospitalization See details
Partial Hospitalization benefits are covered by the MCS Classicare Platino Maximo (HMO D-SNP) plan. There is no information provided about cost-sharing for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the MCS Classicare Platino Maximo (HMO D-SNP) plan, but ground and air ambulance services are not covered. Transportation Services to a plan-approved health-related location are covered for 18 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 by the MCS Classicare Platino Maximo (HMO D-SNP) plan with no copay and no coinsurance. 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 a limit of 6 visits per year. Mental Health Specialty Services and Psychiatric Services do not cover individual or group sessions. Occupational Therapy Services and Physical Therapy and Speech-Language Pathology Services have no copay or coinsurance, but require prior authorization. Podiatry Services are not covered.
Preventive Services See details
The MCS Classicare Platino Maximo (HMO D-SNP) plan covers Medicare-covered preventive services with no copay. Additional preventive services are partially covered, with services such as annual physical exams, in-home safety assessments, and others not covered. Other covered services include health education, alternative therapies (6 visits per year), therapeutic massage (6 sessions per year), nutritional/dietary benefits (6 visits per year), remote access technologies, kidney disease education services, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a Welcome Visit.
Hearing Services See details
Hearing Services includes routine hearing exams and fitting/evaluation for hearing aids, both covered annually, and prescription hearing aids with a maximum benefit of $750 every year, but the plan does not cover OTC hearing aids, and inner, outer, or over-the-ear prescription hearing aids.
Vision Services See details
Vision services include routine eye exams, eyewear, and contact lenses. Eyewear has a combined maximum benefit of $750 per year, and the plan covers contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames. Upgrades are not covered.
Dental Services See details
The MCS Classicare Platino Maximo (HMO D-SNP) plan covers dental services including Medicare Dental Services, Orthodontic Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable and fixed), Implant Services, and Oral and Maxillofacial Surgery. Maxillofacial Prosthetics and Orthodontics are not covered. The plan has a maximum benefit of $1200 per year for Orthodontic Services.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by MCS Classicare Platino Maximo (HMO D-SNP). Medicare Part B Insulin Drugs are covered, and 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 benefits are covered, but some services are not covered, including Durable Medical Equipment for use outside the home, Prosthetic Devices, Medical Supplies, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts. Both Durable Medical Equipment and Prosthetics/Medical Supplies have no copay and no coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by MCS Classicare Platino Maximo (HMO D-SNP), 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 with no copay and no coinsurance, but prior 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 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
The MCS Classicare Platino Maximo (HMO D-SNP) plan covers acupuncture with a limit of 6 treatments per year, and it also covers Over-the-Counter (OTC) items up to $160.00 every month. However, 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 are not covered.
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