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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 2026, 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 2026.
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 $80.00. 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 $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 Maximo (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 your plan begins to pay its share. Because this is a Dual Eligible Special Needs Plan, your actual costs may vary depending on your level of Medicaid eligibility and Extra Help. Specific copayments, coinsurance, and drug tier coverage details are currently unavailable for this plan. To understand your exact medication costs under the MCS Classicare Platino Maximo plan, it is recommended to review the plan's formulary or contact the provider directly to verify how your specific prescriptions are covered.
Additional Benefits
The MCS Classicare Platino Maximo (HMO D-SNP) plan offers robust healthcare coverage with no copay and no coinsurance for most major medical services. Beneficiaries can access inpatient and outpatient hospital care, primary and specialist doctor visits, emergency services, and home health care without any out-of-pocket copays or coinsurance. In addition to core medical care, this plan provides valuable supplemental benefits with no copay, including up to $500 annually for eyeglasses or contacts, up to $500 for prescription hearing aids, and up to $1,200 for select dental services. Members also benefit from a $145 monthly over-the-counter reimbursement and up to 18 one-way health-related transportation trips per year, though ambulance services and cardiac rehabilitation are not covered.
Inpatient Hospital See details
MCS Classicare Platino Maximo (HMO D-SNP) covers inpatient hospital services, including acute and psychiatric stays, with no copay and no coinsurance. This benefit is partially covered because additional days, non-Medicare-covered stays, and upgrades are not covered.
Outpatient Services See details
MCS Classicare Platino Maximo (HMO D-SNP) outpatient services are covered 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
Partial hospitalization services are covered under the MCS Classicare Platino Maximo (HMO D-SNP) plan with no copay and no coinsurance.
Ambulance and Transportation Services See details
MCS Classicare Platino Maximo (HMO D-SNP) does not cover ambulance services, but transportation services are partially covered with no copay and no coinsurance. This transportation benefit includes up to 18 one-way trips per year to plan-approved health-related locations, though trips to any health-related location are not covered.
Emergency Services See details
MCS Classicare Platino Maximo (HMO D-SNP) covers emergency and urgently needed services with no copay and no coinsurance. Worldwide emergency and urgent care are also covered with no copay and no coinsurance, but these worldwide services are only partially covered since worldwide emergency transportation is not covered.
Primary Care See details
Primary care and specialist services under MCS Classicare Platino Maximo (HMO D-SNP) are covered with no copay and no coinsurance, including telehealth, therapies, and opioid treatment. Chiropractic services are partially covered, excluding other chiropractic services, while some mental health and psychiatric services are covered, excluding individual and group sessions, and podiatry is not covered.
Preventive Services See details
Preventive Services under MCS Classicare Platino Maximo (HMO D-SNP) are partially covered with no copay and no coinsurance for covered services like Medicare-covered preventive care, kidney disease education, and limited sessions of alternative therapies, therapeutic massage, and nutritional counseling. However, several services are not covered under this benefit, including annual physical exams, fitness benefits, in-home safety assessments, and personal emergency response systems.
Hearing Services See details
MCS Classicare Platino Maximo (HMO D-SNP) partially covers hearing services with no copay and no coinsurance, including one routine exam and one fitting evaluation per year. Prescription hearing aids are covered up to a $500 annual maximum with no copay and no coinsurance, but OTC hearing aids and inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
MCS Classicare Platino Maximo (HMO D-SNP) offers partially covered vision services with no copay, no coinsurance, and no deductible. While other eye exams and eyewear upgrades are not covered, the plan includes one routine eye exam per year and up to $500 annually for contacts and eyeglasses.
Dental Services See details
MCS Classicare Platino Maximo (HMO D-SNP) covers Medicare dental and select comprehensive services with no copay and no coinsurance, up to a $1,200 annual maximum. However, preventive dental services—including oral exams, cleanings, and x-rays—as well as maxillofacial prosthetics and orthodontics, are not covered.
Home Infusion bundled Services See details
MCS Classicare Platino Maximo (HMO D-SNP) partially covers home infusion bundled services with no copay and no coinsurance, although prior authorization and step therapy are required. While insulin is covered under this benefit with no copay or coinsurance, Medicare Part B chemotherapy, radiation, and other Part B drugs are not covered.
Dialysis Services See details
Dialysis Services are covered by the MCS Classicare Platino Maximo (HMO D-SNP) plan with no copay and no coinsurance.
Medical Equipment See details
MCS Classicare Platino Maximo (HMO D-SNP) covers Durable Medical Equipment with no copay and no coinsurance, subject to prior authorization. While other medical equipment benefits are technically covered with no copay or coinsurance, some services are covered but prosthetic devices, medical supplies, diabetic supplies, and therapeutic shoes or inserts are not covered.
Diagnostic and Radiological Services See details
MCS Classicare Platino Maximo (HMO D-SNP) covers diagnostic and radiological services with no copay and no coinsurance, requiring both prior authorization and a referral. While some services are covered, diagnostic procedures and 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 by MCS Classicare Platino Maximo (HMO D-SNP) with no copay and no coinsurance. Prior authorization and a referral are required to access these services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the MCS Classicare Platino Maximo (HMO D-SNP) plan, as cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are all excluded from coverage.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by MCS Classicare Platino Maximo (HMO D-SNP) with no copay and no coinsurance, though prior authorization and a referral are required. The plan allows for admission without a prior three-day inpatient hospital stay, but additional days beyond those standardly covered by Medicare are not covered.
Other Services See details
MCS Classicare Platino Maximo (HMO D-SNP) provides partial coverage for other services, offering acupuncture for up to 6 treatments per year and a $145 monthly over-the-counter (OTC) reimbursement with no copay and no coinsurance. Meal benefits, nicotine replacement therapy, and naloxone are not covered under this benefit.
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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
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