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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 (LIS), you may have a reduced premium. After meeting your deductible, you will pay the costs for drugs in each tier until your total drug costs reach $2000. Once you reach this amount, you enter the next coverage phase, and you will pay nothing for Medicare Part D covered drugs.
Additional Benefits
The MCS Classicare Platino Maximo (HMO D-SNP) plan offers a variety of benefits, including coverage for outpatient services, emergency services, primary care, preventive services, hearing, vision, and dental services. Many services, such as ambulance transportation, emergency services, and home health services, have no copay, while others, like hearing aids and eyewear, have annual maximum benefits. This plan also covers home infusion, dialysis, medical equipment, and diagnostic and radiological services. The plan includes benefits like acupuncture, and over-the-counter items. However, it's important to note that certain services, such as cardiac rehabilitation, and additional days in the hospital or skilled nursing facilities, are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, but additional days for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, non-Medicare-covered stays for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, and upgrades for Inpatient Hospital-Acute are not covered. Prior authorization and a doctor referral are required for Inpatient Hospital-Acute.
Outpatient Services See details
Outpatient Services are covered under the MCS Classicare Platino Maximo (HMO D-SNP) plan, including outpatient hospital services, observation services, ambulatory surgical center services, and outpatient blood services. Outpatient substance abuse services are partially covered, excluding individual and group sessions.
Partial Hospitalization See details
Partial Hospitalization is covered by the plan.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by MCS Classicare Platino Maximo (HMO D-SNP), but ground and air ambulance services are not covered. Transportation services to a plan-approved health-related location are covered for up to 18 one-way trips per year with no copay or coinsurance, and the mode of transportation includes taxi, and other services.
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
Primary Care benefits include coverage for 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. Chiropractic Services require prior authorization and a doctor referral, with a limit of 6 visits per year. Individual and group sessions for Mental Health Specialty Services and Psychiatric Services are not covered, and Podiatry Services are not covered. Occupational Therapy Services and Physical Therapy and Speech-Language Pathology Services have no copay or coinsurance, but require authorization.
Preventive Services See details
The MCS Classicare Platino Maximo (HMO D-SNP) plan covers Medicare-covered preventive services, including health education, and additional preventive services, such as alternative therapies (6 visits) and therapeutic massage (6 sessions). The plan does not cover 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 benefits, enhanced disease management, telemonitoring services, home and bathroom safety devices and modifications, or counseling services.
Hearing Services See details
Hearing services for MCS Classicare Platino Maximo (HMO D-SNP) include routine hearing exams and fitting/evaluation for hearing aids, each covered once per year, and prescription hearing aids with a maximum benefit of $750 every year, although hearing aids for the inner ear, outer ear, and over the ear are not covered, as well as OTC hearing aids.
Vision Services See details
The MCS Classicare Platino Maximo (HMO D-SNP) plan covers vision services, including routine eye exams with one visit per year, and eyewear with a combined maximum benefit of $750 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
Dental Services are covered, with coverage for 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. This plan has a maximum benefit of $1,200 per year for Orthodontic Services.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the MCS Classicare Platino Maximo (HMO D-SNP) plan, with prior authorization required. Medicare Part B Insulin Drugs are covered, while Medicare Part B Chemotherapy/Radiation Drugs are not covered.
Dialysis Services See details
Dialysis Services are covered under the plan. There is no copay or coinsurance for this benefit.
Medical Equipment See details
Medical Equipment benefits are covered, including Durable Medical Equipment (DME) and Prosthetics/Medical Supplies - Non-Medicare benefit, with no copay or coinsurance. However, 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 covered under the MCS Classicare Platino Maximo (HMO D-SNP) plan, with no copay. However, Diagnostic Procedures/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 or coinsurance. However, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under 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-covered SNF stays and non-Medicare-covered SNF 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, up to 6 treatments per year, and also covers over-the-counter (OTC) items with a maximum benefit of $125.00 every month. This plan does not cover 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.
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