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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) prescription drug coverage features an annual drug deductible of $615. You must meet this deductible amount for covered medications before the plan starts paying its share of your prescription drug costs. Specific drug tier details, including individual copayments and coinsurance rates, are not available for this plan. To determine your exact out-of-pocket costs for your specific medications, we recommend contacting the plan provider directly.
Additional Benefits
The MCS Classicare Platino Maximo (HMO D-SNP) offers comprehensive healthcare coverage featuring no copays and no coinsurance for almost all covered services. This includes essential medical care such as inpatient and outpatient hospital stays, emergency services, primary and specialist visits, and skilled nursing facility care. Members can also access home health care, dialysis, and preventive services with no out-of-pocket costs. In addition to core medical care, this plan provides valuable supplemental benefits with no copay, including up to $1,200 annually for comprehensive dental care, $500 for eyewear, and $500 for prescription hearing aids. Members also receive a $105 monthly reimbursement limit for over-the-counter items and up to 18 one-way trips per year to plan-approved health locations. While these benefits offer robust coverage, certain services may require prior authorization or referrals.
Inpatient Hospital See details
MCS Classicare Platino Maximo (HMO D-SNP) partially covers inpatient hospital services, offering covered acute and psychiatric hospital stays with no copay and no coinsurance. Under this plan, additional days, upgrades, and non-Medicare-covered stays are not covered, and prior authorization or referrals are required.
Outpatient Services See details
MCS Classicare Platino Maximo (HMO D-SNP) covers outpatient hospital, ambulatory surgical center, and blood services with no copay and no coinsurance. While some outpatient substance abuse services are covered with no copay or coinsurance, individual and group sessions are not covered.
Partial Hospitalization See details
Partial hospitalization is covered by MCS Classicare Platino Maximo (HMO D-SNP) with no copay and no coinsurance.
Ambulance and Transportation Services See details
MCS Classicare Platino Maximo (HMO D-SNP) provides transportation services with no copay and no coinsurance for up to 18 one-way trips per year to plan-approved health-related locations. Ambulance services and transportation to other health-related locations are not covered under this plan.
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 or coinsurance, but worldwide emergency transportation is not covered.
Primary Care See details
Primary care, specialist visits, therapy, and telehealth are covered by MCS Classicare Platino Maximo (HMO D-SNP) with no copay and no coinsurance, though podiatry is not covered. Chiropractic services are partially covered with no copay and no coinsurance for up to six routine visits per year, while other chiropractic services are excluded. For mental health and psychiatric care, some services are covered with no copay and no coinsurance, but individual and group sessions are not covered.
Preventive Services See details
MCS Classicare Platino Maximo (HMO D-SNP) covers preventive services with no copay and no coinsurance, including Medicare-covered zero-dollar preventive services, kidney disease education, glaucoma screenings, and limited alternative therapies, therapeutic massages, and nutritional sessions. This benefit is partially covered, as services such as the annual physical exam, fitness benefits, weight management programs, and in-home safety assessments are not covered.
Hearing Services See details
MCS Classicare Platino Maximo (HMO D-SNP) offers partially covered hearing services with no copay and no coinsurance for routine exams, fitting evaluations, and prescription hearing aids up to a $500 annual limit. OTC hearing aids, as well as 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) partially covers vision services with no copay, no coinsurance, and no deductible, providing one routine eye exam per year and up to $500 annually for eyewear. Other eye exam services and eyewear upgrades are not covered.
Dental Services See details
Dental services are partially covered by MCS Classicare Platino Maximo (HMO D-SNP), offering Medicare-covered dental care and select comprehensive services with no copay and no coinsurance, up to a $1,200 annual limit. Preventive and diagnostic dental services, maxillofacial prosthetics, and orthodontics are not covered, and covered comprehensive services require prior authorization.
Home Infusion bundled Services See details
Home infusion bundled services are partially covered by MCS Classicare Platino Maximo (HMO D-SNP) with no copay and no coinsurance, though prior authorization and step therapy are required. Under this benefit, Medicare Part B insulin is covered with no copay and no coinsurance, but Medicare Part B chemotherapy or radiation drugs and other Part B drugs are not covered.
Dialysis Services See details
Dialysis services are covered under 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 and preferred vendor requirements. While some other medical equipment services are covered, prosthetic devices, medical supplies, diabetic supplies, and diabetic therapeutic shoes or inserts are not covered.
Diagnostic and Radiological Services See details
MCS Classicare Platino Maximo (HMO D-SNP) covers some diagnostic and radiological services with no copay and no coinsurance, though prior authorization and referrals are required. However, 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
MCS Classicare Platino Maximo (HMO D-SNP) covers home health services with no copay and no coinsurance. Prior authorization and a referral are required to access this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under MCS Classicare Platino Maximo (HMO D-SNP) with no copay and no coinsurance, subject to prior authorization. While some services are covered, specific sub-services including cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered.
Skilled Nursing Facility (SNF) See details
MCS Classicare Platino Maximo (HMO D-SNP) covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance, requiring prior authorization and a referral. The plan allows SNF admission without a prior three-day inpatient hospital stay, although additional days beyond Medicare-covered limits are not covered.
Other Services See details
MCS Classicare Platino Maximo (HMO D-SNP) partially covers other services, offering acupuncture for up to 6 treatments yearly and over-the-counter items with a $105 monthly reimbursement limit, both with no copay and no coinsurance. Meal benefits, nicotine replacement therapy, naloxone, and highly integrated services 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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