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MCS Classicare Excede (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for MCS Classicare Excede (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on MCS Classicare Excede (HMO) in 2026, please refer to our full plan details page.
MCS Classicare Excede (HMO) is a HMO plan offered by MHH Healthcare, L.P. available for enrollment in 2026 to people living in Puerto Rico West & South. This plan received an overall rating of 5 out of 5 stars in 2026.
It's important to know that MCS Classicare Excede (HMO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about MCS Classicare Excede (HMO).
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 Excede (HMO), 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 $60.00. 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 no drug deductible. Your prescription medication coverage will start immediately.
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 Excede (HMO) Medicare plan features a $0 drug deductible, allowing your prescription coverage to begin immediately. Under this plan, there is no copay for Tier 1 preferred generics, Tier 2 generics, Tier 3 preferred brands, and Tier 4 non-preferred drugs filled at standard pharmacies for one, two, or three-month supplies. You will also pay no copay for a three-month supply of these same tiers when using standard mail order services. For Tier 5 specialty tier drugs, the plan charges a 33% coinsurance for a one-month supply at standard pharmacies and through standard mail order. This straightforward prescription drug coverage helps keep your out-of-pocket costs predictable and low for most tier levels under the MCS Classicare Excede (HMO) plan.
Additional Benefits
The MCS Classicare Excede (HMO) plan offers exceptional value with no copays, no deductibles, and no coinsurance for most major medical services. Members can access inpatient hospital stays, outpatient procedures, primary and specialist visits, and skilled nursing facility care with no out-of-pocket copays or coinsurance. Emergency care is also highly affordable, featuring a $40 copay that is waived upon hospital admission, while urgently needed services require no copay. In addition to core medical care, this plan provides robust coverage for dental, vision, and hearing services with no copays or coinsurance. Members also benefit from a monthly allowance for over-the-counter items and up to twelve one-way transportation trips per year at no cost. While durable medical equipment is fully covered with no copays, some specialized services like dialysis and select Part B drugs require a coinsurance of up to 20 percent.
Inpatient Hospital See details
MCS Classicare Excede (HMO) covers inpatient acute and psychiatric hospital stays with no copay and no coinsurance, though prior authorization is required. Unlimited additional days are covered for acute care, but upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
MCS Classicare Excede (HMO) covers outpatient hospital, ambulatory surgical center, and outpatient blood services with no copay, no coinsurance, and no deductible. Outpatient substance abuse services also feature no copay and no coinsurance, though only some services are covered as individual and group sessions are not covered.
Partial Hospitalization See details
Partial hospitalization is covered under the MCS Classicare Excede (HMO) plan, with members paying no copay and no coinsurance for these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered by MCS Classicare Excede (HMO), featuring transportation with no copay and no coinsurance for up to 12 yearly one-way trips to plan-approved locations, though trips to any other health-related locations are not covered. Additionally, ambulance services are not covered under this plan, as both ground and air ambulance services are excluded.
Emergency Services See details
MCS Classicare Excede (HMO) covers emergency services with a $40 copay—which is waived if admitted to the hospital within 24 hours—and no coinsurance, while urgently needed services have no copay or coinsurance. Worldwide emergency and urgent services are partially covered with a $75 copay and no coinsurance, but worldwide emergency transportation is not covered.
Primary Care See details
Primary care services under MCS Classicare Excede (HMO) feature no copay and no coinsurance for primary care, specialist, therapy, and telehealth visits. Chiropractic care is partially covered with up to 6 routine visits per year, while podiatry is not covered, and some mental health and psychiatric services are covered but individual and group sessions are excluded.
Preventive Services See details
MCS Classicare Excede (HMO) provides partial coverage for preventive services with no copay and no coinsurance for covered benefits like Medicare-covered preventive care, alternative therapies, and kidney disease education. However, some services are not covered under this benefit, including the annual physical exam, fitness benefits, and in-home safety assessments.
Hearing Services See details
Hearing services are partially covered by MCS Classicare Excede (HMO), which offers one routine exam and one fitting evaluation per year with no copay and no coinsurance. Prescription hearing aids are covered up to $500 annually with no copay and no coinsurance, but OTC hearing aids and inner ear, outer ear, and over the ear prescription models are not covered.
Vision Services See details
MCS Classicare Excede (HMO) covers vision services with no copay, no coinsurance, and no deductible, providing one routine eye exam per year and up to $500 annually for contacts and eyeglasses. This benefit is partially covered because other eye exam services and eyewear upgrades are not covered.
Dental Services See details
Dental services are partially covered by MCS Classicare Excede (HMO) with no copay and no coinsurance for most preventive, diagnostic, restorative, and surgical care. While a wide range of treatments is covered at no cost, maxillofacial prosthetics and orthodontics are not covered under this plan.
Home Infusion bundled Services See details
Home infusion bundled services are covered by MCS Classicare Excede (HMO) with no copay, requiring prior authorization and step therapy. Under this benefit, Part B insulin has a $35 copay and no coinsurance, while other Medicare Part B drugs, including chemotherapy and radiation, feature no copay and a coinsurance ranging from 0% to 20%.
Dialysis Services See details
MCS Classicare Excede (HMO) covers dialysis services with no copay and a 20% coinsurance.
Medical Equipment See details
MCS Classicare Excede (HMO) covers durable medical equipment with no copay and no coinsurance, while diabetic equipment is partially covered with no copay or coinsurance, excluding diabetic supplies and therapeutic shoes or inserts. Prosthetics and medical supplies are covered with no copay, carrying a 10% coinsurance for medical supplies and up to 20% coinsurance for prosthetic devices.
Diagnostic and Radiological Services See details
MCS Classicare Excede (HMO) diagnostic and radiological services are partially covered and require prior authorization, featuring no copay and no coinsurance for covered services. Covered benefits include diagnostic procedures, lab services, and both diagnostic and therapeutic radiological services, while outpatient X-ray services are not covered.
Home Health Services See details
Home Health Services are covered by MCS Classicare Excede (HMO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
MCS Classicare Excede (HMO) covers some Cardiac Rehabilitation Services with no copay and no coinsurance, subject to prior authorization, but cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered.
Skilled Nursing Facility (SNF) See details
MCS Classicare Excede (HMO) covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance, though prior authorization is required. This benefit allows for facility admission without a prior three-day inpatient hospital stay, but additional days beyond Medicare-covered limits are not covered.
Other Services See details
MCS Classicare Excede (HMO) provides partially covered other services, featuring acupuncture and over-the-counter (OTC) items with no copay and no coinsurance, while meal benefits are not covered. Acupuncture is limited to 6 treatments per year, and the monthly $39 OTC reimbursement excludes nicotine replacement therapy, naloxone, and some CMS OTC list drugs.
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