A non-government entity
MCS Classicare Estrella (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for MCS Classicare Estrella (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on MCS Classicare Estrella (HMO) in 2026, please refer to our full plan details page.
MCS Classicare Estrella (HMO) is a HMO plan offered by MHH Healthcare, L.P. available for enrollment in 2026 to people living in Select Puerto Rico Counties. This plan received an overall rating of 5 out of 5 stars in 2026.
It's important to know that MCS Classicare Estrella (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 Estrella (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 Estrella (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 $70.00. 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 Estrella (HMO) prescription drug plan features a $0 drug deductible, allowing your coverage to begin immediately. You will pay no copay for Tier 1 (Preferred Generic) and Tier 2 (Generic) medications when filled at a standard pharmacy or through standard mail order. This ensures that essential everyday medications are highly affordable and easy to obtain. For higher-tier medications, the plan provides structured copays and coinsurance options at standard pharmacies. Tier 3 (Preferred Brand) drugs require a $4 copay for a one-month supply, while Tier 4 (Non-Preferred) drugs have a $14 copay. Specialty medications in Tier 5 require a 33% coinsurance for a one-month supply through standard pharmacies or mail order.
Additional Benefits
The MCS Classicare Estrella (HMO) plan offers robust coverage with no copay and no coinsurance for most major medical services, including inpatient hospital stays, primary and specialist visits, and outpatient care. Members also enjoy no copay and no coinsurance for skilled nursing, home health services, and up to 26 one-way trips to plan-approved locations. Emergency room visits carry a $40 copay, which is waived upon admission, while urgent care services require no copay. Routine dental, vision, and hearing benefits are covered with no copay or coinsurance, including up to a $600 annual allowance for eyewear and prescription hearing aids. For specialized treatments, members will pay a 20% coinsurance for dialysis and up to a 20% coinsurance for prosthetic devices and certain Part B drugs. While many essential services have no out-of-pocket costs, some benefits like cardiac rehabilitation and ambulance services are not covered.
Inpatient Hospital See details
MCS Classicare Estrella (HMO) covers inpatient hospital services with no copay and no coinsurance for Medicare-covered acute and psychiatric stays, though prior authorization is required. This benefit is partially covered because upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
MCS Classicare Estrella (HMO) covers outpatient services, including outpatient hospital, ambulatory surgical center, and blood services, with no copay and no coinsurance. Some outpatient substance abuse services are covered, but individual and group sessions are not covered.
Partial Hospitalization See details
Partial hospitalization is covered by MCS Classicare Estrella (HMO) with no copay and no coinsurance. This benefit ensures eligible members receive necessary care with zero out-of-pocket costs.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered by MCS Classicare Estrella (HMO), offering transportation to plan-approved locations with no copay and no coinsurance for up to 26 one-way trips per year. However, transportation to any health-related location is not covered, and ambulance services are not covered because both ground and air ambulance services are excluded.
Emergency Services See details
MCS Classicare Estrella (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 are covered with no copay and no coinsurance. Worldwide emergency and urgent care are partially covered with a $75 copay and no coinsurance, although worldwide emergency transportation is not covered.
Primary Care See details
MCS Classicare Estrella (HMO) covers primary care, specialist, and therapy services with no copay and no coinsurance. Chiropractic services are partially covered with no copay or coinsurance for up to 6 routine visits per year (other chiropractic services are not covered), podiatry is not covered, and while some mental health and psychiatric services are covered with no copay or coinsurance, individual and group sessions are not.
Preventive Services See details
MCS Classicare Estrella (HMO) offers partial coverage for preventive services with no copay and no coinsurance for covered services like diabetes self-management, alternative therapies, and therapeutic massage. However, several sub-services are not covered under this plan, including annual physical exams, fitness benefits, weight management programs, and personal emergency response systems.
Hearing Services See details
Hearing services are covered by MCS Classicare Estrella (HMO) with no copay and no coinsurance for routine exams and fitting evaluations. Prescription hearing aids are partially covered with no copay and no coinsurance up to a $600 annual maximum, though OTC hearing aids and inner ear, outer ear, or over the ear prescription aids are not covered.
Vision Services See details
Vision services are partially covered by MCS Classicare Estrella (HMO) with no copay, no coinsurance, and no deductible for covered care. Covered benefits include one routine eye exam per year and up to $600 annually for eyewear, while upgrades and other eye exam services are not covered.
Dental Services See details
Dental services are partially covered by MCS Classicare Estrella (HMO) with no copay and no coinsurance for covered preventive and comprehensive care. While most diagnostic, preventive, and restorative treatments are included, maxillofacial prosthetics and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by MCS Classicare Estrella (HMO) with no copay, though prior authorization is required. Under this benefit, Medicare Part B insulin drugs require a $35 copay and no coinsurance, while Medicare Part B chemotherapy and other Part B drugs have no copay and a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered under the MCS Classicare Estrella (HMO) plan with no copay and a 20% coinsurance.
Medical Equipment See details
MCS Classicare Estrella (HMO) covers durable medical equipment and diabetic equipment with no copay and no coinsurance, though diabetic supplies and therapeutic shoes or inserts are not covered. Prosthetics and medical supplies are covered with no copay, but require a 10% coinsurance for medical supplies and 0% to 20% coinsurance for prosthetic devices.
Diagnostic and Radiological Services See details
MCS Classicare Estrella (HMO) partially covers diagnostic and radiological services with no copay and no coinsurance for covered diagnostic procedures, lab services, and therapeutic radiological services, though prior authorization is required. Outpatient X-ray services are not covered under this plan.
Home Health Services See details
MCS Classicare Estrella (HMO) covers Home Health Services with no copay and no coinsurance, though prior authorization is required for these services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the MCS Classicare Estrella (HMO) plan, as cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are all excluded from coverage.
Skilled Nursing Facility (SNF) See details
MCS Classicare Estrella (HMO) covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance, though prior authorization is required. The plan allows admission without a prior three-day inpatient hospital stay, but additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by MCS Classicare Estrella (HMO) with no copay and no coinsurance, which includes up to 8 acupuncture treatments yearly and a $25 monthly reimbursement for over-the-counter items. Meal benefits, nicotine replacement therapy, and naloxone are not covered under this plan.
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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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