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Magno (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Magno (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Magno (HMO-POS) in 2025, please refer to our full plan details page.
Magno (HMO-POS) is a HMO-POS plan offered by Guidewell Mutual Holding Corporation available for enrollment in 2025 to people living in Puerto Rico. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that Magno (HMO-POS) 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 Magno (HMO-POS).
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 Magno (HMO-POS), 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 $3650.00 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 Magno (HMO-POS) plan has a $0 deductible for prescription drugs. In the initial coverage phase, you will pay a copay or coinsurance depending on the drug tier and pharmacy you use. For example, preferred generic drugs have no copay at a preferred pharmacy, while standard generic drugs have a $30 copay at a standard pharmacy. After your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for covered drugs.
Additional Benefits
The Magno (HMO-POS) plan offers a range of benefits with varying costs. Inpatient hospital stays have no copay for Medicare-covered services, and outpatient services have a copay of $25-$50. Emergency services have a $50 copay, which is waived if admitted to the hospital. The plan covers a variety of services with copays, including primary care, specialist visits, and hearing exams, while also covering vision and dental services. The plan provides coverage for ambulance services with no copay, and covers many other benefits, such as home health services, and home infusion services.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services. For Inpatient Hospital-Acute services, there is no copay for Medicare-covered stays, and additional days are covered. However, non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute, as well as additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric, are not covered.
Outpatient Services See details
Outpatient services are covered by the Magno (HMO-POS) plan, including outpatient hospital services with a copay of $25-$50, observation services, and ambulatory surgical center services with a $25 copay. Outpatient substance abuse services are not covered, but outpatient blood services are covered.
Partial Hospitalization See details
Partial Hospitalization is covered by the Magno (HMO-POS) plan, but requires prior authorization.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with no copay or coinsurance for all ambulance services. The plan does not cover ground and air ambulance services, but covers transportation services to any health-related location, with a limit of 14 one-way trips per year via taxi, rideshare services, or medical transport.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the Magno (HMO-POS) plan. For Emergency Services, there is a $50 copay and no coinsurance, and the copay is waived if admitted to the hospital within 24 hours. Worldwide Emergency Transportation is not covered.
Primary Care See details
The Magno (HMO-POS) plan covers primary care physician services, chiropractic services with a $5 copay, occupational therapy, physician specialist services with a $0-$5 copay, podiatry services, other health care professional services with a $0-$5 copay, physical therapy and speech-language pathology services, additional telehealth benefits with a $0-$5 copay, and opioid treatment program services. Individual and group sessions for mental health and psychiatric services are not covered.
Preventive Services See details
Preventive Services are covered by the Magno (HMO-POS) plan, but 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, therapeutic massage, 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, telemonitoring services, and home and bathroom safety devices and modifications are not covered. Alternative therapies, Nutritional/Dietary Benefit, and counseling services are covered.
Hearing Services See details
Hearing services with the Magno (HMO-POS) plan include coverage for routine hearing exams and fitting/evaluation for hearing aids with no copay, once per year. Prescription hearing aids are covered for up to $1,500 per year, but Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, and Prescription Hearing Aids - Over the Ear are not covered, nor are OTC hearing aids.
Vision Services See details
The Magno (HMO-POS) plan covers vision services, including routine eye exams and other eye exam services, each limited to one visit per year. Eyewear is covered with a combined maximum benefit of $400 per year, while contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are also covered.
Dental Services See details
The Magno (HMO-POS) plan covers a variety of dental services, including oral exams, dental x-rays, and other diagnostic services with a limit of one visit per service, and prophylaxis (cleaning), fluoride treatment, and other preventive dental services with a limit of one visit every six months. Orthodontic services are covered up to a maximum of $3500 per year, while maxillofacial prosthetics and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. Coinsurance applies, with a maximum of 20% for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs.
Dialysis Services See details
Dialysis Services are covered under the Magno (HMO-POS) plan. You will pay a 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits under the Magno (HMO-POS) plan include Durable Medical Equipment (DME) with 0% to 10% coinsurance, Prosthetics/Medical Supplies with coinsurance for Medicare-covered items, and Diabetic Equipment. Durable Medical Equipment for use outside the home, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with no copay for diagnostic services, and a coinsurance of at most 20% for diagnostic procedures/tests and lab services. Diagnostic Radiological Services have a copay of at most $20, and Therapeutic Radiological Services and Outpatient X-Ray Services are not covered.
Home Health Services See details
Home Health Services are covered by the Magno (HMO-POS) plan with no copay and no coinsurance, but authorization is required. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the Magno (HMO-POS) plan, but additional days beyond Medicare-covered and non-Medicare-covered stays are not covered. Prior authorization is required.
Other Services See details
The Magno (HMO-POS) plan covers acupuncture with a limit of 12 treatments per year, and over-the-counter (OTC) items with a maximum benefit coverage amount of $50.00 every three months, including Nicotine Replacement Therapy (NRT) and Naloxone. Meal Benefit, 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 are not covered.
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