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Platino Blindao (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Platino Blindao (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Platino Blindao (HMO D-SNP) in 2026, please refer to our full plan details page.
Platino Blindao (HMO D-SNP) is a HMO D-SNP 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 4.5 out of 5 stars in 2026.
It's important to know that Platino Blindao (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:
Platino Blindao (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 Platino Blindao (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 Platino Blindao (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 $40.00. 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 $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 Platino Blindao (HMO D-SNP) prescription drug coverage features an annual drug deductible of $615. Beneficiaries must pay this deductible amount out-of-pocket for covered medications before the plan begins to pay its share. Specific drug tier details, including individual copayments and coinsurance rates, are currently unavailable for this plan. To understand your exact out-of-pocket medication costs, it is best to review the Platino Blindao (HMO D-SNP) comprehensive formulary list.
Additional Benefits
The Platino Blindao (HMO D-SNP) plan offers exceptionally robust coverage with no copay, no coinsurance, and no deductibles for the vast majority of its medical services. Members can access inpatient and outpatient hospital stays, primary and specialist doctor visits, emergency care, and home health services without any out-of-pocket costs. Even specialized treatments like dialysis, diagnostic services, and skilled nursing facility care are covered with no copay or coinsurance. In addition to standard medical care, this plan provides valuable extra benefits including vision and hearing exams with annual allowances for eyewear and hearing aids at no copay. Dental care is also covered up to a 1,500 dollar annual limit, and members receive up to 14 free one-way transportation trips per year to health-related locations. While most durable medical equipment has no copay, some items may require a minimal coinsurance of up to 5 percent.
Inpatient Hospital See details
Platino Blindao (HMO D-SNP) covers inpatient acute and psychiatric hospital stays with no copay and no coinsurance, although prior authorization is required for acute care. While unlimited additional days are covered for acute stays, this benefit does not cover upgrades, additional psychiatric days, or non-Medicare-covered stays.
Outpatient Services See details
Platino Blindao (HMO D-SNP) covers outpatient hospital, ambulatory surgical center, and outpatient blood services with no copay and no coinsurance. While some outpatient substance abuse services are covered with no copay and no coinsurance, individual and group sessions are not covered.
Partial Hospitalization See details
Partial hospitalization is covered by Platino Blindao (HMO D-SNP) with no copay and no coinsurance, although prior authorization is required.
Ambulance and Transportation Services See details
Platino Blindao (HMO D-SNP) covers some ambulance services with no copay or coinsurance, though prior authorization is required and ground and air ambulance services are not covered. Transportation services to any health-related location are also covered with no copay or coinsurance, offering up to 14 one-way trips per year via taxi, rideshare, or medical transport.
Emergency Services See details
Emergency services are covered by Platino Blindao (HMO D-SNP) with no copay and no coinsurance for both emergency and urgently needed care. Worldwide emergency and urgent services are partially covered with no copay or coinsurance up to a $75 maximum limit, excluding worldwide emergency transportation.
Primary Care See details
Platino Blindao (HMO D-SNP) covers primary care, specialist visits, therapy, and telehealth services with no copay and no coinsurance. While routine chiropractic care (up to 5 visits per year) and routine foot care (up to 4 visits per year) are covered, other chiropractic services and individual or group sessions for mental health and psychiatric services are not covered.
Preventive Services See details
Platino Blindao (HMO D-SNP) partially covers preventive services with no copay and no coinsurance, offering coverage for Medicare-covered preventive care, kidney disease education, alternative therapies, and counseling. However, several sub-services are not covered, including annual physical exams, fitness benefits, weight management programs, and in-home support services.
Hearing Services See details
Platino Blindao (HMO D-SNP) covers hearing exams with no copay and no coinsurance, which includes one routine exam and one fitting evaluation per year. Prescription hearing aids are partially covered with no copay and no coinsurance up to a $300 annual limit, but inner ear, outer ear, over the ear, and OTC hearing aids are not covered.
Vision Services See details
Vision services are covered under the Platino Blindao (HMO D-SNP) plan with no copay, no coinsurance, and no deductible for eye exams and eyewear. This benefit includes one routine eye exam and one eyewear exam per year, alongside a $275 annual allowance for contact lenses, eyeglasses, frames, and upgrades.
Dental Services See details
Platino Blindao (HMO D-SNP) dental services are partially covered with no copay and no coinsurance for Medicare dental, restorative, endodontics, periodontics, prosthodontics, and oral surgery up to a $1,500 annual limit. However, preventive and diagnostic services—including oral exams, cleanings, and x-rays—along with implants, maxillofacial prosthetics, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are partially covered by Platino Blindao (HMO D-SNP) with no copay and no coinsurance, although prior authorization and step therapy are required. While insulin is covered under this benefit with no copay or coinsurance, Medicare Part B chemotherapy, radiation, and other Part B drugs are not covered.
Dialysis Services See details
Dialysis Services are covered by Platino Blindao (HMO D-SNP) with no copay and no coinsurance.
Medical Equipment See details
Medical equipment is partially covered by Platino Blindao (HMO D-SNP) with no copay and 0% to 5% coinsurance for durable medical equipment, prosthetics, and medical supplies, though prior authorization is required. While diabetic equipment features no copay and no coinsurance, diabetic supplies and diabetic therapeutic shoes or inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Platino Blindao (HMO D-SNP) with no copay and no coinsurance, though prior authorization is required. While some services are covered, diagnostic procedures or tests, lab services, diagnostic radiological services, therapeutic radiological services, and outpatient x-rays are not covered.
Home Health Services See details
Platino Blindao (HMO D-SNP) covers home health services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Platino Blindao (HMO D-SNP) covers some Cardiac Rehabilitation Services with no copay and no coinsurance, though cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered.
Skilled Nursing Facility (SNF) See details
Platino Blindao (HMO D-SNP) covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance per admission, though prior authorization and a prior three-day inpatient hospital stay are required. Additional days beyond standard Medicare-covered SNF services are not covered.
Other Services See details
Other services are partially covered by Platino Blindao (HMO D-SNP), which offers acupuncture with no copay and no coinsurance for up to 12 treatments per year. Over-the-counter (OTC) items, meal benefits, and other additional 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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