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Cubiertas-Individuales-MCS-Classicare-Excede-Region-1-2025

2025 MCS Classicare Excede (HMO) Region 1

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Summary of Benefits

MCS Classicare Te Paga Card $1,380 annual ($115 monthly)

Benefits of this plan
Below you can see the details of the benefits offered by the cover MCS Classicare Excede (HMO/Open Access) Region 1

MCS Classicare Te Paga $1,380 annual ($115 monthly), what you don't use is transferred to the next month.

Te Paga Card 1,6

Medicare Part B Premium Reduction $612 annual ($51 monthly)

Medicare Part B Premium Reduction

$0 copay Primary Physician and Specialists

Visits to Physicians

0% Special Network / 20% General Network

Labs and X-rays 5

$500 annual in combined benefit for vision care and hearing services

Eyewear 6

$500 annual in combined benefit for vision care and hearing services

Hearing aids 6

$1,500 annual 0% coinsurance

Comprenhensive Dental 5,6

12 One-Way trips

Transportation 1,6

Pest control, yard clean-up, hairstyling, electricity, preventive home cleaning/disinfection, plumbing, locksmith and technology assistence. 8 visits per year (2 quarterly)

Home Assistence 1,4,6

Not covered

Home Bundle 4

Not covered

In-Home Care Support 4

Not covered

In Home Foot Care 4

$0 copay per encounter

Telemedicine

7 pills per month

ED Drugs

Nutritionist, Acupuncture, Therapeutic Massage, Foot Reflexology 6 visits annual / $0 copay

Wellness Benefits
MCS Classicare is a product subscribed by MCS Advantage, Inc. MCS Classicare is an HMO plan with a Medicare contract and a contract with Puerto Rico Medicaid program. Enrollment in MCS Classicare depends on contract renewal. Based on a Model of Care review, MCS Classicare has been approved by the National Committee for Quality Assurance (NCQA) to operate a Special Needs Plan (SNP) through 2025. 1. SSBCI: The benefits mentioned are a part of special supplemental program for members with chronic diseases, such as: Cardiovascular disorders, Hypertension, Diabetes, Chronic and disabling mental health conditions, Chronic kidney disease and other conditions not listed. Eligibility cannot be guaranteed based solely on your condition. All applicable eligibility requirements must be met before the benefit is provided. For details, please contact us.VBID: Eligibility for the Additional Benefits under the VBID Model is not assured and will be determined by MCS after enrollment, based on relevant criteria (area deprivation index). Amounts may vary per coverage. If you have questions, need materials on a standing basis in alternate formats and/or languages or need oral interpretation services, you can call us at 1.866.627.8183 (TTY: 1.866.627.8182). 2. MCS Classicare Intelicare (HMO) is a coordinated care coverage. 3. Unused amounts does not roll over to the next month for the following groups: MCS Classicare Efectivo (HMO), MCS Classicare InteliCare (HMO), MCS Classicare Exacto (HMO) and MCS Classicare En Tu Hogar (HMO).4. Unused amounts do not rollover to the next month or quarter. 5. Some services may require pre-authorization. Contact the plan for details. 6. Benefits may vary per coverage. Call us or refer to your Evidence of Coverage available on our website www.mcsclassicare.com for benefit information, limitations and exclusions. 7. Access to the network of providers throughout Puerto Rico. The service area for MCS Classicare Excede Region 1 is 13 municipalities, Excede Region 2 is 21 municipalities, Del Caribe is 8 municipalities, Firme is 39 municipalities, Metro is 8 municipalities. For details see the Evidence of Coverage or contact the plan.
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