MCS-Classicare-Platino-Máximo (HMO D SNP) Region 3 2024

2024 MCS Classicare Platino Máximo (HMO D-SNP) Region 3

Summary of Benefits

Benefits of this plan
Below you can see the details of the benefits offered by the cover MCS Classicare Platino Máximo (HMO D-SNP) Region 3

MCS Classicare Te Paga Card $1,920 annual ($160 monthly), what you don't use is transferred to the next month.

Te Paga Card^1,2

Medicare Part B Premium Reduction $1,200 annual ($100 monthly)

Medicare Part B Premium Reduction

$0 copay Primary Physician and Specialists

Visits to Physicians

$0 copay

Labs and X-rays

$750 annual in combined benefit for vision care and hearing services

Eyewear

$750 annual in combined benefit for vision care and hearing services

Hearing aids

$1,200 annual 0% coinsurance

Comprenhensive Dental

18 One-Way trips

Transportation⁸

Not covered

Cell phone⁶

Pest control, yard clean-up, hairstyling₅, electricity, preventive home cleaning/disinfection, plumbing, locksmith and technology assistence. 8 visits per year (2 quarterly)

Home Assistance^1,3,4

Not covered

In Home Foot Care⁷

$0 copay per encounter

Telemedicine

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

Wellness Benefits

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. 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 (toll free) or 1.866.627.8182 (TTY, for the hearing impaired). 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 2026. Access to the provider's network all over Puerto Rico. The service area for MCS Classicare Platino Máximo Region 1 includes 13 municipalities, MCS Classicare Platino Máximo Region 2 includes 21 municipalities, MCS Classicare Platino Máximo Region 3 includes 44 municipalities, MCS Classicare Platino Del Sur includes 8 municipalities For details see the Evidence of Coverage or contact the plan.

1. All qualify

2. The Te Paga Card :The benefit cannot be used for cash withdrawal and to buy alcohol beverages nor tobacco, or its derivatives. Unused amounts do not rollover to the next month for MCS Classicare Platino Ideal (HMO D-SNP), MCS Classicare Platino Mascash (HMO D-SNP).

3. Only simple repairs and basic services apply, according to the evaluation performed by the service supplier.

4. Services are limited by quarter; unused amounts do not roll over to the next quarter.

5. For hairstyling services (wash, cut and dry) you must visit participating establishments to receive these services. Contact the Home Assistance supplier for more details.

6. One (1) cell phone per year with data plan, from a supplier approved by the plan for MCS Classicare Platino MásCa$h (HMO D-SNP) only.

7. Unused amounts do not rollover to the next month or quarter.

8. Transportation to plan-approved locations through contracted suppliers.

MCS Classicare received the highest 5-star rating for the year 2024 in Puerto Rico.

Highlights:

MCS Classicare is the first and only plan with the highest rating of 5 out of 5 stars for the 2024 contract year.
For the first time, the Centers for Medicare & Medicaid Services (CMS), the federal health care agency, awarded MCS Classicare a 5-Star rating for its strong performance, placing it among the best Medicare Advantage (MA) plans in the United States and Puerto Rico.
For 2024, MCS Classicare - H5577 received the following Star Ratings from Medicare:
- Overall Star Rating:
- Health Services Rating:
- Drug Services Rating: