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Individual coverages list 2025

2025 Individual Coverages

MCS Classicare has developed innovative health coverage options designed to meet your needs as a Medicare beneficiary.

MCS Classicare En tu Hogar (HMO)

Benefits such as home bundle with $1,800 annually ($150 monthly) for items such as: diapers, cream, wet wipes, nutritional drinks, rash creams and ointments, and pressure ulcer creams. In-Home foot care (1 visit per quarter).

MCS Classicare Essential (HMO POS)

You will have the benefit of eyewear of $1,100 annual, and for Comprehensive Dental benefit $3,500 annual which includes Restorative Services, Crowns and Prosthodontics. $0 copayments Primary Physician and Specialists. In addition, you will have the hearing aids benefit for $1,500 annual ($750 per ear).

MCS Classicare Efectivo (HMO)

Includes Comprehensive Dental benefit $3,000 annual for Restorative Services, Crowns and Prosthodontics. Medicare Part B Premium reduction of $828 annually ($69 monthly). Health benefits such as: visits to primary care physicians and specialists with $0 copayments.

MCS Classicare Firme (HMO)

You will have available on the Te Paga card benefit $1,440 annually ($120 monthly). Enjoy benefits such as: Comprehensive Dental with $3,000 annually for Restorative Services, Crowns, and Prosthodontics. Combined benefits for eyewear and hearing aids $950 annual. $0 copayments for visits to primary care physicians and specialists, among others.

MCS Classicare Intelicare (HMO)

You will have a benefit of the Te Paga card with $1,080 annually ($90 monthly), and the Comprehensive Dental benefit with $2,500 annual for Restorative Services, Crowns and Prosthodontics. In addition, $0 co-payments on visits to primary care physicians and specialists.

MCS Classicare Metro (HMO)

You will have available on the Te Paga card benefit $828 annually ($69 monthly). In addtion, you have a Medicare Part B Premium reduction of $612 annually ($51 monthly). Home care support with 60 hours annually (5 hours monthly). Home Assitance with services such as hairstyling and yard clean-up.

MCS Classicare Patriot (HMO)

You will have available on the Te Paga card benefit $2,760 annually ($230 monthly), Comprehensive Dental benefit with $2,500 annual, and a combined benefit of eyewear and hearing aids $1,000 annual . In addition, transportation with 28 one-way trips, and 40 one-way trips to Veteran affairs facilities.

MCS Classicare Exacto (HMO)

Includes benefit such as Medicare Part B premium reduction of $960 annual ($80 monthly) . You will have available Comprehensive Dental benefit $2,500 annually for Restorative Services, crowns and Prosthodontics. Additional, combined benefits for hearing aids and eyewear $500 annual and access to the network around the island.

MCS Classicare Primero (HMO C-SNP)

You will have available on the Te Paga card Benefit $1,068 annually ($89 monthly). A Medicare Part B Premium Reduction of $480 annual ($40 monthly). In addition, Comprehensive Dental benefit with $3,000 annual for Restorative Services, Crowns and Prosthodontics. You will receive 16 visits annually (4 quarterly) for home assistance.

MCS Classicare Del Caribe (HMO)

You will have available $576 annual ($48 monthly) on Te Paga card and with Medicare Part B Premium Reduction $960 annual ($80 monthly). Also, $1,500 annual in Comprehensive Dental in Restorative, Services Crowns Prosthodontics. Additional, $500 annual in combined benefits in hearing aids and eyewar, and access to the network around the island.

MCS Classicare Excede (HMO) (Región 1)

You will have available on the Te Paga card benefit $1,380 annual ($115 monthly). A Medicare Part B Premium Reduction $612 annual ($51 monthly). In addition, in Comprehensive Dental $1,500 annual for Restorative Services, Crowns and Prosthodontics. Additional, combined benefits of hearing aids and eyewear $500 annual, and access to the network around the island.

MCS Classicare Excede (HMO) (Región 2)

You will have available on Te Paga card benefit $840 annual ($70 monthly). A Medicare Part B Premium Reduction $612 annual ($51 monthly). Also, in Comprehensive Dental $1,500 annual for Restorative Services, Crowns and Prosthodontics. Additional, combined benefits of hearing aids and eyewear $500 annual, and access to the network around the island

MCS Classicare RxMax (HMO)

You will have available $720 annual ($60 monthly) on Te Paga card and Medicare Part B Premium Reduction $216 annual ($18 monthly). Also, in Comprehensive Dental $2,000 annual for Restorative Services, Crowns and Prosthodontics. In addition, you will have the hearing aids benefit of $2,000 annual ($1,000 per ear). You will receive 16 annual visits (4 quarterly) for home assistance.

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. 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. 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). Access to the provider's network all over Puerto Rico. The service area for MCS Classicare < Excede Region 1 includes 13 municipalities, Excede Region 2 includes 21 municipalities, Del Caribe includes 8 municipalities, Firme includes 39 municipalities, Metro includes 8 municipalities >. For details see the Evidence of Coverage or contact the plan. MCS Classicare Intelicare (HMO) is a coordinated care coverage. 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. The Te Paga Card cannot be used for the withdrawal of cash nor for the purchase of alcoholic beverages, nor tobacco or any of its derivatives. Unused amounts do not rollover to the next month for the coverages: MCS Classicare Efectivo (HMO), MCS Classicare En tu Hogar (HMO), MCS Classicare Exacto (HMO), MCS Classicare Intelicare (HMO) y MCS Classicare Metro (HMO). Card cannot be used for the withdrawal of cash nor for the purchase of alcoholic beverages, nor tobacco or any of its derivatives. Home Assistance, Home Bundle, In-Home Foot care: Unused amounts do not rollover to the next quarter.
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