Service Area: Adjuntas, Aguada, Aguadilla, Añasco, Arecibo, Barceloneta, Cabo Rojo, Camuy, Ciales, Corozal, Florida, Guánica, Guayanilla, Hatillo, Hormigueros, Isabela, Jayuya, Juana Díaz, Lajas, Lares, Las Marías, Manatí, Maricao, Mayagüez, Moca, Morovis, Orocovis, Peñuelas, Ponce, Quebradillas, Rincón, Sabana Grande, San Germán, San Sebastián, Utuado, Vega Alta, Vega Baja, Villalba and Yauco.
OTC and Eligible Items through the Te Paga Card $2,100 annually ($175 monthly4), unused amounts do not rollover to the next month.
Medicare Part B Premium Reduction $2,100 annually ($175 monthly)
$0 copay Primary Physician and Specialists
$0 copay
$300 annually Combined benefit11
0% of total cost $1,000 annually
8 trips per year (One-way)
Pest control, yard clean-up, hairstyling10, electricity, preventive home cleaning/disinfection, plumbing, locksmith and technology assistence. 8 visits per year (2 quarterly)
Not covered
$0 copay / 10 visitis annually
Acupuncture, Therapeutic Massage, Foot Reflexology $0 copay / 6 visits annually
1. The Te Paga Debit Card includes your monthly OTC allowance. Enrollees who meet the eligibility criteria for Special Supplemental Benefits for the Chronically Ill (SSBCI) may use the same allowance for OTC items and other SSBCI-eligible items and services.
2. Eligible enrollees with chronic conditions, such as Chronic Hypertension, Cardiovascular Disorders, Diabetes Mellitus, Chronic Kidney Disease, Chronic and Disabling Mental Health Conditions, and other conditions not listed may be eligible for the SSBCI program. Eligibility for the benefits described is not guaranteed solely based on the presence of a listed chronic condition. All applicable eligibility requirements must be met before the benefit is provided. For details, please contact us.
3. The benefit cannot be used for cash withdrawal nor purchase the following services or products: cosmetic procedures, hospital indemnity insurance, funeral planning and expenses, life insurance, alcohol, tobacco, cannabis products that are illegal under State or Federal law, broad membership programs inclusive of multiple unrelated services and discounts, and non-healthy food.
4. Unused amounts do not rollover to the next month or quarter as applicable.
5. Some services may require prior authorization. Contact the plan for details.
6. Referrals are required for certain services.
7. Benefits may vary by plan. Call us or refer to your Evidence of Coverage available on our website www.mcsclassicare.com for benefit information, periodicity, limitations, and exclusions.
8. Comprehensive dental benefit periodicity varies depending on the service. Limitations and prior authorization apply.
9. Transportation to plan-approved locations through contracted suppliers.
10. Home Assistance: Only simple repairs and basic services apply, according to the evaluation carried out by the service supplier. Hairstyling; You must visit participating establishments to receive these services. Contact the Home Assistance supplier for more details.
11. Eyewear and hearing aids share a combined allowance. Choosing to use one benefit will reduce or eliminate the amount available for the other benefit, including repairs.
12. Unused allowances rollover monthly within the plan year.
13. Access to the provider's network all over Puerto Rico. The service area for MCS Classicare Platino Ultra (HMO D-SNP) is available to beneficiaries residing in any of the 39 eligible municipalities. For details see the Evidence of Coverage or contact the plan.