After reviewing the different options available through MCS Classicare (HMO), you may complete the Enrollment Application.
Before deciding about your enrollment, it is important that you fully understand our benefits, as well as the applicable rules and conditions. To ensure a proper understanding of our benefits, we recommend the following:
Understanding important rules
For MCS Classicare Essential (HMO-POS) and MAPD groups (HMO-POS) plans, you should know:
For MCS Classicare Primero (HMO C-SNP), you should know:
For MCS Classicare Excede (HMO), you should know:
For MCS Classicare Firme (HMO), you should know:
For MCS Classicare Estrella (HMO), you should know:
For MCS Classicare Platino plans, you should know:
For MCS Classicare Platino Máximo (HMO D-SNP), you should know:
The following instructions may help you complete your Enrollment Application.
SELECT THE BENEFITS PLAN YOU WISH TO ENROLL IN
Choose the plan you wish to enroll in and mark your choice. Also, indicate the name of your previous health plan.
BENEFICIARY INFORMATION
Complete all sections related to the beneficiary’s information:
YOUR MEDICARE INFORMATION
Complete the section related to your Original Medicare:
PAYING YOUR PLAN PREMIUM / PREMIUM PAYMENT METHOD (IF APPLICABLE)
Please review this section carefully and select the payment method for your monthly premium and/or late enrollment penalty. This section only applies if:
If none of these conditions apply, you may skip this section.
ANSWER TO THESE IMPORTANT QUESTIONS
Read and answer all the questions in this section of the Enrollment Application.
PRIMARY CARE PHYSICIAN (PCP) INFORMATION
Select your primary care physician (PCP) from the MCS Classicare provider network and write their name in the space provided. If you do not have a primary care physician, MCS Classicare will assign one to you. You may change it later if you wish. To access the Providers Directory, visit our website: https://mcsclassicare.com/en/Pages/providers-directory.aspx.
INFORMATIONAL MATERIALS
CHRONIC SPECIAL NEEDS PLAN (C-SNP)
IMPORTANT: READ THE FOLLOWING
Please read carefully the terms and conditions established by MCS Classicare. Once you have finished all the steps above, your Enrollment Application will be complete. If you need additional assistance, you may contact us at:
Metro area: 787.620.2528
Toll free: 1.866.627.8181
TTY (Hearing Impaired): 1.866.627.8182
Our Customer Service hours are Monday through Sunday, from 8:00 a.m. to 8:00 p.m., from October 1 through March 31. From April 1 through September 30, our hours are Monday through Friday, from 8:00 a.m. to 8:00 p.m., and Saturdays, from 8:00 a.m. to 4:30 p.m.
Please remember that there are limits on when and how often you may change the way you receive your Medicare services:
During the Medicare Advantage Open Enrollment Period (MA OEP) - From January 1 through March 31st, anyone enrolled in a Medicare Advantage Plan may switch to another Medicare Advantage plan or disenroll and return to Original Medicare. Members may make only one election during the MA OEP. In addition, during this period, they may add or drop Medicare Part D prescription drug coverage.
Medicare limits when you may make changes to your coverage. From October 15 through December 7 of each year, you may enroll in a new Medicare Prescription Drug Plan (Part D) or a Medicare Advantage Plan for the following year.
Outside this period, you may not enroll in a new plan unless you meet certain special conditions that qualify you for a Special Enrollment Period. Examples include moving outside the MCS Classicare service area, losing other creditable prescription drug coverage, or qualifying for the Extra Help program to assist with the cost of your prescription medications.
Benefits, the prescription drug formulary, providers and pharmacy networks, as well as premiums, copayments and coinsurance, may change from year to year.
In addition, the plan may not be available in the next contract year. Under applicable regulations, plans may choose not to renew their contract with the Centers for Medicare & Medicaid Services (CMS) or may reduce their service area. Likewise, CMS may decide not to renew a contract. Any of these situations could result in the plan being terminated or not renewed.
Special Enrollment Period (SEP) for Dual-eligible individuals (Medicare and Medicaid) – This SEP allows a dual-eligible individual to make one monthly change from their Dual Eligible Special Needs Plan (D-SNP) to any other available D-SNP plan.
Members may make one election per month, and coverage under the new plan will become effective on the first day of the month following the date the enrollment request is received.
Benefits, the prescription drug formulary, provider and pharmacy networks, as well as premiums, copayments and coinsurance, may change from year to year.
In addition, the plan may not be available during the next contract year. Plans may choose not to renew their contract with CMS (Centers for Medicare & Medicaid Services) or may reduce their service area. Likewise, CMS may decide not to renew the plan’s contract. Any of these situations could result in the plan being terminated or not renewed.
2027
To enroll in any of our products for plan year 2027, click here to access the Enrollment Application. For detailed information about our health benefit plans, please refer to the Summary of Benefits section. You may also refer to the Plan Classification section.
Each year, Medicare evaluates plans using a 5-Star Rating System, designed to help you compare the quality and performance of health and prescription drug plans. For more information about this rating system, click the following link:
If you wish to enroll in any of our products, you may complete the Enrollment Application and submit it at any of our service centers located throughout Puerto Rico.
You may also send it by fax to 787.620.1343 or by mail to the following address:
MCS Advantage Enrollment Department PO Box 191720 San Juan PR 00919-1720
Medicare beneficiaries may enroll in MCS Classicare through the CMS Medicare Online Enrollment Center available at https://www.medicare.gov. Click here to enroll through Medicare.gov.
This information is available free of charge in other languages. To request it, please contact our Customer Service Department at 787.620.2530 (metro area) or 1.866.627.8183 (toll-free). Individuals with hearing impairments may use the TTY service at 1.866.627.8182.
Our Customer Service hours are Monday through Sunday, from 8:00 a.m. to 8:00 p.m., from October 1 through March 31. From April 1 through September 30, our hours are Monday through Friday, from 8:00 a.m. to 8:00 p.m., and Saturdays from 8:00 a.m. to 4:30 p.m.