Cubiertas-Individuales-MCS-Classicare-Metro-2024

2024 MCS Classicare Metro (HMO)

Summary of Benefits

Benefits of this plan
Below you can see the details of the benefits offered by the cover MCS Classicare Activo (HMO)

MCS Classicare Te Paga card $900 annual ($75 monthly),unused amounts do not rollover to the next month.

Te Paga Card^1,2

Medicare Part B Premium Reduction $600 annual ($50 monthly)

Medicare Part B Premium Reduction

$5 copay Primary Physician $10 copay Specialists

Visits to Physicians

0% Special Network / 20% General Network

Labs and X-rays

$1,250 annual in combined benefit for vision care and hearing services

Eyewear

$1,250 annual in combined benefit for vision care and hearing services

Hearing aids

$1,600 annual 0% coinsurance

Comprenhensive Dental

$600 annually for transportation to plan-approved locations provided by contracted rideshare transportation provider

Transportation⁸

Covered

Cell phone^1,7

Pest control, yard clean-up, hairstyling, electricity, preventive home cleaning/disinfection, plumbing, locksmith and technology assistence. 12 visits per year (3 quarterly)

Home Assistence^1,3,4

Not covered

Home Bundle Benefit⁶

Not covered

In Home Foot Care⁴

$0 copay per encounter

Telemedicine

7 pills per month

ED Drugs

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

Wellness Benefits

60 hours annual / 5 hours monthly

Home Care Support

MCS Classicare is a product subscribed by MCS Advantage, Inc. MCS Classicare is an HMO plan with a Medicare contract. Enrollment in MCS Classicare depends on contract renewal. For MCS Classicare Primero (HMO C-SNP): 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 2024. Access to plan's in-network providers 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.

1.The benefits mentioned are a part of special supplemental program for members with chronic diseases. Members must meet all benefit’s eligibility criteria.

2. The Te Paga card benefit cannot be used for cash withdrawal and to buy alcohol beverages nor tobacco, or its derivatives. Unused amounts does not roll over to the next month for the following groups: MCS Classicare Efectivo (HMO), MCS Classicare Intellicare (HMO), MCS Classicare Exacto (HMO), MCS Classicare Metro (HMO) and MCS Classicare En Tu Hogar (HMO).

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

4. Services are limited per quarter, and if you do not use the full amount during a quarter, the remaining balance will not accumulate for use during the next quarter.

5. Some services may require a referral for MCS Classicare InteliCare (HMO) only.

6. Unused amounts do not carry over to the next month for the Home Bundle Benefit.

7. One (1) cell phone per year with data plan, from a supplier approved by the plan for MCS Classicare Metro (HMO) and MCS Classicare Firme (HMO) only.

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: