Medicare Advantage Plans for Puerto Rico
638,508 Total Medicare Advantage Enrollees
| OTC Supplemental Benefits | Prescription Hearing Aid Coverage | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Company | Plan name | Plan type | OTC Supplement | OTC Rolls Over? | Annual OTC Supplement | Coverage? | Covered Amount | Covers OTC Aids? | Coinsurance? | Copay? | Prior Authorization? | Need Referral? | Puerto Rico Enrollees |
| Medicare y Mucho Mas |
MMM Diamante Platino (HMO D-SNP) H4003-017-0 |
HMO | $100 per Quarter | No | $400 | Yes | $3,000 | No | No | No | Yes | No | 70,578 |
| Medicare y Mucho Mas |
MMM Elite (HMO-POS) H4003-034-0 |
HMOPOS | $90 per Quarter | No | $360 | Yes | $2,000 | No | No | No | Yes | No | 42,023 |
| PMC Medicare Choice |
MMM Plenitud (HMO-POS) H4004-065-0 |
HMOPOS | $25 per Quarter | No | $100 | Yes | $1,250 | No | No | No | Yes | No | 39,235 |
| MCS Classicare |
MCS Classicare Platino Ideal (HMO D-SNP) H5577-002-0 |
HMO | No | $0 | Yes | $700 | No | No | No | Yes | Yes | 32,359 | |
| PMC Medicare Choice |
MMM Relax Platino (HMO D-SNP) H4004-062-0 |
HMO | $60 per Quarter | No | $240 | Yes | $600 | No | No | No | Yes | No | 32,082 |
| MCS Classicare |
MCS Classicare Platino Progreso (HMO D-SNP) H5577-017-0 |
HMO | No | $0 | Yes | $3,000 | No | No | No | Yes | Yes | 30,808 | |
| Triple S Advantage |
Employer BD 3 (HMO-POS) H5774-814-0 |
HMOPOS | No | $0 | No | 25,879 | |||||||
| Medicare y Mucho Mas |
MMM Group A Calendar (HMO-POS) H4003-806-0 |
HMOPOS | No | $0 | No | 21,471 | |||||||
| MCS Classicare |
MCS Classicare Platino MasCa$h (HMO D-SNP) H5577-029-0 |
HMO | No | $0 | Yes | $650 | No | No | No | Yes | Yes | 21,348 | |
| MCS Classicare |
MCS Classicare Essential (HMO-POS) H5577-008-0 |
HMOPOS | $35 per Month | Yes | $0 | Yes | $1,500 | No | No | No | Yes | No | 18,784 |
| Triple S Advantage |
Platino Plus (HMO D-SNP) H5774-024-0 |
HMO | $95 per Quarter | No | $380 | Yes | $1,000 | No | No | No | No | No | 18,391 |
| Medicare y Mucho Mas |
MMM Valor Platino (HMO D-SNP) H4003-047-0 |
HMO | $100 per Quarter | No | $400 | Yes | $500 | No | No | No | Yes | No | 18,093 |
| Medicare y Mucho Mas |
MMM Group D Calendar (HMO-POS) H4003-821-0 |
HMOPOS | No | $0 | No | 18,091 | |||||||
| MCS Classicare |
MCS Classicare Efectivo (HMO) H5577-005-0 |
HMO | $20 per Month | No | $0 | Yes | $800 | No | No | No | Yes | No | 16,624 |
| MCS Classicare |
MCS Classicare Platino Solido (HMO D-SNP) H5577-041-0 |
HMO | $230 per Month | Yes | $2,760 | Yes | $2,500 | No | No | No | No | Yes | 15,576 |
| Triple S Advantage |
Real (HMO) H5774-005-0 |
HMO | $50 per Quarter | No | $200 | Yes | $1,500 | No | No | No | No | No | 13,780 |
| MCS Classicare |
MCS Classicare Activo (HMO) H5577-031-0 |
HMO | $60 per Month | Yes | $720 | Yes | $1,000 | No | No | No | No | No | 11,600 |
| MCS Classicare |
MCS Classicare Firme (HMO) H5577-042-0 |
HMO | $120 per Month | Yes | $0 | Yes | $950 | No | No | No | Yes | No | 11,233 |
| Triple S Advantage |
Magno (HMO-POS) H5774-027-0 |
HMOPOS | $50 per Quarter | No | $200 | Yes | $500 | No | No | No | No | No | 9,832 |
| MCS Classicare |
MCS Classicare MA-PD Group 2nd Formulary Opt. (HMO) H5577-809-0 |
HMO | No | $0 | No | 9,806 | |||||||
| Triple S Advantage |
Platino Blindao (HMO D-SNP) H5774-028-0 |
HMO | $40 per Quarter | No | $160 | Yes | $1,500 | No | No | No | No | No | 9,208 |
| PMC Medicare Choice |
PMC Premier Platino (HMO D-SNP) H4004-048-0 |
HMO | $200 per Month | No | $0 | Yes | $2,500 | No | No | No | Yes | No | 9,171 |
| Triple S Advantage |
Brillante (HMO-POS) H5774-031-0 |
HMOPOS | $60 per Quarter | No | $240 | Yes | $1,750 | No | No | No | No | No | 8,605 |
| Medicare y Mucho Mas |
MMM Supremo (HMO C-SNP) H4003-009-0 |
HMO | $25 per Quarter | No | $100 | Yes | $1,000 | No | No | No | Yes | No | 8,497 |
| MCS Classicare |
MCS Classicare Exacto (HMO) H5577-053-0 |
HMO | $20 per Month | No | $0 | Yes | $1,100 | No | No | No | Yes | No | 7,914 |
| MCS Classicare |
MCS Classicare MA-PD Group (HMO) H5577-802-0 |
HMO | No | $0 | No | 7,152 | |||||||
| Medicare y Mucho Mas |
MMM Group C Calendar (HMO-POS) H4003-820-0 |
HMOPOS | No | $0 | No | 7,044 | |||||||
| Triple S Advantage |
Platino Titan (HMO D-SNP) H5774-036-0 |
HMO | $50 per Quarter | No | $200 | Yes | $1,000 | No | No | No | No | No | 6,176 |
| PMC Medicare Choice |
MMM Balance (HMO-POS) H4004-063-0 |
HMOPOS | $25 per Quarter | No | $100 | Yes | $1,250 | No | No | No | Yes | No | 5,996 |
| PMC Medicare Choice |
PMC Max (HMO-POS) H4004-056-0 |
HMOPOS | $75 per Month | No | $0 | Yes | $1,000 | No | No | No | Yes | No | 5,304 |
| MCS Classicare |
MCS Classicare CeroCeroCero (HMO C-SNP) H5577-045-0 |
HMO | $130 per Month | Yes | $1,560 | Yes | $2,000 | No | No | No | No | No | 4,718 |
| Humana |
Humana Gold Plus SNP-DE H4007-018 (HMO D-SNP) H4007-018-0 |
HMO | $720 per Month | No | $0 | Yes | $4,000 | Yes | No | Yes | No | No | 4,564 |
| MCS Classicare |
MCS Classicare MA-PD Group 2F (HMO) H5577-821-0 |
HMO | No | $0 | No | 4,251 | |||||||
| Triple S Advantage |
Platino Ultra (HMO D-SNP) H5774-025-0 |
HMO | $75 per Quarter | No | $300 | Yes | $2,500 | No | No | No | No | No | 4,117 |
| MCS Classicare |
MCS Classicare MA-PD Group 2L (HMO) H5577-827-0 |
HMO | No | $0 | No | 4,055 | |||||||
| Triple S Advantage |
Royal D (HMO-POS) H5774-809-0 |
HMOPOS | No | $0 | No | 3,731 | |||||||
| Triple-S Advantage |
Óptimo Plus A (PPO) H4005-802-0 |
Local PPO | No | $0 | No | 3,678 | |||||||
| Triple S Advantage |
Platino Advance (HMO D-SNP) H5774-026-0 |
HMO | $45 per Quarter | No | $180 | Yes | $1,500 | No | No | No | No | No | 3,108 |
| Humana |
Humana Gold Plus SNP-DE H4007-016 (HMO D-SNP) H4007-016-0 |
HMO | $480 per Month | No | $0 | Yes | $4,000 | Yes | No | Yes | No | No | 2,896 |
| Triple S Advantage |
AhorroMax (HMO) H5774-037-0 |
HMO | $50 per Quarter | No | $200 | Yes | $1,250 | No | No | No | No | No | 2,797 |
| Medicare y Mucho Mas |
MMM Encanto (HMO-POS) H4003-054-0 |
HMOPOS | $25 per Quarter | No | $100 | Yes | $1,250 | No | No | No | Yes | No | 2,609 |
| Humana |
Humana Gold Plus H4007-012 (HMO) H4007-012-0 |
HMO | $20 per Month | Yes | $0 | Yes | $1,500 | Yes | No | Yes | No | No | 2,538 |
| MCS Classicare |
MCS Classicare Primero (HMO C-SNP) H5577-038-0 |
HMO | $90 per Month | Yes | $0 | Yes | $900 | No | No | No | Yes | No | 2,335 |
| MCS Classicare |
MCS Classicare Platino Total (HMO D-SNP) H5577-046-0 |
HMO | No | $0 | Yes | $800 | No | No | No | Yes | Yes | 2,272 | |
| Triple-S Advantage |
Óptimo Plus (PPO) H4005-004-0 |
Local PPO | $0 per Month | No | $0 | Yes | $1,250 | No | No | No | No | No | 2,210 |
| Medicare y Mucho Mas |
MMM Grande Platino (HMO D-SNP) H4003-049-0 |
HMO | $25 per Quarter | No | $100 | Yes | $1,000 | No | No | No | Yes | No | 2,052 |
| Humana |
Humana Gold Plus SNP-DE H4007-019 (HMO D-SNP) H4007-019-0 |
HMO | $720 per Month | No | $0 | Yes | $1,500 | Yes | No | Yes | No | No | 1,863 |
| Humana |
Humana Gold Plus SNP-DE H4007-026 (HMO D-SNP) H4007-026-0 |
HMO | $780 per Month | No | $0 | Yes | $500 | Yes | No | Yes | No | No | 1,815 |
| MCS Classicare |
MCS Classicare En Tu Hogar (HMO) H5577-043-0 |
HMO | $35 per Month | No | $0 | Yes | $700 | No | No | No | Yes | No | 1,658 |
| Triple S Advantage |
Contigo Plus (HMO C-SNP) H5774-022-0 |
HMO | $100 per Quarter | No | $400 | Yes | $1,000 | No | No | No | No | No | 1,401 |
