Medicare Advantage Plans for Toa Baja County, Puerto Rico
- 60 Total Plans
- 16,930 Seniors Eligible for Medicare
- 13,923 Seniors on Medicare Advantage (82%)
- 4 plans with 528 seniors have enough OTC benefit to fully cover MDHearing hearing aids
- 36 plans with 8,354 seniors have OTC benefits that partially cover MDHearing hearing aids
- 52% of seniors can partially or fully cover OTC hearing aids from MDHearing (if their plan has MDHearing hearing aids)
| 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 | 1,425 |
| 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 | 1,055 |
| PMC Medicare Choice |
MMM Plenitud (HMO-POS) H4004-065-0 |
HMOPOS | $25 per Quarter | No | $100 | Yes | $1,250 | No | No | No | Yes | No | 963 |
| MCS Classicare |
MCS Classicare Platino Progreso (HMO D-SNP) H5577-017-0 |
HMO | No | $0 | Yes | $3,000 | No | No | No | Yes | Yes | 775 | |
| MCS Classicare |
MCS Classicare Platino Ideal (HMO D-SNP) H5577-002-0 |
HMO | No | $0 | Yes | $700 | No | No | No | Yes | Yes | 685 | |
| MCS Classicare |
MCS Classicare Essential (HMO-POS) H5577-008-0 |
HMOPOS | $35 per Month | Yes | $0 | Yes | $1,500 | No | No | No | Yes | No | 636 |
| Triple S Advantage |
Employer BD 3 (HMO-POS) H5774-814-0 |
HMOPOS | No | $0 | No | 617 | |||||||
| 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 | 606 |
| Medicare y Mucho Mas |
MMM Group D Calendar (HMO-POS) H4003-821-0 |
HMOPOS | No | $0 | No | 535 | |||||||
| Medicare y Mucho Mas |
MMM Group A Calendar (HMO-POS) H4003-806-0 |
HMOPOS | No | $0 | No | 482 | |||||||
| MCS Classicare |
MCS Classicare Efectivo (HMO) H5577-005-0 |
HMO | $20 per Month | No | $0 | Yes | $800 | No | No | No | Yes | No | 463 |
| MCS Classicare |
MCS Classicare Platino MasCa$h (HMO D-SNP) H5577-029-0 |
HMO | No | $0 | Yes | $650 | No | No | No | Yes | Yes | 453 | |
| MCS Classicare |
MCS Classicare Activo (HMO) H5577-031-0 |
HMO | $60 per Month | Yes | $720 | Yes | $1,000 | No | No | No | No | No | 450 |
| 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 | 316 |
| MCS Classicare |
MCS Classicare MA-PD Group 2nd Formulary Opt. (HMO) H5577-809-0 |
HMO | No | $0 | No | 313 | |||||||
| MCS Classicare |
MCS Classicare Exacto (HMO) H5577-053-0 |
HMO | $20 per Month | No | $0 | Yes | $1,100 | No | No | No | Yes | No | 303 |
| Triple S Advantage |
Real (HMO) H5774-005-0 |
HMO | $50 per Quarter | No | $200 | Yes | $1,500 | No | No | No | No | No | 301 |
| 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 | 282 |
| Triple S Advantage |
Magno (HMO-POS) H5774-027-0 |
HMOPOS | $50 per Quarter | No | $200 | Yes | $500 | No | No | No | No | No | 239 |
| Medicare y Mucho Mas |
MMM Group C Calendar (HMO-POS) H4003-820-0 |
HMOPOS | No | $0 | No | 229 | |||||||
| Triple S Advantage |
Brillante (HMO-POS) H5774-031-0 |
HMOPOS | $60 per Quarter | No | $240 | Yes | $1,750 | No | No | No | No | No | 217 |
| 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 | 214 |
| 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 | 172 |
| MCS Classicare |
MCS Classicare MA-PD Group (HMO) H5577-802-0 |
HMO | No | $0 | No | 153 | |||||||
| Triple-S Advantage |
Óptimo Plus A (PPO) H4005-802-0 |
Local PPO | No | $0 | No | 153 | |||||||
| PMC Medicare Choice |
MMM Balance (HMO-POS) H4004-063-0 |
HMOPOS | $25 per Quarter | No | $100 | Yes | $1,250 | No | No | No | Yes | No | 137 |
| MCS Classicare |
MCS Classicare MA-PD Group 2F (HMO) H5577-821-0 |
HMO | No | $0 | No | 131 | |||||||
| 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 | 115 |
| 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 | 110 |
| MCS Classicare |
MCS Classicare MA-PD Group 2L (HMO) H5577-827-0 |
HMO | No | $0 | No | 108 | |||||||
| PMC Medicare Choice |
PMC Max (HMO-POS) H4004-056-0 |
HMOPOS | $75 per Month | No | $0 | Yes | $1,000 | No | No | No | Yes | No | 101 |
| MCS Classicare |
MCS Classicare Primero (HMO C-SNP) H5577-038-0 |
HMO | $90 per Month | Yes | $0 | Yes | $900 | No | No | No | Yes | No | 84 |
| Triple S Advantage |
AhorroMax (HMO) H5774-037-0 |
HMO | $50 per Quarter | No | $200 | Yes | $1,250 | No | No | No | No | No | 75 |
| Triple S Advantage |
Royal D (HMO-POS) H5774-809-0 |
HMOPOS | No | $0 | No | 75 | |||||||
| 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 | 70 |
| 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 | 52 |
| MCS Classicare |
MCS Classicare En Tu Hogar (HMO) H5577-043-0 |
HMO | $35 per Month | No | $0 | Yes | $700 | No | No | No | Yes | No | 51 |
| MCS Classicare |
MCS Classicare Platino Total (HMO D-SNP) H5577-046-0 |
HMO | No | $0 | Yes | $800 | No | No | No | Yes | Yes | 51 | |
| Triple-S Advantage |
Óptimo Plus (PPO) H4005-004-0 |
Local PPO | $0 per Month | No | $0 | Yes | $1,250 | No | No | No | No | No | 51 |
| Medicare y Mucho Mas |
MMM Unico (HMO-POS) H4003-019-0 |
HMOPOS | $25 per Quarter | No | $100 | Yes | $1,250 | No | No | No | Yes | No | 40 |
| Triple S Advantage |
Royal C (HMO) H5774-808-0 |
HMO | No | $0 | No | 40 | |||||||
| Triple S Advantage |
Employer BD 7 (HMO-POS) H5774-818-0 |
HMOPOS | No | $0 | No | 35 | |||||||
| Triple S Advantage |
Platino Alcance (HMO D-SNP) H5774-035-0 |
HMO | $150 per Month | No | $0 | Yes | $1,000 | No | No | No | No | No | 35 |
| 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 | 34 |
| 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 | 32 |
| MCS Classicare |
MCS Classicare Platino @Home (HMO D-SNP) H5577-037-0 |
HMO | $50 per Month | Yes | $600 | Yes | $1,000 | No | No | No | No | Yes | 32 |
| Medicare y Mucho Mas |
MMM Deluxe (HMO-POS) H4003-055-0 |
HMOPOS | $25 per Quarter | No | $100 | Yes | $1,250 | No | No | No | Yes | No | 29 |
| Humana |
Humana Gold Plus H4007-012 (HMO) H4007-012-0 |
HMO | $20 per Month | Yes | $0 | Yes | $1,500 | Yes | No | Yes | No | No | 25 |
| MCS Classicare |
MCS Classicare Patriot (HMO) H5577-016-0 |
HMO | $230 per Month | Yes | $0 | Yes | $1,000 | No | No | No | Yes | No | 25 |
| Medicare y Mucho Mas |
MMM Advantage Group A Calendar (PPO) H7522-801-0 |
Local PPO | No | $0 | No | 25 | |||||||
| Medicare y Mucho Mas |
MMM Flexi Max (HMO-POS) H4003-057-0 |
HMOPOS | $50 per Quarter | No | $200 | Yes | $1,250 | No | No | No | Yes | No | 25 |
| MCS Classicare |
MCS Classicare Hero (HMO) H5577-044-0 |
HMO | $20 per Month | Yes | $0 | Yes | $2,000 | No | No | No | Yes | No | 24 |
| Humana |
Humana Gold Plus H4007-024 (HMO) H4007-024-0 |
HMO | $0 per Month | No | $0 | Yes | $1,500 | Yes | No | Yes | No | No | 23 |
| Medicare y Mucho Mas |
MMM Dinamico (HMO-POS) H4003-051-0 |
HMOPOS | $40 per Quarter | No | $160 | Yes | $1,250 | No | No | No | Yes | No | 23 |
| Medicare y Mucho Mas |
MMM Group E Calendar (HMO-POS) H4003-826-0 |
HMOPOS | No | $0 | No | 23 | |||||||
| Humana |
Humana Gold Plus H4007-020 (HMO) H4007-020-0 |
HMO | $0 per Month | No | $0 | Yes | $1,000 | Yes | No | Yes | No | No | 18 |
| Humana |
Humana Gold Plus H4007-025 (HMO) H4007-025-0 |
HMO | $20 per Month | Yes | $0 | Yes | $1,500 | Yes | No | Yes | No | No | 15 |
| 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 | 14 |
| Humana |
Humana Medicare Employer (HMO) H4007-819-0 |
HMO | No | $0 | No | 13 | |||||||
| Triple-S Advantage |
Óptimo Plus B (PPO) H4005-804-0 |
Local PPO | No | $0 | No | 12 | |||||||
