MCS Classicare En Tu Hogar (HMO)

H5577 - 043 - 0
5 out of 5 stars (5 / 5)

MCS Classicare En Tu Hogar (HMO) is a Medicare Advantage Plan by MCS Classicare.

This page features plan details for 2025 MCS Classicare En Tu Hogar (HMO) H5577 – 043 – 0 available in Puerto Rico.

Locations

MCS Classicare En Tu Hogar (HMO) is offered in the following locations.

Plan Overview

MCS Classicare En Tu Hogar (HMO) offers the following coverage and cost-sharing.

Insurer:MCS Classicare
Health Plan Deductible:$0
MOOP:$3,400 In-network
Drugs Covered:Yes

Ready to sign up for MCS Classicare En Tu Hogar (HMO) ?

Get help from a licensed insurance agent.

Call 1-877-354-4611 / TTY 711.

M-F: 8:00 am – 10:00 pm EST

Sat-Sun: 8:00 am – 9:00 pm EST

Medicare Part B Give Back Benefit

The Part B Premium Reduction (Medicare Part B Give Back Benefit) lowers the cost of some Medicare Advantage plans. 

MCS Classicare En Tu Hogar (HMO) qualifies for a monthly Medicare Give Back Benefit of $21.00.

Premium Reduction:$21.00

Premium Breakdown

MCS Classicare En Tu Hogar (HMO) has a monthly premium of $0.00. This amount includes your Part C and D premiums but does not include your Part B premium. The following is a breakdown of your monthly premium with Part B costs included.
Part B Part C Part D Part B Give Back Total
$185.00 $0.00 $0.00 $21.00 $
Please Note:
  • Your Part B premium may differ based on factors including late enrollment, income, and disability status.
  • You may also qualify for “Extra Help” on drug costs. See the Part D Premium Reduction section below for more details.

Drug Info

MCS Classicare En Tu Hogar (HMO) provides the following cost-sharing on drugs. Please check the plan’s formulary for specific drugs covered.

Drug Deductible: $0.00
Drug Out-Of-Pocket maximum: $2,000.00
Drug Benefit Type: Enhanced Alternative

Part D Premium Reduction

The Low-Income Subsidy (also known as LIS or “Extra Help”) helps people with Medicare lower the cost of prescription drugs.

The table below shows how the LIS impacts the Part D premium of this plan.

Part DLIS Full
$0.00$0.00

Initial Coverage Phase

After you pay your $0.00 drug deductible, you will pay the following costs for drugs in each tier until your total drug costs (including what this plan has paid and what you have paid) reach $2,000.00. Once you reach that amount, you will enter the next coverage phase.

Catastrophic Coverage Phase

After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reach $2,000.00, you pay nothing for Medicare Part D covered drugs. However, you may still pay a share of the costs for excluded drugs covered under any enhanced benefit. Please note, that this plan has a Enhanced Alternative benefit type.

Additional Benefits

MCS Classicare En Tu Hogar (HMO) also provides the following benefits.

Additional benefits and/or reduced cost-sharing for enrollees with certain health conditions?

    • In-Network: Yes, contact plan for further details

Comprehensive Dental

  • Adjunctive General Services
    • In-Network: No Coins – No Co pay (Authorization Required)
  • Endodontics
    • In-Network: No Coins – No Co pay (Authorization Required)
  • Implant Services
    • In-Network: No Coins – No Co pay (Authorization Required)
  • Oral and Maxillofacial Surgery
    • In-Network: No Coins – No Co pay (Authorization Required)
  • Periodontics
    • In-Network: No Coins – No Co pay (Authorization Required)
  • Prosthodontics, fixed
    • In-Network: No Coins – No Co pay (Authorization Required)
  • Prosthodontics, removable
    • In-Network: No Coins – No Co pay (Authorization Required)
  • Restorative Services
    • In-Network: No Coins – No Co pay (Authorization Required)

Diagnostic and Preventive Dental

  • Dental X-Rays
    • In-Network: No Coins – No Copay (Authorization Required)
  • Fluoride Treatment
    • In-Network: No Coins – No Copay
  • Oral Exams
    • In-Network: No Coins – No Copay
  • Other Diagnostic Dental Services
    • In-Network: No Coins – No Copay
  • Other Preventive Dental Services
    • In-Network: No Coins – No Copay
  • Prophylaxis (cleaning)
    • In-Network: No Coins – No Copay

Diagnostic procedures/lab services/imaging

  • Lab services
    • 0-20% coinsurance (Authorization Required)
  • Outpatient x-rays
    • $0 copay (Authorization Required)
  • Diagnostic tests and procedures
    • 0-20% coinsurance (Authorization Required)
  • Diagnostic radiology services (e.g., MRI)
    • 0-20% coinsurance (Authorization Required)

Doctor visits

  • Primary
    • $0 copay
  • Specialist
    • $0 copay

Emergency care/Urgent care

  • Urgent care
    • $0 copay
  • Emergency
    • $40 copay per visit (always covered)

Foot care (podiatry services)

  • Routine foot care
    • $0 copay (Limits Apply)
  • Foot exams and treatment
    • $0 copay

Ground ambulance

    • $0 copay

Health plan deductible

    • $0

Hearing

  • Fitting/evaluation
    • $0 copay (Limits Apply)
  • Hearing aids OTC
    • Not covered
  • Hearing aids
    • $0 copay (Limits Apply, Authorization Required)
  • Medicare-Covered Hearing Exam
    • $0 copay

Inpatient hospital coverage

    • Tier 1
      $0 copay per stay
      Tier 2
      $50 per stay (Authorization Required)

Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)

    • $3,400 In-network

Medical equipment/supplies

  • Durable medical equipment (e.g., wheelchairs, oxygen)
    • $0 copay (Authorization Required)
  • Prosthetics (e.g., braces, artificial limbs)
    • 0-20% coinsurance per item (Authorization Required)
  • Diabetes supplies
    • $0 copay (Authorization Required)

Medicare Part B drugs

  • Other Part B drugs
    • 0-20% coinsurance (Authorization Required)
  • Chemotherapy
    • 0-20% coinsurance (Authorization Required)

Mental health services

  • Outpatient group therapy visit
    • $0 copay (Authorization Required)
  • Outpatient individual therapy visit
    • $0 copay (Authorization Required)
  • Outpatient individual therapy visit with a psychiatrist
    • $0 copay
  • Inpatient hospital – psychiatric
    • $0 copay (Authorization Required)
  • Outpatient group therapy visit with a psychiatrist
    • $0 copay

Optional supplemental benefits

    • No

Other health plan deductibles?

    • In-Network: No

Outpatient hospital coverage

    • $0 copay (Authorization Required)

Preventive care

    • $0 copay

Rehabilitation services

  • Occupational therapy visit
    • $0 copay (Authorization Required)
  • Physical therapy and speech and language therapy visit
    • $0 copay (Authorization Required)

Skilled Nursing Facility

    • $0 copay (Authorization Required)

Transportation

    • $0 copay (Limits Apply)

Vision

  • Other
    • Not covered
  • Routine eye exam
    • $0 copay (Limits Apply)
  • Contact lenses
    • $0 copay (Limits Apply)
  • Eyeglass frames
    • $0 copay (Limits Apply)
  • Eyeglass lenses
    • $0 copay (Limits Apply)
  • Upgrades
    • Not covered
  • Eyeglasses (frames and lenses)
    • $0 copay (Limits Apply)

Wellness programs (e.g., fitness, nursing hotline)

    • Covered

Ready to sign up for MCS Classicare En Tu Hogar (HMO) ?

Get help from a licensed insurance agent.

Call 1-877-354-4611 / TTY 711.

M-F: 8:00 am – 10:00 pm EST

Sat-Sun: 8:00 am – 9:00 pm EST

Need more information on MCS Classicare En Tu Hogar (HMO)? See 2025 MCS Classicare En Tu Hogar (HMO) at MedicareAdvantageRX.com.

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