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The 2023 Medicare Advantage Plans in Lares County PR.



2022 Lares County Puerto Rico
Medicare Advantage Plans

There are 25 Medicare Advantage Plans available in Lares County PR from 5 different health insurance providers. 18 of these Medicare Advantage plans offer additional gap coverage. The plan with the lowest out of pocket expense is $3250 and the highest out of pocket is $6700. Lares County Puerto Rico residents can also pick from 26 Medicare Special Needs Plans. The best Medicare Advantage plan in Lares County Puerto Rico received a 4.5 overall star rating from CMS and the lowest rated plan is 4.5 stars.



(Click the Plan Name for More Details)
(⇅ Click the Header to Sort)

Name ⇅ Premium Deductible MOOP Gap Plan
Rating
Click
for
Formulary
Brillante (HMO-POS)
(H5774-031)

$0$0$3,400YesBrowse
Formulary
Humana Gold Plus H4007-012 (HMO)
(H4007-012)

$0$0$5,000NoBrowse
Formulary
Humana Gold Plus H4007-020 (HMO)
(H4007-020)

$0$0$5,000NoBrowse
Formulary
Humana Gold Plus H4007-021 (HMO)
(H4007-021)

$0$0$5,000NoBrowse
Formulary
HumanaChoice Value H2029-001 (PPO)
(H2029-001)

$43.00$0$6,700NoNABrowse
Formulary
Magno (HMO-POS)
(H5774-027)

$0$0$3,400YesBrowse
Formulary
MCS Classicare Activo (HMO)
(H5577-031)

$0$0$3,400YesBrowse
Formulary
MCS Classicare Efectivo (HMO)
(H5577-005)

$0$0$3,400YesBrowse
Formulary
MCS Classicare En Tu Hogar (HMO)
(H5577-043)

$0$0$3,400YesBrowse
Formulary
MCS Classicare Essential (HMO-POS)
(H5577-008)

$0$0$3,400YesBrowse
Formulary
MCS Classicare Firme (HMO)
(H5577-042)

$0$0$3,400YesBrowse
Formulary
MCS Classicare Hero (HMO)
(H5577-044)

$0$0$3,400YesBrowse
Formulary
MCS Classicare MediCa$h (HMO)
(H5577-014)

$0$480.00$6,700NoBrowse
Formulary
MCS Classicare SuperRx (HMO)
(H5577-039)

$0$0$3,400YesBrowse
Formulary
MMM Balance (HMO-POS)
(H4004-063)

$0$0$3,250YesBrowse
Formulary
MMM Dinamico (HMO-POS)
(H4003-051)

$0$0$3,250YesBrowse
Formulary
MMM Elite (HMO-POS)
(H4003-034)

$0$0$3,250YesBrowse
Formulary
MMM Extra (HMO-POS)
(H4003-044)

$0$0$3,250YesBrowse
Formulary
MMM Plenitud (HMO-POS)
(H4004-065)

$0$0$3,250YesBrowse
Formulary
MMM Poderoso (HMO-POS)
(H4004-064)

$0$0$3,250YesBrowse
Formulary
MMM Unico (HMO-POS)
(H4003-019)

$15.00$0$3,250YesBrowse
Formulary
PMC Max (HMO-POS)
(H4004-056)

$0$0$3,250YesBrowse
Formulary
Real (HMO)
(H5774-005)

$0$0$3,400YesBrowse
Formulary


Return to 2022 Medicare Advantage Plans in Puerto Rico

Las Marias County Medicare Advantage





Medicare Advantage Health Plans Without Drug Coverage

Plan Name ⇅ Premium Type MOOP Overall
Rating
Basic (HMO)
(H5774-003)

$0Local HMO *$3,400
MCS Classicare MediOnly (HMO)
(H5577-016)

$0Local HMO *$3,400





2022 Medicare Special Needs Plans in Lares county Puerto Rico

Plan Name ⇅ Monthly
Premium
Part D
Deductible
 Gap  Special Needs
Type
Overall
Rating
Contigo Plus (HMO C-SNP) $0$0ManyChronic or Disabling Condition
Humana Gold Plus SNP-DE H4007-016 (HMO D-SNP) $0$480.0No Gap CoverageDual-Eligible
Humana Gold Plus SNP-DE H4007-018 (HMO D-SNP) $0$480.0No Gap CoverageDual-Eligible
Humana Gold Plus SNP-DE H4007-019 (HMO D-SNP) $0$480.0No Gap CoverageDual-Eligible
Humana Gold Plus SNP-DE H4007-022 (HMO D-SNP) $0$480.0No Gap CoverageDual-Eligible
MCS Classicare CeroCeroCero (HMO C-SNP) $0$0ManyChronic or Disabling Condition
MCS Classicare Platino @Home (HMO D-SNP) $0$480.0No Gap CoverageDual-Eligible
MCS Classicare Platino Ideal (HMO D-SNP) $0$480.0No Gap CoverageDual-Eligible
MCS Classicare Platino MasCa$h (HMO D-SNP) $0$480.0No Gap CoverageDual-Eligible
MCS Classicare Platino Progreso (HMO D-SNP) $0$480.0No Gap CoverageDual-Eligible
MCS Classicare Platino Recarga (HMO D-SNP) $0$480.0No Gap CoverageDual-Eligible
MCS Classicare Platino Solido (HMO D-SNP) $0$480.0No Gap CoverageDual-Eligible
MCS Classicare Primero (HMO C-SNP) $0$0ManyChronic or Disabling Condition
MMM Bono Platino (HMO D-SNP) $0$480.0No Gap CoverageDual-Eligible
MMM Diamante Platino (HMO D-SNP) $0$480.0No Gap CoverageDual-Eligible
MMM Grande Platino (HMO D-SNP) $0$480.0No Gap CoverageDual-Eligible
MMM Integral (HMO C-SNP) $0$0SomeChronic or Disabling Condition
MMM Relax Platino (HMO D-SNP) $0$480.0No Gap CoverageDual-Eligible
MMM Supremo (HMO C-SNP) $0$0SomeChronic or Disabling Condition
MMM Valor Platino (HMO D-SNP) $0$480.0No Gap CoverageDual-Eligible
Platino Advance (HMO D-SNP) $0$480.0No Gap CoverageDual-Eligible
Platino Alcance (HMO D-SNP) $0$480.0No Gap CoverageDual-Eligible
Platino Blindao (HMO D-SNP) $0$480.0No Gap CoverageDual-Eligible
Platino Plus (HMO D-SNP) $0$480.0No Gap CoverageDual-Eligible
Platino Ultra (HMO D-SNP) $0$480.0No Gap CoverageDual-Eligible
PMC Premier Platino (HMO D-SNP) $0$480.0No Gap CoverageDual-Eligible



Plan Type Is the type of organization offering the Medicare Plan.

  • HMO - Health Maintenance Organization
  • PPO - Preferred Provider Organization
  • PDP - Prescription Drug Plan
  • SNP - Special Needs Plan
  • POS - Point of Service
  • PFFS - Private Fee For Service

Monthly Consolidated Premium (Includes Part C + D) Your premium may be lower depending on your eligibility for medical assistance. Call your provider for details.

Part D Total Premium: The Part D Total Premium is the sum of the Basic and Supplemental Premiums. Note: the Part D Total Premium is net of any Part A/B rebates applied to "buy down" the drug premium for Medicare Advantage; for some plans the total premium may be lower than the sum of the basic and supplemental premiums due to negative basic or supplemental premiums.

Benefit Type
  • (EA) Enhanced Alternative may offer additional gap coverage which is calculated as the percentage of generic formulary products with coverage above standard generic coverage gap cost-sharing benefit and/or the percentage of brand formulary products covered in addition to the coverage gap discount for applicable drugs.
  • (DS) Defined Standard Benefit
  • (BA) Basic Alternative
  • (AE) Actuarially Equivalent Standard

GAP
  • Many - Many Generics and Some Brands
  • Some - Some Generics and Few Brands

Maximum Out-of-Pocket (MOOP) limit on enrollee spending that includes costs for all in-network Part A and Part B Services. NOT Part D - prescription drugs. N/A is defined as Not Applicable



Source: CMS. Data as of September 1, 2021.
Plans are subject to change as contracts are finalized.
Includes 2022 approved contracts. Employer sponsored 800 series and plans under sanction are excluded. For 2022, enhanced alternative may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part-D benefit.


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Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options. Enrollment depends on the plan’s contract renewal.

Every year, Medicare evaluates plans based on a 5-star rating system.