Medicare Advantage Plans, Rincon Municipio, PR, 2024
We reviewed the top 34 Medicare Advantage Plans available in Rincon Municipio, Puerto Rico for 2024. Here's what we learned:
Key Facts
- The average premium is $2.62 per month.[3]
- The average out-of-pocket limit is $4,126 per year.[3]
- The average drug plan deductible (for plans that include Part D) is $0.00 per year.[3]
- The Centers for Medicare & Medicaid Services (CMS) rated 97% of all plans available in Rincon Municipio 4 stars or higher.[3]
- There are 8 5-star plans available that qualify for the 5-star special enrollment period.
- There are 3 plan types to choose from, including HMO, HMO-POS, PPO, and possibly SNP plans (see: Rincon Municipio, PR Medicare Special Needs Plans.
Rincon Municipio, Puerto Rico Medicare Advantage Plans
Plan Name | Type | Premium | MOOP | Rx Ded. | Rating |
---|---|---|---|---|---|
MCS Classicare Efectivo* | HMO | $0 | $3,400 | $0 | |
MCS Classicare En Tu Hogar* | HMO | $0 | $3,400 | $0 | |
MCS Classicare Essential* | HMO-POS | $0 | $3,400 | $0 | |
MCS Classicare Exacto* | HMO | $0 | $3,400 | $0 | |
MCS Classicare Excede* | HMO | $0 | $3,400 | $0 | |
MCS Classicare Firme* | HMO | $0 | $3,400 | $0 | |
MCS Classicare Hero* | HMO | $0 | $3,400 | $0 | |
MCS Classicare InteliCare* | HMO | $0 | $3,400 | $0 | |
AhorroMax* | HMO | $0 | $3,650 | $0 | |
Basic* | HMO | $0 | $3,650 | N/A | |
Brillante* | HMO-POS | $0 | $3,650 | $0 | |
Enlace Plus* | HMO | $0 | $3,650 | $0 | |
Humana Gold Plus H4007-012* | HMO | $0 | $5,000 | $0 | |
Humana Gold Plus H4007-020* | HMO | $0 | $5,000 | $0 | |
Humana Gold Plus H4007-021* | HMO | $0 | $5,000 | $0 | |
Humana Gold Plus H4007-024* | HMO | $0 | $5,000 | $0 | |
Humana Gold Plus H4007-025* | HMO | $0 | $5,000 | $0 | |
Humana Gold Plus H4007-028* | HMO-POS | $0 | $5,000 | $0 | |
Humana Gold Plus H4007-029* | HMO | $0 | $5,000 | $0 | |
Magno* | HMO-POS | $0 | $3,650 | $0 | |
MCS Classicare Patriot* | HMO | $0 | $3,400 | N/A | |
MMM Balance* | HMO-POS | $0 | $3,250 | $0 | |
MMM Plenitud* | HMO-POS | $0 | $3,250 | $0 | |
MMM Valioso* | HMO-POS | $0 | $3,250 | $0 | |
PMC Max* | HMO-POS | $0 | $3,250 | $0 | |
Real* | HMO | $0 | $3,650 | $0 | |
Triple-S Advantage ?ptimo | PPO | $0 | $6,700 | N/A | |
?ptimo Plus | PPO | $0 | $6,700 | $0 | |
MMM Deluxe | HMO-POS | $0 | $3,250 | $0 | |
MMM Elite | HMO-POS | $0 | $3,250 | $0 | |
MMM Encanto | HMO-POS | $0 | $3,250 | $0 | |
MMM Unico | HMO-POS | $15 | $3,250 | $0 | |
Optimo Xtra | PPO | $30 | $6,700 | $0 | |
HumanaChoice Value H2029-001 | PPO | $44 | $6,700 | $0 | |
*Recognized as one of the top-rated Medicare Advantage plans available in Puerto Rico based on the most recent CMS performance ratings.[4] **Certain PFFS, MSA, and HMO-POS plans have a combined in and out-of-network maximum. Limits are detailed on the plan pages. |
Rincon Municipio, PR
Medicare Advantage Plan Information
In Municipio, Rincon, Medicare Advantage (MA) plans offer a distinct option for people on Medicare. These plans, also referred to as Medicare Part C, are provided by private companies authorized by Medicare, adhering to stringent regulations. Presently, there are 34 MA plans available (not including Special Needs Plans). Many deliver supplementary benefits beyond what Original Medicare provides.
Prescription medication coverage is one of the most popular additional benefits. These plans are also known as Medicare Advantage Prescription Drug Plans (MAPDs). These Rincon Municipio plans offer people on Medicare comprehensive coverage that can help them reduce their out-of-pocket costs.
Medicare Advantage plans in Puerto Rico with a star rating of 4.0 or higher are often the plans people consider first. See: medicarewire.com/medicare-advantage/puerto-rico/
3 Plan Types to Choose in Rincon Municipio
The Medicare Advantage program was created to give people on Medicare (beneficiaries) a choice. To that end, Medicare developed 7 different types of private health plans. In Rincon Municipio, 3 of the 7 types of Medicare Advantage plans are available, as follows:
Plan Type | Description |
---|---|
HMO | Health Maintenance Organization (HMO) members usually receive services through the plan's local network of providers. Referrals are typically required to see a specialist and other providers. However, plans allow out-of-network care for emergencies and out-of-area dialysis. Prescription drug coverage is often included in HMO plans, and many plans include some coverage for dental, vison, and hearing. |
PPO | Preferred Provider Organization (PPO) members can usually use in-network and out-of-network providers for care, including hospitalization. However, visits to non-network providers could cost significantly more. PPO plans often include prescription drug coverage and other benefits, and referrals are typically not required for specialist visits. |
HMO-POS | An HMO-POS (point-of-sale) plan offers the same features as an HMO plan. There is however one major difference. HMO-POS plans allow members to access healthcare providers outside of the plan's network to receive some or all of their services. In most cases, to go out of the plan's network a member will need to get a referral from their physician. Plus, there are separate deductibles for in-network and out-of-network services. |
SNP |
See below. |
Getting Enrolled in a Medicare Advantage Plan
Most people with Medicare in Puerto Rico qualify to join a Medicare Advantage plan. The availability of plans in your area that meet your needs may be the determining factor.
You can join or switch Medicare Advantage plans during a Medicare Election Period. For most people, the Annual Enrollment Period, which starts on October 15 and ends on December 7, is the time they update their plan choices.
There's also an Individual Election Period (IEP) that you can use once. Your IEP is a 7-month period of time around your 65th birthday. It begins three months before you turn 65 and ends three months later. If you have Social Security Disability Insurance (SSDI), your IEP begins on the 25th month.
Adding Prescription Drug Coverage
Some individuals may be eligible to join a standalone prescription drug plan. Otherwise known as a PDP or Part D plan, a standalone prescription drug plan adds prescription coverage to Original Medicare and Medicare Advantage plans that do not include coverage for prescriptions.
It’s important to note that health plans that include prescription drug coverage may disenroll members who sign up for a separate drug plan. You cannot be enrolled in plans with overlapping benefits.
An Option to Medicare Advantage
If you are worried that your Medicare Advantage plan options in Rincon Municipio may not meet your needs, or that Medicare Advantage plans are bad, inconvenient, or will limit your services, there is another way to get more coverage. There are Medicare Supplements available in Puerto Rico, as well as Medicare prescription drug plans. These work hand-in-hand with your Original Medicare to give you more coverage and more flexibility.
A Medicare Supplement protects you from big medical bills and may help you lower the total annual cost of your healthcare. See our directory of supplemental plans to compare supplemental Medicare insurance available in your area. The good news is that all supplemental insurance is standardized, offering you the luxury to buy the coverage you need based on the lowest price.
TIP: Medicare Advantage and Medicare Supplements do not complement each other as insurance options. Medicare Supplements are designed to work with Original Medicare and cannot be purchased while you are actively enrolled in Medicare Advantage.
Special Needs Plans (SNP) in Rincon Municipio
Many people on Medicare have unique health plan needs. This includes institutional care, care for chronic diseases, and access to both Medicare and Medicaid. Consider a Medicare Advantage Special Care Plan (SNP) if you or your loved one has one or more of these special needs.
We organize Medicare Special Needs Plans for Rincon Municipio, Puerto Rico in a separate directory. Although SNP plans are Medicare Advantage plans, they are only available to qualifying individuals, including:
- Individuals in a nursing home or receiving skilled nursing care at home;
- Individuals with both Medicare and Medicaid benefits; and
- Individuals with certain chronic health conditions.
Plan Availability
The MA and MAPD plans on this page are available to people on Medicare enrolled in both Medicare Part A and Part B living in Rincon, and all other areas of Rincon Municipio, Puerto Rico.
Plans Offered
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, GlobalHealth, Health Care Service Corporation, Cigna Healthcare, Humana, Molina Healthcare, Mutual of Omaha, Premera Blue Cross, Medica Central Health Plan, SCAN Health Plan, Scott and White Health Plan now part of Baylor Scott & White Health, UnitedHealthcare(R), and Wellcare.
Citations & References
- CMS.gov, "2024 Medicare Part C Landscape Source Files", Last Accessed October 14, 2023
- CMS.gov, "2024 Part C and D Performance Data", Last Accessed October 14, 2023
- Medicare.gov, "Types of Medicare Advantage Plans", Last Accessed 17 May, 2022
- Medicare.gov, "Special Needs Plans (SNP)", Last Accessed 11 June, 2023
- Medicare.gov, "Learn How Medigap Works", Last Accessed 1 July, 2023
[3]Data & Statistics
The data presented on this page is derived from the 2024 Landscape Source Files and the Part C and D Performance Data published by CMS.
The average premium, average out-of-pocket limit, and average drug plan deductible statistics for Rincon Municipio, Puerto Rico are derived from the most recent Landscape Source Files, excluding employer, MMP and SNP plans. MedicareWire publishes Special Needs Plans here.
Star rating statistics are derived from the most recent Part C and D Performance Data, excluding employer, MMP, SNP, and plans that have not yet been rated by CMS.
[4]Highest-Rated Medicare Advantage Plans
CMS publishes the Medicare Advantage and Medicare Part D Star Ratings each year to measure the quality of health and drug services received by people on Medicare in Rincon Municipio. MedicareWire highlights plans rated 4.0 or better as "highest-rated" or "top-rated" because they received the overall highest summary rating from CMS. According to CMS, "The Star Ratings system helps Medicare consumers compare the quality of Medicare health and drug plans being offered so they are empowered to make the best health care decisions for them."