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Puerto Rico · 2027 plan year

Medicare Advantage HMO plans in Puerto Rico

There are 62 Medicare Advantage HMO plans in Puerto Rico from 3 carriers, averaging 4.80 out of 5 stars across the 62 plans CMS has rated. Every one with a published premium charges $0 a month, so what separates them is network, drug coverage and how much you could owe in a bad year.

62
HMO plans
3
Carriers
78
Counties covered
4.8
Average stars
$3,400
Median out-of-pocket max

Across the 62 HMO plans in Puerto Rico that publish one, the in-network out-of-pocket maximum has a median of $3,400 and tops out at $4,200 — the ceiling on what you pay in a year for covered in-network care. The mean is $3,407, which sits above the median — the spread is not symmetric, so the median is the better guide.

A $0 plan premium is not a free plan. You still pay your Part B premium to Medicare, plus copays and coinsurance as you use care. Star ratings are published by CMS per contract, so every plan a carrier files under the same contract shares one rating — it describes the carrier’s performance, not this specific plan’s benefits. Estimate your real costs.

Puerto Rico has 37 five-star Medicare Advantage HMO plans.

Of the 62 HMO plans here, 37 carry CMS's top overall rating of 5 stars and 62 rate 4 or above. That matters beyond quality: a 5-star plan can be joined at almost any point in the year through a special enrollment period, rather than only during the autumn window.

Puerto Rico HMO plans rate well above the national average.

Averaged across the 62 rated plans here, HMO coverage in Puerto Rico scores 4.80 stars against a national median of 3.75 for this plan type — 1st highest of 49 states. Star ratings measure the contract's performance on care quality, member experience and complaints.

Not sure whether Medicare Advantage suits you at all? Medicare Advantage vs Original Medicare covers the trade in plain language.

Highest rated

Top-rated HMO plans in Puerto Rico

PlanStarsOut-of-pocket maxPremium / mo
Platino Vita Plus (HMO D-SNP)Triple S Advantage · Dual-Eligible SNP5★$0$0
MCS Classicare Efectivo (HMO)MCS Classicare5★$3,400$0
MCS Classicare En Tu Hogar (HMO)MCS Classicare5★$3,400$0
MCS Classicare Essential (HMO-POS)MCS Classicare5★$3,400$0
MCS Classicare Estrella (HMO)MCS Classicare5★$3,400$0

Showing 5 of 62. See all Puerto RicoMedicare Advantage plans →

Who sells here

HMO plans by carrier

CarrierPlansAvg starsSNPs
Medicare y Mucho Mas (MMM)Elevance Health, Inc.254.511
MCS ClassicareMHH Healthcare, L.P.215.09
Triple S AdvantageGuidewell Mutual Holding Corporation165.011
Other plan types in Puerto Rico

How HMO compares

HMO
4.8★ avg · 3 carriers
62 plans · you are here
PPO
4.5★ avg · 1 carriers
1 plans

All Puerto RicoMedicare Advantage plans →

Nearby on quality

States with similar HMO star ratings

Hawaii
4.25★ average
18 HMO plans
Florida
4.15★ average
474 HMO plans
Common questions

Puerto Rico Medicare Advantage HMO plans, answered

How much do Medicare Advantage HMO plans cost in Puerto Rico?
Of the Puerto Rico HMO plans with a published premium, 100% charge $0 a month. The monthly premium is what you pay the plan for its medical (Part C) and drug (Part D) coverage together. A $0 premium does not mean the plan is free: you still pay your Part B premium to Medicare, plus copays and coinsurance as you use care. The number that actually caps a bad year is the in-network out-of-pocket maximum, with a median of $3,400 across these plans.
What are the star ratings for Puerto Rico HMO plans?
The 62 rated HMO plans in Puerto Rico average 4.80 out of 5 stars, with 62 rating 4 or better and 37 rating a full 5. CMS rates a contract rather than an individual plan, so every plan a carrier files under the same contract shares one score. A contract that is too new or has too little data is not rated at all, which is different from rating badly.
How many Medicare Advantage HMO plans are available in Puerto Rico?
There are 62 HMO plans from 3 carriers, sold across 78 counties. Availability is set by county, so the plans you can actually join depend on where you live — the full list is rarely available in any one place. 31 of them are Special Needs Plans with extra eligibility rules (see below).
Do Puerto Rico HMO plans include prescription drug coverage?
60 of the 62 HMO plans here bundle Part D drug coverage into the plan. That is the usual arrangement for Medicare Advantage, and you pay one monthly premium to the plan — but that premium has a medical (Part C) part and a drug (Part D) part, and the drug part is often what makes it more than $0. Each plan's page shows both. If you join a Medicare Advantage plan without drug coverage, you generally cannot add a standalone Part D plan alongside it.
What is a Special Needs Plan, and are there any in Puerto Rico?
31 of the 62 HMO plans in Puerto Rico are Special Needs Plans. SNPs limit enrollment to people who also have Medicaid, live in a nursing home or similar institution, or have a qualifying chronic condition. They often carry richer benefits for that group, but if you do not meet the criteria you cannot join one — so the real number of plans open to you may be lower than the total.

A $0 premium is not the whole cost.
See what a year really looks like.

Simplivera models your actual annual costs across Puerto Rico Medicare Advantage plans.

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