PLATINO PLUS (HMO D-SNP)
TRIPLE S ADVANTAGE, INC. · 2026 plan year
Plan ID H5774-043-004
HMO★ 4.5 CMS StarsDual-Eligible SNP
- MOOP (in-network)
- $3,650
- MOOP (combined)
- —
- Monthly premium
- $0/mo
- Part C $0 + Part D $0
- Prescription drugs
- Included
This plan in 2027
- PLATINO PLUS (HMO D-SNP)
There are several regional versions of this plan in 2027. Open it to find the one for your area.
Plan information
- Contract / Plan / Segment
- H5774-043-004
- Medical deductible
- $0 — no deductible
- Part D premium
- $0/mo (part of the monthly premium above)
- Part D deductible
- $615/yr
- Also owed
- Your Medicare Part B premium, paid separately
Other segments for this plan:
More TRIPLE S ADVANTAGE, INC. plans in PR
Benefits & cost sharing
Primary Care
| Benefit | In-network |
|---|---|
| Chiropractic — Routine Care | No charge |
Hospital
| Benefit | In-network |
|---|---|
| Inpatient Hospital — Acute | No charge |
| Inpatient Hospital — Additional Days (Acute) | No charge |
| Inpatient Hospital — Psychiatric | No charge |
| Worldwide Urgent Care Coverage | No charge |
Pharmacy
| Benefit | In-network |
|---|---|
| Part B Drugs | See plan details |
| Chemotherapy & Radiation Drugs (Part B) | No charge |
| Other Part B Drugs | No charge |
Mental Health
| Benefit | In-network |
|---|---|
| Mental Health Specialty Services | See plan details |
| Mental Health — Individual Sessions | No charge |
| Mental Health — Group Sessions | No charge |
| Supplemental Health Benefits | See plan details |
Other
| Benefit | In-network |
|---|---|
| Skilled Nursing Facility (SNF) | No charge |
| Cardiac & Pulmonary Rehabilitation | See plan details |
| Cardiac Rehabilitation — Additional Sessions | No charge |
| Intensive Cardiac Rehabilitation — Additional Sessions | No charge |
| Pulmonary Rehabilitation — Additional Sessions | No charge |
| Supervised Exercise Therapy (SET) | No charge |
| Outpatient Substance Abuse Services | See plan details |
| Emergency Services | No charge |
| Urgently Needed Services | No charge |
| Worldwide Emergency & Urgent Coverage | See plan details |
| Worldwide Emergency Coverage | No charge |
| Partial Hospitalization Program | No charge |
| Intensive Outpatient Program (IOP) | No charge |
| Home Health Services | No charge |
| Primary Care Physician Services | No charge |
| Chiropractic Services | No charge |
| Chiropractic Services | See plan details |
| Occupational Therapy Services | No charge |
| Physician Specialist Services | No charge |
| Podiatry Services | No charge |
| Podiatry Services | No charge |
| Other Health Care Professional Services | No charge |
| Psychiatric Services | See plan details |
| Psychiatric Services — Individual Sessions | No charge |
| Psychiatric Services — Group Sessions | No charge |
| Physical Therapy & Speech-Language Pathology | No charge |
| Additional Telehealth Services (Part B) | No charge |
| Opioid Treatment Program Services | No charge |
| Diagnostic Tests & Lab Services | See plan details |
| Diagnostic Procedures & Tests | No charge |
| Laboratory Services | No charge |
| Radiological Services | See plan details |
| Diagnostic Radiology | No charge |
| Therapeutic Radiology | No charge |
| X-Ray Services | No charge |
| Outpatient Hospital Services | No charge |
| Hospital Observation Services | No charge |
| Ambulatory Surgical Center (ASC) | No charge |
| Outpatient Blood Services | No charge |
| Ambulance Services | See plan details |
| Ground Ambulance | No charge |
| Air Ambulance | No charge |
| Non-Emergency Transportation — Any Health Location | No charge |
| Durable Medical Equipment (DME) | No charge |
| Prosthetics & Orthotics | See plan details |
| Prosthetic Devices | 0%-5% coinsurance |
| Medical Supplies | No charge |
| Diabetic Supplies & Services | See plan details |
| Diabetic Supplies | No charge |
| Diabetic Therapeutic Shoes & Inserts | No charge |
| Dialysis Services | No charge |
| Acupuncture | No charge |
| Over-the-Counter (OTC) Items | No charge |
| Health Education | No charge |
| Nutritional & Dietary Benefit | No charge |
| Remote Access Technologies | No charge |
| Counseling Services | No charge |
| Alternative Therapies | No charge |
| Kidney Disease Education Services | No charge |
| Glaucoma Screening | No charge |
| Diabetes Self-Management Training | No charge |
| Digital Rectal Exams | No charge |
| Welcome to Medicare EKG | No charge |
| Insulin (Part B) | No charge |
| Dental — Medicare-Covered Services | No charge |
| Dental — Comprehensive | See plan details |
| Dental — Restorative Services | No charge |
| Dental — Endodontics (Root Canal) | No charge |
| Dental — Periodontics (Gum Care) | No charge |
| Dental — Removable Prosthodontics (Dentures) | No charge |
| Dental — Implant Services | No charge |
| Dental — Fixed Prosthodontics (Bridges) | No charge |
| Dental — Oral & Maxillofacial Surgery | No charge |
| Dental — Adjunctive General Services | No charge |
| Vision — Eye Exams | No charge |
| Vision — Routine Eye Exams | No charge |
| Vision — Other Eye Services | No charge |
| Vision — Eyewear | No charge |
| Hearing — Exams | No charge |
| Hearing — Exams | See plan details |
| Hearing — Routine Exams | No charge |
| Hearing — Fitting & Evaluation for Hearing Aid | No charge |
| Hearing — Prescription Hearing Aids | See plan details |
| Hearing — Hearing Aids (All Types) | No charge |
| Substance Abuse — Individual Sessions | No charge |
| Substance Abuse — Group Sessions | No charge |
| Medicare-Covered Preventive Services | See plan details |
| Vision — Eye Exams | See plan details |
| Vision — Eyewear | See plan details |
| Vision — Contact Lenses | No charge |
| Vision — Eyeglasses (Lenses & Frames) | No charge |
| Vision — Eyeglass Lenses | No charge |
| Vision — Eyeglass Frames | No charge |
| Vision — Eyewear Upgrades | No charge |
Service area
- PR: 11 counties
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