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Special Needs Plan (Medicare Advantage) · HMO D-SNP · Plan ID H5774-043-1

PLATINO PLUS (HMO D-SNP)

Offered by Triple S Advantage (Guidewell Mutual Holding Corporation) · available in 46 counties in PR

Only for people who have both Medicare and Medicaid.

Monthly premium$0health + drug coverage
Yearly out-of-pocket max$3,650in network
Drug deductible$700Defined Standard
Star Rating★★★★★ 5 out of 52027 CMS rating

Extra benefits listed in the CMS file

Part B premium reductionGives back $202.90 a month toward your Part B premium
DentalPreventive and comprehensive dental, up to $2,400 a year for comprehensive
Visionroutine eye exam; eyewear
Hearingroutine hearing exam; hearing aids, plan pays up to $500 every 3 years
Over-the-counter items$60 per quarter allowance
TransportationRides to health-related locations

Allowances and limits come from the plan's filing with CMS and are simplified here. Some benefits are only for members with certain chronic conditions. The plan's Evidence of Coverage is the final word.

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