MCS Classicare RxMax (HMO)
Medicare Advantage Plan H5577-059 • 2026 • Canovanas Municipio, PR
MCS Classicare RxMax (HMO) Medicare Advantage Plan H5577-059 • 2026 • Canovanas Municipio, PR
This Medicare Advantage HMO plan, identified by CMS Plan ID H5577-059, is offered by MCS Classicare for the 2026 plan year. The plan uses a Health Maintenance Organization (HMO) provider network and comes with prescription coverage (Part D ).
MCS Classicare RxMax Overview
Plan Overview for H5577-059-0 |
|
|---|---|
| CMS Plan ID: | H5577-059-0 |
| Plan Type: | HMO |
| Plan Year: | 2026 |
| Monthly Premium: | $0.00 Plus your Medicare Part B premium. |
| Medical Deductible: | $0.00 |
| Maximum Out-of-Pocket: | $3400.00 (In-Network) |
| Part B Give Back: | −$20.00 reduction |
| Prescription Drug Coverage: | Enhanced, $0.00 deductible |
| Additional Benefits: | Dental, Vision, Hearing |
| Service Area: | Canovanas Municipio, PR |
| Enrollment (Nationwide) | 453 beneficiaries |
| Enrollment (CMS – Local) | 0 beneficiaries in Canovanas Municipio |
| Provided By: | MCS Classicare |
Plan Overview for MCS Classicare RxMax
MCS Classicare RxMax is a Medicare Advantage Prescription Drug (MAPD) Health Maintenance Organization (HMO) plan that includes hospital, medical, and prescription drug coverage under Medicare Parts A and B. The monthly premium is $0.00, and services are generally covered when received from in-network providers, except in emergency situations. The annual Part D deductible is $0.00.
Primary care visits have a $0 copay, specialist visits come with a $0 copay, urgent care services carry a $0 copay, and ambulance transportation is $0 copay. These costs apply toward the maximum out-of-pocket (MOOP) limit of $3400.00. After this limit is reached, in-network services are fully covered for the remainder of the year.
This plan is listed by CMS under Plan ID {title_plan_id}. Cost-sharing details for key services are provided below.
Cost Sharing Expenses
MCS Classicare RxMax has cost-sharing, meaning there are out-of-pocket costs when receiving covered healthcare services. The table below details the most common in-network out-of-pocket expenses for plan H5577-059.
This section outlines in-network costs for primary care and specialist office visits, along with related preventive services.
| Covered Service | In-Network Cost |
|---|---|
| Primary: | In-network: $0 copay |
| Specialist: | In-network: $0 copay |
This section outlines in-network costs for preventive and wellness services included in the plan.
| Covered Service | In-Network Cost |
|---|---|
| Annual wellness exam: | Not covered |
| Telehealth benefit: | In-network: $0 copay |
| Routine chiropractic: | In-network: $0 copay |
| Fitness benefits: | Not covered |
| Health education: | In-network: $0 copay |
| Counseling services: | Not covered |
| Over-the-counter drug benefits: | In-network: $0 copay |
| Health transportation (non-emergency): | In-network: $0 copay |
This section outlines in-network costs for diagnostic services, lab tests, x-rays, and other imaging services.
| Covered Service | In-Network Cost |
|---|---|
| Diagnostic radiology services: | In-network: 0%-20% coinsurance |
| Lab services: | In-network: 0%-20% coinsurance |
| Outpatient x-rays: | In-network: $0 copay |
| Diagnostic tests and procedures: | In-network: 0%-20% coinsurance |
This section outlines in-network costs for emergency services, urgent care, ambulance transportation, inpatient hospital stays, and skilled nursing facility care.
| Covered Service | In-Network Cost |
|---|---|
| Emergency room care: | $40 copay |
| Worldwide emergency care: | $75 copay |
| Urgent care: | $0 copay |
| Inpatient hospital care: | Tier 1 | $0 per stay | Tier 2 | $50 per stay |
| Skilled Nursing Facility: | Tier 1 | Tier 2 | $0 copay |
| Ground ambulance: | In-network: $0 copay |
This section outlines in-network costs for mental health services, including outpatient therapy and inpatient psychiatric care.
| Covered Service | In-Network Cost |
|---|---|
| Outpatient individual therapy: | In-network: $0 copay |
| Outpatient group therapy: | In-network: $0 copay |
| Inpatient psychiatric hospital care: | Tier 1 | $0 per stay | Tier 2 | $50 per stay |
This section outlines in-network costs for rehabilitation services, including physical therapy, speech and language therapy, and occupational therapy.
| Covered Service | In-Network Cost |
|---|---|
| Physical therapy and speech and language therapy: | In-network: $0 copay |
| Occupational therapy: | In-network: $0 copay |
This section outlines in-network costs for medical equipment and supplies, including diabetes supplies, durable medical equipment, and prosthetics.
| Covered Service | In-Network Cost |
|---|---|
| Diabetes supplies: | In-network: $0 copay |
| Durable medical equipment: | In-network: $0 copay |
| Prosthetics: | In-network: 0%-20% coinsurance |
This section outlines in-network cost sharing for chemotherapy and other Medicare Part B-covered drugs.
| Covered Service | In-Network Cost |
|---|---|
| Chemotherapy: | In-network: 0%-20% coinsurance |
| Other Part B drugs (Medicare-covered): | In-network: 0%-20% coinsurance |
This section outlines in-network cost sharing for dental services, including preventive care, exams, x-rays, cleanings, and comprehensive dental procedures.
| Covered Service | In-Network Cost |
|---|---|
| Oral exam: | In-network: $0 copay |
| Dental x-rays: | In-network: $0 copay |
| Cleaning: | In-network: $0 copay |
| Periodontics: | In-network: $0 copay |
| Endodontics: | In-network: $0 copay |
| Restorative services: | In-network: $0 copay |
| Implant services: | In-network: $0 copay |
| Orthodontics: | Not covered |
| Oral/Maxillofacial surgery: | In-network: $0 copay |
This section outlines in-network cost sharing for vision services, including eye exams, eyeglasses, and contact lenses.
| Covered Service | In-Network Cost |
|---|---|
| Routine eye exam: | In-network: $0 copay |
| Contact lenses: | In-network: $0 copay |
| Eyeglass frames only: | In-network: $0 copay |
| Eyeglass lenses only: | In-network: $0 copay |
| Eyeglasses (frames & lenses): | In-network: $0 copay |
| Upgrades: | Not covered |
This section outlines in-network cost sharing for hearing-related services, including exams, fittings, and hearing aids.
| Covered Service | In-Network Cost |
|---|---|
| Hearing exam: | In-network: $0 copay |
| Fitting/evaluation: | In-network: $0 copay |
| Prescription hearing aids: | In-network: $0 copay |
| OTC hearing aids: | Not covered |
This section outlines in-network cost sharing for additional and special needs services that may be included in the plan.
| Covered Service | In-Network Cost |
|---|---|
| Adult day health services: | Not covered |
| Home-based palliative care: | Not covered |
| Personal emergency response system: | Not covered |
| Weight management programs: | Not covered |
| Wigs for chemotherapy-related hair loss: | Not covered |
| Alternative therapies: | In-network: $0 copay |
| Massage therapy: | In-network: $0 copay |
| Home/bathroom safety devices: | Not covered |
Certain preventive services are covered 100% by MCS Classicare RxMax as a Part B benefit.
Prescription Drug Coverage
MCS Classicare RxMax includes a Medicare Part D prescription drug plan (PDP). Plan type and coverage level are defined by CMS and may vary between basic and enhanced benefit designs.
This plan includes an enhanced benefit Medicare Part D plan (PDP), providing coverage beyond the standard CMS-defined minimum.
Prescription Drug Plan Premium
The Part D prescription drug plan premium is included in the overall Medicare Advantage plan cost. Additional adjustments may apply through the Low-Income Subsidy (LIS) program, also known as Extra Help, administered by Social Security. LIS benefits are separate from Medicare Advantage coverage.
| Basic Part D Premium: | $-31.80 |
|---|---|
| Supplemental Part D Premium: | $31.80 |
| Total Part D Premium: | $0.00 |
| Low-Income Premium Subsidy: | $Not Applicable |
| Low-Income Premium Subsidy Paid by CMS: | $0.00 |
| Low-Income Subsidy Premium: | $0.00 |
For more details, visit the Social Security Extra Help program.
Prescription Drug Plan Deductible
This plan has a $0.00 annual Part D deductible. You'll pay this deductible at the pharmacy before MCS Classicare starts contributing towards your prescription costs.
Prescription Drug Plan Out-of-Pocket Costs
Beyond premiums and deductibles, MCS Classicare RxMax may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.
| Drug Tier | Retail | Mail Order |
|---|---|---|
| Preferred Generic | $0.00 copay | Coming soon |
| Generic | $5.00 copay | Coming soon |
| Preferred Brand | $15.00 copay | Coming soon |
| Non-Preferred Drug | $30.00 copay | Coming soon |
| Specialty Tier | 33% coinsurance | Coming soon |
| *Deductible does not apply. | ||
CMS Star Ratings
The Centers for Medicare & Medicaid Services (CMS) rates Medicare Advantage (Part C) and Part D prescription drug plans each year using a 5-star system. These ratings measure plan performance in areas such as preventive care, management of chronic conditions, and member experience.
| CMS Measure | Star Rating |
|---|---|
| 2026 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | |
| Managing Chronic (Long Term) Conditions | |
| Member Experience with Health Plan | |
| Complaints and Changes in Plans Performance | |
| Health Plan Customer Service | |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | |
| Member Experience with the Drug Plan | |
| Drug Safety and Accuracy of Drug Pricing |
How much does plan H5577-059 cost per month?
The plan’s monthly premium is $0.00 for 2026. The Part B premium is not included.
What is the annual out-of-pocket maximum (MOOP) for this plan?
The annual in-network MOOP is $3400.00 for 2026. After this limit is reached, covered in-network services are fully paid.
What is the CMS star rating for MCS Classicare RxMax?
The 2026 CMS star rating for MCS Classicare RxMax is ★5.0 out of 5.
What is the current enrollment for MCS Classicare RxMax?
The plan has 453 enrolled beneficiaries according to CMS.
What is the prescription drug deductible for 2026?
For 2026, the prescription drug deductible is $0.00.
Contact Information for MCS Classicare
| Contact Type | Details |
|---|---|
| Website: | MCS Classicare Plan Page |
| New Members: | 1-866-627-8181 |
| Existing Members: | 1-866-627-8183 |
| Plan Address: | MCS Advantage | PO Box 191720 | San Juan, PR 00919 |
Enrollment status and eligibility information are available through the Social Security Administration. Additional information about Medicare Advantage is available at medicare.gov.
- CMS.gov, Landscape Source Files — Last accessed May 2, 2026
- CMS.gov, Medicare Part C & D Performance — Last accessed May 2, 2026
- CMS.gov, Plan Benefits Package — Last accessed May 2, 2026
- CMS.gov, Monthly Enrollment by Contract/Plan/State/County — Last accessed May 2, 2026
Data sources and methodology documentation..
- MCS Classicare (official source), http://www.mcsclassicare.com — Last accessed October 13, 2025
- Medicare.gov, "Compare types of Medicare Advantage Plans" — Last accessed 25 May, 2025
- NCOA.org, "5 Steps to Choosing the Right Medicare Plan for You" — Last accessed 25 May, 2025
- Medicare.gov, "Compare Original Medicare & Medicare Advantage" — Last accessed 25 May, 2025
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