Triple S Advantage Brillante (HMO-POS) Medicare Advantage Plan H5774-031 • 2027 • Rincon Municipio, PR
- Monthly Premium
- $0.00Plus Part B premium.
- Medical Deductible
- $0.00
- Maximum Out-of-Pocket
- $4200.00In-network
- Part B Giveback
- −$40.00 reduction
- Prescription Coverage
- Enhanced, $0.00 deductible
- Additional Benefits
- Dental, Vision, Hearing
- Service Area
- Rincon Municipio, PR
- Local Enrollment
- 0 beneficiaries in Rincon Municipio
Triple S Advantage Brillante (HMO-POS) Introduction
Triple S Advantage Brillante is a Medicare Advantage HMO-POS plan offered by Triple S Advantage. It uses a Health Maintenance Organization with a Point of Service (HMO-POS) provider network and comes with prescription drug coverage. For the 2027 plan year it has a $0.00 monthly premium, $0.00 medical deductible, and $4200.00 in-network maximum out-of-pocket. CMS Plan ID H5774-031 identifies this plan. The 2027 Part D prescription drug deductible is $0.00.
You must live in Rincon Municipio, Puerto Rico to enroll in this plan. CMS reports 0 beneficiaries enrolled in this plan in Rincon Municipio. For assistance with this plan, new members can call (833)221-2234 (TTY (866)620-2520).
Compare Similar Plans in Rincon Municipio
Compare this plan with the two most-enrolled HMO-POS plans available in Rincon Municipio, Puerto Rico. Enrollment is based on CMS local enrollment data.
| Plan Detail | Brillante | MMM Balance | MCS Classicare Essential |
|---|---|---|---|
| CMS Plan ID | H5774-031-0 |
H4004-073-1 |
H5577-008-0 |
| Local Enrollment | 0 | 87 | 64 |
| Monthly Premium | $0.00 | $0.00 | $0.00 |
| Medical Deductible | $0.00 | $0.00 | $0.00 |
| Maximum Out-of-Pocket | $4,200.00 | $3,250.00 | $3,400.00 |
| Part B Giveback | −$40.00 reduction | −$52.00 reduction | Not offered |
| Primary Care | $0 copay | $0 copay | $0 copay |
| Specialist | $0-$15 copay | $0-$5 copay | $0 copay |
| Part D Deductible | $0.00 | $0.00 | $0.00 |
| CMS Star Rating | Not yet rated | Not yet rated | Not yet rated |
| Dental | $0 copay | $0 copay | $0 copay |
| Vision | $0 copay | $0 copay | $0 copay |
| Hearing | $0 copay | $0 copay | $0 copay |
Plan Benefits
Triple S Advantage Brillante has cost-sharing, meaning there are out-of-pocket costs when receiving covered healthcare services. The tables below detail the most common in-network out-of-pocket expenses for plan H5774-031.
You can also compare 2027 costs and coverage with last year, side-by-side: Plan H5774-031-0 Cost Compare.
Office Visits
- Primary care
- In-network: $0 copay
Out-of-network: 35% coinsurance - Specialist
- In-network: $0-$15 copay
Out-of-network: 35% coinsurance
Preventive and Wellness Services
- Annual wellness exam
- Not covered
- Telehealth benefit
- In-network: $0-$15 copay
- Routine chiropractic
- In-network: $0-$5 copay
Out-of-network: 35% coinsurance - Fitness benefits
- Coming soon
- Health education
- In-network: $0 copay
- Counseling services
- In-network: $0 copay
- Over-the-counter drug benefits
- In-network: $0 copay
- Health transportation (non-emergency)
- Coming soon
Diagnostic, Lab, and Imaging Services
- Diagnostic radiology services
- In-network: $0-$75 copay
Out-of-network: 35% coinsurance - Lab services
- In-network: 0%-20% coinsurance
Out-of-network: 35% coinsurance - Outpatient x-rays
- In-network: $0 copay
Out-of-network: 35% coinsurance - Diagnostic tests and procedures
- In-network: 0%-20% coinsurance
Out-of-network: 35% coinsurance
Emergency and Urgent Care Services
- Emergency room care
- $50 copay
- Worldwide emergency care
- Coming soon
- Urgent care
- $0 copay
- Inpatient hospital care
- In-network:
Tier 1
$50 per stay
Tier 2
$150 per stay
Out-of-network:
35% per stay - Skilled Nursing Facility
- In-network:
$0 copay
Out-of-network:
35% per stay - Ground ambulance
- In-network: $65 copay
Out-of-network: 35% coinsurance
Mental Health Services
- Outpatient individual therapy
- In-network: $0 copay
Out-of-network: 35% coinsurance - Outpatient group therapy
- In-network: $0 copay
Out-of-network: 35% coinsurance - Inpatient psychiatric hospital care
- In-network:
Tier 1
$50 per stay
Tier 2
$150 per stay
Out-of-network:
35% per stay
Rehabilitation Services
- Physical therapy and speech and language therapy
- In-network: $0 copay
Out-of-network: 35% coinsurance - Occupational therapy
- In-network: $0 copay
Out-of-network: 35% coinsurance
Medical Equipment and Supplies
- Diabetes supplies
- In-network: $0 copay
Out-of-network: 35% coinsurance - Durable medical equipment
- In-network: 0%-10% coinsurance
Out-of-network: 35% coinsurance - Prosthetics
- In-network: 0%-20% coinsurance
Out-of-network: 35% coinsurance
Medicare Part B Drugs
- Chemotherapy
- In-network: 0%-20% coinsurance
Out-of-network: 35% coinsurance - Other Part B drugs (Medicare-covered)
- In-network: 0%-20% coinsurance
Out-of-network: 35% coinsurance
Dental Services
- Oral exam
- In-network: $0 copay
Out-of-network: 35% coinsurance - Dental x-rays
- In-network: $0 copay
Out-of-network: 35% coinsurance - Cleaning
- In-network: $0 copay
Out-of-network: 35% coinsurance - Periodontics
- In-network: $0 copay
Out-of-network: 35% coinsurance - Endodontics
- In-network: $0 copay
Out-of-network: 35% coinsurance - Restorative services
- In-network: $0 copay
Out-of-network: 35% coinsurance - Implant services
- Not covered
- Orthodontics
- Not covered
- Oral/Maxillofacial surgery
- In-network: $0 copay
Out-of-network: 35% coinsurance
Vision Services
- Routine eye exam
- In-network: $0 copay
Out-of-network: 35% coinsurance - Contact lenses
- In-network: $0 copay
Out-of-network: 35% coinsurance - Eyeglass frames only
- In-network: $0 copay
Out-of-network: 35% coinsurance - Eyeglass lenses only
- In-network: $0 copay
Out-of-network: 35% coinsurance - Eyeglasses (frames & lenses)
- In-network: $0 copay
Out-of-network: 35% coinsurance - Upgrades
- In-network: $0 copay
Out-of-network: 35% coinsurance
Hearing Services
- Hearing exam
- In-network: $0 copay
Out-of-network: 35% coinsurance - Fitting/evaluation
- In-network: $0 copay
Out-of-network: 35% coinsurance - Prescription hearing aids
- In-network: $0 copay
Out-of-network: 35% coinsurance - OTC hearing aids
- Not covered
Additional and Special Needs Services
- Adult day health services
- Not covered
- Home-based palliative care
- Not covered
- Personal emergency response system
- Coming soon
- Weight management programs
- Not covered
- Wigs for chemotherapy-related hair loss
- Coming soon
- Alternative therapies
- In-network: $0 copay
Out-of-network: 35% coinsurance - Massage therapy
- Not covered
- Home/bathroom safety devices
- Not covered
Certain preventive services are covered 100% by Triple S Advantage Brillante as a Part B benefit.
Prescription Drug Coverage
Triple S Advantage Brillante 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 Special Needs Plan coverage.
| Part D Premium Component | Amount |
|---|---|
| Basic Part D Premium: | ($11.10) |
| Supplemental Part D Premium: | $$11.10 |
| 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 Triple S Advantage starts contributing towards your prescription costs.
Prescription Drug Plan Out-of-Pocket Costs
Beyond premiums and deductibles, Triple S Advantage Brillante 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 | $0.00 copay | Coming soon |
| Preferred Brand | $10.00 copay | Coming soon |
| Non-Preferred Brand | $40.00 copay | Coming soon |
| Specialty Tier | 33% coinsurance | Coming soon |
| Select Care Drugs | $0.00 copay | Coming soon |
| *Deductible does not apply. | ||
CMS 5-Star Performance Ratings (Contract ID: H5774)
Medicare Advantage (Part C) and Part D plans are rated each year by CMS on a 5-star scale. Ratings summarize plan performance across clinical care and member experience measures.
| CMS Measure | Star Rating |
|---|---|
| 2027 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 |
Contact Information for Triple S Advantage
- Website
- Triple S Advantage Plan Page
- Providers
- Triple S Advantage Providers Page
- Formulary
- Triple S Advantage Formulary Page
- Pharmacy
- Triple S Advantage Pharmacy Page
- New Member Health Plan Help
- (833)221-2234
- New Member Health Plan TTY
- (866)620-2520
- New Member Part D Help
- (833)221-2234
- New Member Part D TTY Users
- (866)620-2520
Enrollment status and eligibility information are available through the Social Security Administration. Additional information about Medicare Advantage is available at Medicare.gov.
Medicare Plan Data Sources and Methodology
| Data Source | Publisher | Last Accessed |
|---|---|---|
| Landscape Source Files | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Medicare Part C & D Performance | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Plan Benefits Package | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Monthly Enrollment by Contract/Plan/State/County | Centers for Medicare & Medicaid Services | October 5, 2026 |
Data sources and methodology documentation.
| Publisher | Reference | Last Accessed |
|---|---|---|
| Triple S Advantage (official source) | http://www.sssadvantage.com | October 4, 2026 |
| Medicare.gov | Compare types of Medicare Advantage Plans | 25 May, 2025 |
| Medicare.gov | Joining a plan | 25 May, 2025 |
| Medicare.gov | Explore your Medicare coverage options | 25 May, 2025 |
MedicarePlans.com operates as an independent, non-government informational resource and is not affiliated with or endorsed by the U.S. Government or the federal Medicare program.
Provenance documentation for this data is maintained under the U.S. Core Data for Interoperability (USCDI) Provenance standard.
Page content independently curated and maintained by David W. Bynon, Editorial Steward, using a standardized, data-driven methodology for accurate, non-commercial Medicare plan interpretation and resolution.