2026 Medicare Advantage Plans in San Juan Municipio, PR
Last update: . Enrollment data updated: May 2, 2026
For 2026, San Juan Municipio, PR includes 21 Medicare Advantage plans. Enrollment across these plans totals approximately 26,985, with 20 $0 premium options and 95% rated 4 stars or higher.
This page and its statistics exclude Medicare Advantage Special Needs Plans (SNPs). Special Needs Plans in San Juan Municipio, PR are summarized separately. Visit Medicare Options in San Juan Municipio, PR to see more options.
Medicare Advantage PPO Plans
Preferred Provider Organization (PPO) plans allow members to choose care from both in-network and out-of-network providers. Out-of-network care usually costs more, but PPOs offer greater flexibility in how members access care.
- Total PPO Plans
- 1
- Average Monthly Premium
- $0.00/mo
- Total PPO Enrollment
- 850
- $0 Premium PPO Plans
- 1
- Average MOOP
- $6,751
- Top PPO by Enrollment
- Óptimo Plus (PPO) — 850 enrollees
- PPO Plans Without Drug Coverage
- 0
| Plan Name | CMS Stars* | Premium/Mo | MOOP | Rx Ded. | CMS ID |
|---|---|---|---|---|---|
| Óptimo Plus | $0 | $6,751 | $0 | H4005-004-0 |
- What is the average monthly premium for PPO plans in San Juan?
- PPO plans in San Juan cost $0.00 per month on average.
- Which PPO plan has the highest enrollment in San Juan?
- The most popular PPO plan in San Juan is Óptimo Plus (PPO), with 850 enrollees.
- How many PPO plans in San Juan do not include prescription drug coverage?
- 0 PPO plans in San Juan do not include prescription drug coverage.
Medicare Advantage HMO Plans
Health Maintenance Organization (HMO) plans are built around a defined network of doctors and hospitals. Care is generally covered only within the network, except in emergencies, but this structure often results in lower premiums and out-of-pocket costs.
| Plan Name | CMS Stars* | Premium/Mo | MOOP | Rx Ded. | CMS ID |
|---|---|---|---|---|---|
| MCS Classicare Efectivo | $0 | $3,400 | $0 | H5577-005-0 | |
| MCS Classicare En Tu Hogar | $0 | $3,400 | $0 | H5577-043-0 | |
| MCS Classicare Estrella | $0 | $3,400 | $0 | H5577-060-0 | |
| MCS Classicare Hero | $0 | $3,400 | $0 | H5577-044-0 | |
| MCS Classicare InteliCare | $0 | $3,400 | $0 | H5577-052-0 | |
| MCS Classicare Patriot | $0 | $3,400 | N/A | H5577-016-0 | |
| MCS Classicare RxMax | $0 | $3,400 | $0 | H5577-059-0 | |
| Ahorro Plus | $0 | $4,200 | $0 | H5774-047-4 | |
| Enlace Plus | $0 | $4,200 | $0 | H5774-038-0 |
What is the total number of HMO plans offered in San Juan?
There are 9 HMO plans in 2026, covering 13,788 enrollees.
How much do HMO plans cost in San Juan?
The average HMO premium in San Juan is $0.00 per month, with 9 plans offering $0 premiums.
What is the top HMO by enrollment in San Juan?
MCS Classicare Estrella (HMO) is the top HMO in San Juan, with 4,348 enrollees.
What is the number of HMO plans without Part D coverage in San Juan?
1 HMO plans in San Juan do not include prescription drug coverage.
Medicare Advantage HMO-POS Plans
HMO-POS plans are structured like HMOs, requiring in-network care for the lowest costs, while allowing limited out-of-network access at higher cost. This provides added flexibility compared with standard HMO plans.
- Total HMO-POS Plans
- 11
- Average Monthly Premium
- $1.36/mo
- Total HMO-POS Enrollment
- 12,347
- $0 Premium HMO-POS Plans
- 10
- Average MOOP
- $3,350
- Top HMO-POS by Enrollment
- MCS Classicare Essential (HMO-POS) — 3,632 enrollees
- HMO-POS Plans Without Drug Coverage
- 0
| Plan Name | CMS Stars* | Premium/Mo | MOOP | Rx Ded. | CMS ID |
|---|---|---|---|---|---|
| MCS Classicare Essential | $0 | $3,400 | $0 | H5577-008-0 | |
| MMM Balance | $0 | $3,250 | $0 | H4004-073-3 | |
| MMM Deluxe | $0 | $3,250 | $0 | H4003-055-0 | |
| MMM Elite | $0 | $3,250 | $0 | H4003-034-0 | |
| MMM Grandioso | $0 | $3,250 | $0 | H4004-070-0 | |
| MMM Mega Flex | $0 | $3,250 | $0 | H4004-071-0 | |
| MMM Plenitud | $0 | $3,250 | $0 | H4004-065-0 | |
| MMM Unico | $15 | $3,250 | $0 | H4003-019-0 | |
| MMM Valioso | $0 | $3,250 | $0 | H4004-066-0 | |
| PMC Max | $0 | $3,250 | $0 | H4004-056-0 | |
| Triple S Advantage Brillante | $0 | $4,200 | $0 | H5774-031-0 |
What is the average monthly premium for HMO-POS plans?
HMO-POS plans in San Juan cost $1.36 per month on average.
Which HMO-POS plan is most popular in San Juan?
The most popular HMO-POS plan in San Juan is MCS Classicare Essential (HMO-POS), with 3,632 enrollees.
How many HMO-POS plans in San Juan do not include drug coverage?
There are 0 HMO-POS plans in San Juan without prescription drug coverage.
CMS quality ratings for Medicare Advantage plans in San Juan Municipio, PR (2026) are summarized below.
| Rating Category | Number of Plans | Percent of Plans |
|---|---|---|
| 5 Stars | 17 | 81% |
| 4 Stars (includes 5 Stars) | 20 | 95% |
| 3 Stars | 1 | 5% |
| Below 3 Stars | 0 | 0% |
| Not Rated | 0 | 0% |
| Average Rating | 4.86 | |
* CMS assigns Medicare Advantage star ratings annually based on plan quality and performance measures.
- CMS.gov, Medicare Advantage Landscape Source Files — Last accessed May 2, 2026
- CMS.gov, Medicare Part C & D Performance Data — Last accessed May 2, 2026
- CMS.gov, Medicare Advantage & Part D Contract and Enrollment Data — Last accessed May 2, 2026
All plan counts, enrollment totals, averages, and percentage distributions are calculated at the county level using CMS data and include standard Medicare Advantage (MA/MAPD) plans only, based on a consistent aggregation methodology.
Data sources and methodology documentation .
- Medicare.gov, "Understanding Medicare Advantage Plans" — Last accessed 25 May, 2025
- Medicare.gov, "Compare Original Medicare & Medicare Advantage" — Last accessed 25 May, 2025
- NCOA.org, "5 Steps to Choosing the Right Medicare Plan for You" — Last accessed 25 May, 2025
MedicarePlans.com is an independent informational resource and has no affiliation with, or endorsement from, the U.S. Government or the federal Medicare program.
Data provenance is documented in accordance with 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.