- Entity
- county:puerto-rico-san-sebastian-72131
- Digest
- 2026-county-ma-aggregate
- Population Scope
- Standard Medicare Advantage plans only; Special Needs Plans (SNPs) excluded
- Source URL
- https://www.medicareplans.com/medicare-advantage/puerto-rico/san-sebastian/
- Glossary Scope
- cms_landscape
- Fragment Scope
- semantic-digest
- Method
- https://webmem.com/protocol/serialization/html/
- fragment-county-plan-index
- Total Standard Medicare Advantage Plans
- 22
- PPO Plans
- 1
- HMO Plans
- 10
- HMO-POS Plans
- 11
- PFFS Plans
- 0
- Average Monthly Premium
- 0.68
- Average MOOP
- 3600.05
- Average Part D Deductible
- 0
- $0 Premium Plans
- 21
- Plans Without Part D Coverage
- 1
- Average CMS Star Rating
- 4.86
- $0 Premium Plan Share
- 95.45
- 5-Star Plan Share
- 82
- 4+ Star Plan Share
- 95
- 3-Star Plan Share
- 5
- Below 3-Star Plan Share
- 0
- Not-Rated Plan Share
- 0
- PPO Average Monthly Premium
- 0
- PPO Average MOOP
- 6751
- PPO Enrollment
- 0
- PPO $0 Premium Plans
- 1
- PPO Plans Without Part D Coverage
- 0
- HMO Average Monthly Premium
- 0
- HMO Average MOOP
- 3560
- HMO Enrollment
- 2686
- HMO $0 Premium Plans
- 10
- HMO Plans Without Part D Coverage
- 1
- HMO-POS Average Monthly Premium
- 1.36
- HMO-POS Average MOOP
- 3350
- HMO-POS Enrollment
- 406
- HMO-POS $0 Premium Plans
- 10
- HMO-POS Plans Without Part D Coverage
- 0
- Entity
- county:puerto-rico-san-sebastian-72131
- Digest
- 2026-county-ma-aggregate
- Population Scope
- Standard Medicare Advantage plans only; Special Needs Plans (SNPs) excluded
- Source URL
- https://www.medicareplans.com/medicare-advantage/puerto-rico/san-sebastian/
- Glossary Scope
- cms_landscape
- Fragment Scope
- semantic-digest
- Method
- https://webmem.com/protocol/serialization/html/
- fragment-puerto-rico-san-sebastian-72131-landscape-stats
- Plans Indexed
- 22
- Standard Medicare Advantage Plans
-
-
MCS Classicare Efectivo
H5577-005-0 -
MCS Classicare En Tu Hogar
H5577-043-0 -
MCS Classicare Essential
H5577-008-0 -
MCS Classicare Excede
H5577-056-1 -
MCS Classicare Firme
H5577-042-0 -
MCS Classicare Hero
H5577-044-0 -
MCS Classicare InteliCare
H5577-052-0 -
MCS Classicare Patriot
H5577-016-0 -
MCS Classicare RxMax
H5577-059-0 -
MMM Balance
H4004-073-1 -
MMM Deluxe
H4003-055-0 -
MMM Elite
H4003-034-0 -
MMM Grandioso
H4004-070-0 -
MMM Mega Flex
H4004-071-0 -
MMM Plenitud
H4004-065-0 -
MMM Unico
H4003-019-0 -
MMM Valioso
H4004-066-0 -
PMC Max
H4004-056-0 -
Ahorro Plus
H5774-047-1 -
Brillante
H5774-031-0 -
Enlace Plus
H5774-038-0 -
Óptimo Plus
H4005-004-0
-
MCS Classicare Efectivo
- Total Standard Medicare Advantage Enrollment
- 3092
2026 Medicare Advantage Plans in San Sebastian Municipio, PR
Last update: .
In San Sebastian Municipio, PR, there are 22 Medicare Advantage plans available for 2026. Of these, 21 offer a $0 monthly premium, and about 95% are rated 4 stars or higher based on CMS quality ratings.
Medicare Advantage Special Needs Plans (SNPs) are not included in the figures shown above. View Special Needs Plans in San Sebastian Municipio, PR. Or explore all Medicare Options available in San Sebastian Municipio, PR.
Medicare Advantage PPO Plans
Preferred Provider Organization (PPO) plans allow access to both in-network and out-of-network providers. Out-of-network care usually costs more, but PPOs offer greater flexibility in choosing doctors and hospitals.
- Total PPO Plans 1
- Average Monthly Premium $0.00/mo
- Total PPO Enrollment 0
- $0 Premium PPO Plans 1
- Average MOOP $6,751
- Top PPO by Enrollment — 0 enrollees
- PPO Plans Without Drug Coverage 0
| Health Plan Name | CMS Rating* | Premium Per Mo | MOOP | PDP Ded. | CMS Plan ID |
|---|---|---|---|---|---|
| Óptimo Plus | $0 | $6,751 | $0 | H4005-004-0 |
What is the total number of PPO plans offered in San Sebastian?
There are 1 PPO plans in 2026, covering 0 beneficiaries.
How much do PPO plans cost in San Sebastian?
The average PPO premium in San Sebastian is $0.00 per month, with 1 plans offering $0 premiums.
What is the most popular PPO plan in San Sebastian?
is the top PPO in San Sebastian, with 0 enrollees.
What is the number of PPO plans without Part D coverage in San Sebastian?
There are 0 PPO plans in San Sebastian without prescription drug coverage.
Medicare Advantage HMO Plans
HMO plans typically require members to use in-network providers and facilities, except in emergencies. In return, HMOs often offer lower monthly premiums and reduced cost-sharing.
- Total HMO Plans
- 10
- Average Monthly Premium
- $0.00/mo
- Total HMO Enrollment
- 2,686
- $0 Premium HMO Plans
- 10
- Average MOOP
- $3,560
- Top HMO by Enrollment
- MCS Classicare Excede (HMO) — 1,305 enrollees
- HMO Plans Without Drug Coverage
- 1
| Health Plan Name | CMS Rating* | Premium Per Mo | MOOP | PDP Ded. | CMS Plan 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 Excede | $0 | $3,400 | $0 | H5577-056-1 | |
| MCS Classicare Firme | $0 | $3,400 | $0 | H5577-042-0 | |
| 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 | H5774-047-1 | |
| Enlace Plus | $0 | $4,200 | $0 | H5774-038-0 |
What is the average monthly premium for HMO plans?
HMO plans in San Sebastian cost $0.00 per month on average.
Which HMO plan is most popular in San Sebastian?
The most popular HMO plan in San Sebastian is MCS Classicare Excede (HMO), with 1,305 enrollees.
How many HMO plans in San Sebastian do not include drug coverage?
There are 1 HMO plans in San Sebastian without prescription drug coverage.
Medicare Advantage HMO-POS Plans
HMO Point-of-Service (HMO-POS) plans combine HMO network rules with limited out-of-network access. Care outside the network typically costs more, but HMO-POS plans provide added flexibility compared with standard HMOs.
| Health Plan Name | CMS Rating* | Premium Per Mo | MOOP | PDP Ded. | CMS Plan ID |
|---|---|---|---|---|---|
| MCS Classicare Essential | $0 | $3,400 | $0 | H5577-008-0 | |
| MMM Balance | $0 | $3,250 | $0 | H4004-073-1 | |
| 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 leading HMO-POS plan in San Sebastian?
MCS Classicare Essential (HMO-POS) is the top HMO-POS in San Sebastian, with 116 enrollees.
What is the number of HMO-POS plans without Part D coverage in San Sebastian?
0 HMO-POS plans in San Sebastian do not include prescription drug coverage.
The table below shows CMS star ratings for Medicare Advantage plans in San Sebastian Municipio, PR for 2026.
| Rating Category | Number of Plans | Percent of Plans |
|---|---|---|
| 5 Stars | 18 | 82% |
| 4 Stars (includes 5 Stars) | 21 | 95% |
| 3 Stars | 1 | 5% |
| Below 3 Stars | 0 | 0% |
| Not Rated | 0 | 0% |
| Average Rating | 4.86 | |
* Medicare Advantage star ratings are determined by CMS each year using a standardized 5-star rating system.
- CMS.gov, Medicare Advantage & Special Needs Plan Landscape Source Files — Version: 202608
- CMS.gov, Medicare Part C & D Performance Data — Version: 2026
- CMS.gov, Medicare Advantage & Part D Contract and Enrollment Data — Version: 2026-08
County-level figures shown on this page, including plan counts, enrollment totals, averages, and percentage distributions, reflect standard Medicare Advantage (MA/MAPD) plans only and are derived from CMS datasets using a standardized aggregation methodology.
Data sources and methodology documentation .
- Medicare.gov, "Compare types of Medicare Advantage Plans" — Last accessed 25 May, 2025
- Medicare.gov, "Your coverage options" — Last accessed 25 May, 2025
- Medicare.gov, "Joining a plan" — Last accessed 25 May, 2025
MedicarePlans.com is an independent, non-government informational resource and is not affiliated with or endorsed by the U.S. Government or the federal Medicare program.
This page follows data provenance practices aligned with the 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.