MMM Unico (HMO-POS) Medicare Advantage Plan H4003-019 • 2026 • San Sebastian Municipio, PR

MMM Unico Overview

Plan Details for MMM Unico

This Medicare Advantage Prescription Drug (MAPD) HMO-POS plan includes hospital, medical, and prescription drug coverage under Medicare Parts A and B. The monthly premium is $15.00, and the plan provides coverage through a network of participating providers, with limited access to out-of-network services in certain situations. The annual Part D deductible is $0.00.

Primary care visits have a $0 copay | Out-of-network: 20% coinsurance, specialist visits come with a $0 copay | Out-of-network: 20% coinsurance, urgent care services carry a $0 copay, and ambulance transportation is $0 copay | Out-of-network: 20% coinsurance. These costs apply toward the maximum out-of-pocket (MOOP) limit of $3250.00. Once 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 H4003-019. Cost-sharing details are provided below.

Cost-Sharing Overview

MMM Unico includes cost-sharing, which refers to out-of-pocket expenses for covered healthcare services. The table below outlines the most common in-network out-of-pocket costs associated with plan H4003-019.

Certain preventive services are covered 100% by MMM Unico as a Part B benefit.

Prescription Drug Coverage

MMM Unico 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 Special Needs 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.

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 Medicare y Mucho Mas (MMM) starts contributing towards your prescription costs.

Prescription Drug Plan Out-of-Pocket Costs

Beyond premiums and deductibles, MMM Unico may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.

Medicare Plan Star Ratings

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.