PMC Premier Platino (HMO D-SNP) Medicare Special Need Plan H4004-048 • 2027
- Monthly Premium
- $0.00Plus Part B premium.
- Medical Deductible
- $0.00
- Maximum Out-of-Pocket
- $3250.00In-network
- Part B Giveback
- −$29.00 reduction
- Prescription Coverage
- Basic, $700.00 deductible
- Additional Benefits
- Dental, Vision, Hearing
- Service Area
- See List
- Total Enrollment
- 5,847 beneficiaries
Introduction
PMC Premier Platino is a Medicare Advantage Dual-Eligible Special Needs Plan (D-SNP) offered by Medicare y Mucho Mas (MMM). The plan uses a Health Maintenance Organization (HMO) provider network and includes Medicare Part D prescription drug coverage. For the 2027 plan year, it has a $0.00 monthly premium, $0.00 medical deductible, and $3250.00 in-network maximum out-of-pocket. CMS Plan ID H4004-048 identifies this plan. The 2027 Part D prescription drug deductible is $700.00.
CMS reports 5,847 beneficiaries enrolled across all service areas. You must live in the plan's service area to enroll: See List.
Eligibility
PMC Premier Platino is a Dual Eligible Special Needs Plan (D-SNP) designed for individuals enrolled in both Medicare and Medicaid.
- Special Needs Plan Type
- Dual-Eligible Special Needs Plan (D-SNP)
- Medicare Requirement
- Medicare Part A and Part B
- Special Needs Requirement
- Must qualify for Medicaid
- Service Area Requirement
- Must live in the plan's service area
- Prescription Drug Coverage
- Medicare Part D prescription drug coverage is included.
Plan Benefits
PMC Premier Platino 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 H4004-048.
Compare 2027 plan benefits with 2026.
Office Visits
| Covered Service | 2027 | 2026 |
|---|---|---|
| Primary care | In-network: $0 copay | In-network: $0 copay |
| Specialist | In-network: $0 copay | In-network: $0 copay |
Preventive and Wellness Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Annual wellness exam | Not covered | Not covered |
| Telehealth benefit | In-network: $0 copay | In-network: $0 copay |
| Routine chiropractic | In-network: $0 copay | In-network: $0 copay |
| Fitness benefits | Coming soon | In-network: $0 copay |
| Health education | In-network: $0 copay | In-network: $0 copay |
| Counseling services | Not covered | Not covered |
| Over-the-counter drug benefits | In-network: $0 copay | In-network: $0 copay |
| Health transportation (non-emergency) | Coming soon | In-network: $0 copay |
Diagnostic, Lab, and Imaging Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Diagnostic radiology services | In-network: $0 copay | In-network: $0 copay |
| Lab services | In-network: $0 copay | In-network: $0 copay |
| Outpatient x-rays | In-network: $0 copay | In-network: $0 copay |
| Diagnostic tests and procedures | In-network: $0 copay | In-network: $0 copay |
Emergency and Urgent Care Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Emergency room care | $0 copay | $0 copay |
| Worldwide emergency care | Coming soon | $75 copay |
| Urgent care | $0 copay | $0 copay |
| Inpatient hospital care | Tier 1 $0 per stay |
Tier 1 $0 per stay |
| Skilled Nursing Facility | $0 copay | Tier 1 Tier 2 $0 copay |
| Ground ambulance | In-network: $0 copay | In-network: $0 copay |
Mental Health Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Outpatient individual therapy | In-network: $0 copay | In-network: $0 copay |
| Outpatient group therapy | In-network: $0 copay | In-network: $0 copay |
| Inpatient psychiatric hospital care | Tier 1 $0 per stay |
Tier 1 $0 per stay |
Rehabilitation Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Physical therapy and speech and language therapy | In-network: $0 copay | In-network: $0 copay |
| Occupational therapy | In-network: $0 copay | In-network: $0 copay |
Medical Equipment and Supplies
| Covered Service | 2027 | 2026 |
|---|---|---|
| Diabetes supplies | In-network: $0 copay | In-network: $0 copay |
| Durable medical equipment | In-network: $0 copay | In-network: $0 copay |
| Prosthetics | In-network: $0 copay | In-network: $0 copay |
Medicare Part B Drugs
| Covered Service | 2027 | 2026 |
|---|---|---|
| Chemotherapy | In-network: $0 copay | In-network: $0 copay |
| Other Part B drugs (Medicare-covered) | In-network: $0 copay | In-network: $0 copay |
Dental Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Oral exam | Not covered | Not covered |
| Dental x-rays | Not covered | Not covered |
| Cleaning | Not covered | Not covered |
| Periodontics | Not covered | Not covered |
| Endodontics | Not covered | Not covered |
| Restorative services | In-network: $0 copay | In-network: $0 copay |
| Implant services | In-network: $0 copay | In-network: $0 copay |
| Orthodontics | Not covered | Not covered |
| Oral/Maxillofacial surgery | Not covered | Not covered |
Vision Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Routine eye exam | Not covered | Not covered |
| Contact lenses | In-network: $0 copay | In-network: $0 copay |
| Eyeglass frames only | Not covered | Not covered |
| Eyeglass lenses only | Not covered | Not covered |
| Eyeglasses (frames & lenses) | In-network: $0 copay | In-network: $0 copay |
| Upgrades | Not covered | Not covered |
Hearing Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Hearing exam | Not covered | Not covered |
| Fitting/evaluation | In-network: $0 copay | In-network: $0 copay |
| Prescription hearing aids | In-network: $0 copay | In-network: $0 copay |
| OTC hearing aids | Not covered | Not covered |
Additional and Special Needs Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Adult day health services | Not covered | Not covered |
| Home-based palliative care | Not covered | Not covered |
| Personal emergency response system | Coming soon | Not covered |
| Weight management programs | Not covered | Not covered |
| Wigs for chemotherapy-related hair loss | Coming soon | Not covered |
| Alternative therapies | In-network: $0 copay | In-network: $0 copay |
| Massage therapy | Not covered | Not covered |
| Home/bathroom safety devices | In-network: $0 copay | In-network: $0 copay |
Certain preventive services are covered 100% by PMC Premier Platino as a Part B benefit.
Prescription Drug Coverage
PMC Premier Platino 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.
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: | $0.00 |
| Supplemental Part D Premium: | $0.00 |
| 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 $700.00 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, PMC Premier Platino may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.
| Drug Tier | Retail | Mail Order |
|---|---|---|
| Brand-name drugs | 25% coinsurance | 25% coinsurance |
| Generic drugs | 25% coinsurance | 25% coinsurance |
| *Deductible does not apply. | ||
CMS 5-Star Performance Ratings (Contract ID: H4004)
CMS star ratings reflect how well a Medicare plan performs across key quality measures, such as managing chronic conditions, member satisfaction, and customer service. Ratings range from 1 to 5 stars and are updated each year by Medicare.
| 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 Medicare y Mucho Mas (MMM)
- Website
- Medicare y Mucho Mas (MMM) Plan Page
- Providers
- Medicare y Mucho Mas (MMM) Providers Page
- Formulary
- Medicare y Mucho Mas (MMM) Formulary Page
- Pharmacy
- Medicare y Mucho Mas (MMM) Pharmacy Page
- New Member Health Plan Help
- (833)668-2402
- New Member Health Plan TTY
- 711
- New Member Part D Help
- (833)668-2401
- New Member Part D TTY Users
- 711
Enrollment status and eligibility information are available through the Social Security Administration. Additional information about Medicare Advantage is available at Medicare.gov.
Plan Availability
PMC Premier Platino (H4004-048-0) is available in the following locations (click to open):
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 |
|---|---|---|
| Medicare y Mucho Mas (MMM) (official source) | http://www.mmmpr.com | October 4, 2026 |
| CMS.gov | Dual Eligible Special Needs Plans (D-SNPs) | April 28, 2026 |
| CMS.gov | Medicare Advantage Plan Fact Sheet | April 28, 2026 |
| Medicare.gov | Joining a plan | April 28, 2026 |
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.
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.