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MMM Flexi Platino (HMO D-SNP) H4004-069 • 2026 • Manati Municipio, PR

CMS Rating: ☆☆☆☆☆ (5.0 out of 5 stars*)

MMM Flexi Platino is a Medicare Dual-Eligible plan offered by Medicare y Mucho Mas (MMM) for the 2026 plan year. It is identified by CMS Plan ID H4004-069 and serves individuals who meet defined eligibility criteria.

Last update:

MMM Flexi Platino Overview

2026 Medicare Special Needs Plan Overview for H4004-069-0
Plan Overview for H4004-069-0
CMS Plan ID: H4004-069-0
Plan Type: HMO D-SNP
Plan Year: 2026
Monthly Premium: $0.00
Plus your Medicare Part B premium.
Medical Deductible: $0.00
Maximum Out-of-Pocket: $3250.00 (In-Network)
Part B Give Back: Not offered
Prescription Drug Coverage: Basic, $615.00 deductible
Additional Benefits: Dental, Vision, Hearing
Service Area: Manati Municipio, PR
Enrollment (Nationwide): 285 beneficiaries
Enrollment (CMS – Local)0 beneficiaries in Manati Municipio
Provided By: Medicare y Mucho Mas (MMM)

Plan Overview and Eligibility

MMM Flexi Platino is a Medicare D-SNP plan for dual-eligible beneficiaries (Medicare and Medicaid).

Eligibility requirements for MMM Flexi Platino (H4004-069-0)
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.

This plan uses a Health Maintenance Organization (HMO) network, meaning covered services are primarily provided by in-network doctors and facilities. Referrals are typically required for specialist care. Emergency services and out-of-area dialysis are covered outside the network.

Covered Services & Costs

This section outlines in-network costs for primary care and specialist office visits, along with related preventive services.

In-network cost sharing for primary and specialist office visits.
Covered Service In-Network Cost
Primary: In-network: $0 copay
Specialist: In-network: $0 copay

This section outlines in-network costs for preventive and wellness services included in the plan.

In-network cost sharing for preventive and wellness services.
Covered Service In-Network Cost
Annual wellness exam: Not covered
Telehealth benefit: In-network: $0 copay
Routine chiropractic: In-network: $0 copay
Fitness benefits: Not covered
Health education: In-network: $0 copay
Counseling services: Not covered
Over-the-counter drug benefits: Not covered
Health transportation (non-emergency): In-network: $0 copay

This section outlines in-network costs for diagnostic services, lab tests, x-rays, and other imaging services.

In-network cost sharing for diagnostic, lab, and imaging services.
Covered Service In-Network Cost
Diagnostic radiology services: In-network: $0 copay
Lab services: In-network: $0 copay
Outpatient x-rays: In-network: $0 copay
Diagnostic tests and procedures: In-network: $0 copay

This section outlines in-network costs for emergency services, urgent care, ambulance transportation, inpatient hospital stays, and skilled nursing facility care.

In-network cost sharing for emergency, urgent care, and inpatient hospital services.
Covered Service In-Network Cost
Emergency room care: $0 copay
Worldwide emergency care: $75 copay
Urgent care: $0 copay
Inpatient hospital care: Tier 1 | $0 per stay
Skilled Nursing Facility: Tier 1 | Tier 2 | $0 copay
Ground ambulance: In-network: $0 copay

This section outlines in-network costs for mental health services, including outpatient therapy and inpatient psychiatric care.

In-network cost sharing for mental health services.
Covered Service In-Network Cost
Outpatient individual therapy: In-network: $0 copay
Outpatient group therapy: In-network: $0 copay
Inpatient psychiatric hospital care: Tier 1 | $0 per stay

This section outlines in-network costs for rehabilitation services, including physical therapy, speech and language therapy, and occupational therapy.

In-network cost sharing for rehabilitation services.
Covered Service In-Network Cost
Physical therapy and speech and language therapy: In-network: $0 copay
Occupational therapy: In-network: $0 copay

This section outlines in-network costs for medical equipment and supplies, including diabetes supplies, durable medical equipment, and prosthetics.

In-network cost sharing for medical equipment and supplies.
Covered Service In-Network Cost
Diabetes supplies: In-network: $0 copay
Durable medical equipment: In-network: 0% or 20% coinsurance
Prosthetics: In-network: 0% or 20% coinsurance

This section outlines in-network cost sharing for chemotherapy and other Medicare Part B-covered drugs.

In-network cost sharing for Medicare Part B-covered drugs.
Covered Service In-Network Cost
Chemotherapy: In-network: $0 copay
Other Part B drugs (Medicare-covered): In-network: $0 copay

This section outlines in-network cost sharing for dental services, including preventive care, exams, x-rays, cleanings, and comprehensive dental procedures.

In-network cost sharing for dental services.
Covered Service In-Network Cost
Oral exam: Not covered
Dental x-rays: Not covered
Cleaning: Not covered
Periodontics: Not covered
Endodontics: Not covered
Restorative services: Not covered
Implant services: Not covered
Orthodontics: Not covered
Oral/Maxillofacial surgery: Not covered

This section outlines in-network cost sharing for vision services, including eye exams, eyeglasses, and contact lenses.

In-network cost sharing for vision services and eyewear.
Covered Service In-Network Cost
Routine eye exam: Not covered
Contact lenses: Not covered
Eyeglass frames only: Not covered
Eyeglass lenses only: Not covered
Eyeglasses (frames & lenses): Not covered
Upgrades: Not covered

This section outlines in-network cost sharing for hearing-related services, including exams, fittings, and hearing aids.

In-network cost sharing for hearing aids and related services.
Covered Service In-Network Cost
Hearing exam: Not covered
Fitting/evaluation: Not covered
Prescription hearing aids: Not covered
OTC hearing aids: Not covered

This section outlines in-network cost sharing for additional and special needs services that may be included in the plan.

In-network cost sharing for additional and special needs services.
Covered Service In-Network Cost
Adult day health services: Not covered
Home-based palliative care: Not covered
Personal emergency response system: Not covered
Weight management programs: Not covered
Wigs for chemotherapy-related hair loss: Not covered
Alternative therapies: In-network: $0 copay
Massage therapy: Not covered
Home/bathroom safety devices: Not covered

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

Prescription Drug Coverage

MMM Flexi 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 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.

MMM Flexi Platino (H4004-069-0) Prescription Drug Plan Premium Details
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 $615.00 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 Flexi Platino may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.

MMM Flexi Platino (H4004-069-0) Pharmacy Out-of-Pocket Costs by Drug Tier
Drug Tier Retail Mail Order
Brand-name drugs25% coinsuranceComing soon
Generic drugs25% coinsuranceComing soon
*Deductible does not apply.

CMS Star Ratings

Medicare assigns star ratings to plans based on quality and performance across multiple measures, including customer service, member experience, and health outcomes. Ratings are updated annually by the Centers for Medicare & Medicaid Services (CMS) and are shown on a 1 to 5 star scale, with 5 stars representing the highest quality.

2026 Medicare Star Ratings for Contract H4004
CMS Measure Star Rating
2026 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)

Medicare y Mucho Mas (MMM) Plan Contact Details for MMM Flexi Platino (H4004-069-0)
Contact Type Details
Website: Medicare y Mucho Mas (MMM) Plan Page
New Members: 1-833-668-2402
Existing Members: 1-866-333-5471
Plan Address: 350 Chardon Avenue | Suite 500 Torre Chardon | San Juan, PR 00918

Enrollment status and eligibility information are available through the Social Security Administration . Additional information about Medicare Advantage is available at medicare.gov .

Primary CMS datasets used for this Medicare Advantage Special Needs Plan resource.
Data Source Publisher Last Accessed
Landscape Source Files Centers for Medicare & Medicaid Services September 8, 2026
Medicare Part C & D Performance Centers for Medicare & Medicaid Services September 8, 2026
Plan Benefits Package Centers for Medicare & Medicaid Services September 8, 2026
Monthly Enrollment by Contract/Plan/State/County Centers for Medicare & Medicaid Services September 8, 2026

Data sources and methodology documentation.

Official plan information and secondary Medicare references.
Publisher Reference Last Accessed
Medicare y Mucho Mas (MMM) (official source) http://www.mmmpr.com October 13, 2025
CMS.gov Dual Eligible Special Needs Plans (D-SNPs) April 28, 2026
Medicare.gov Compare types of Medicare Advantage Plans April 28, 2026
AARP.org The Big Choice: Original Medicare vs. Medicare Advantage April 28, 2026

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Data provenance documentation is maintained in alignment with the U.S. Core Data for Interoperability (USCDI) Provenance standard.