Elevance Medicare Advantage Plans Puerto Rico 2025

Elevance Medicare Advantage Plans in Puerto Rico: An Overview

Elevance Health, under the brand MMM, offers Medicare Advantage plans in Puerto Rico. These plans have seen tremendous growth, with an impressive 94% enrollment among beneficiaries who have both Part A and B coverage. Puerto Rico’s territorial status limits access to certain Medicare subsidies, making Medicare Advantage plans an appealing option as they fill coverage gaps left by traditional Medicare.

Plan Types and Coverage

Elevance Health offers a variety of Medicare Advantage plans, catering to diverse beneficiary needs. These plans include:

• HMO

• HMO DSNP (Dual-Eligible Special Needs Plans)

• LPPO (Local Preferred Provider Organizations)

• RPPO (Regional Preferred Provider Organizations)

The HMO health plan, operated under MMM, is particularly popular, as it offers Medicare Advantage recipients a range of options, including various health plans.

Prescription Drug Coverage

Prescription drug coverage plays a significant role in healthcare. Elevance’s Medicare Advantage plans in Puerto Rico may offer improved prescription drug coverage.

Benefits of Enrolling in an Elevance Medicare Advantage Plan

The simplicity, flexibility, and affordability of Elevance’s Medicare Advantage plans set them apart. They may offer customizable supplemental benefits that emphasize whole health, reflecting a commitment to providing choice, simplicity, and affordability, along with benefits that consumers demand. The additional offerings beyond traditional Medicare are a key factor in the popularity of Medicare Advantage in Puerto Rico and are leveraged in Elevance’s plans.

Extra Benefits

Elevance Medicare Advantage plans extend beyond meeting basic healthcare needs. They may offer an ‘Essential Extras’ benefits package that provides comprehensive dental care services and may allow members to choose from options like:

• Dental

• Vision

• Hearing

These supplemental benefits are particularly crucial in Puerto Rico due to low Medicaid funding.

Affordability and Cost Savings

Elevance designs its Medicare Advantage plans focusing on affordability. The plans also include enhanced prescription drug coverage with no copays for Tier 1 and Tier 2 medications, offering significant cost savings for beneficiaries.

Quality Measures and Star Ratings

Despite facing a significant drop in Medicare Advantage star ratings for 2024, Elevance Health remains committed to improving its earnings and quality of care. Elevance has challenged the changes to the Medicare Advantage star rating calculation for 2024 by filing a lawsuit against the federal government.

Frequently Asked Questions

Does Medicare Advantage cover PR?

Yes, Medicare Advantage covers PR because Puerto Rico is a U.S. territory and Medicare operates there similarly to other U.S. territories like Guam.

Can I keep my Medicare if I move to Puerto Rico?

No, Medicare generally does not cover care in Puerto Rico. Medicare is usually not accepted in foreign countries, and in most cases, it won’t cover care received outside the 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands.

What types of Medicare Advantage plans does Elevance Health offer?

Elevance Health offers a variety of Medicare Advantage plans, including HMO, HMO DSNP, LPPO, and RPPO, catering to diverse healthcare needs.

How can I enroll in Elevance’s Medicare Advantage plans?

To enroll in Elevance’s Medicare Advantage plans, you can visit medicareadvantageplans2025.org, or call 1-844-709-9937 (TTY user 711) Mon-Fri 8am-9pm Est.