MMM Grandioso (HMO-POS) 2026 Plan Details for Las Piedras Municipio, Puerto Rico Residents
MMM Grandioso (HMO-POS) 2026 Plan Details for Las Piedras Municipio, Puerto Rico Residents
Choosing the right Medicare Advantage plan in Las Piedras Municipio is crucial for your healthcare needs in 2026. With MMM Grandioso (HMO-POS) as one of the options, you can compare it side-by-side with other available plans to find the best fit for you. Whether you prefer enrolling online or seeking advice from a licensed agent, we’ve made the process simple and straightforward.
According to CMS enrollment data, there are approximately 3,130 members enrolled in this plan, 0 in Las Piedras Municipio.
MMM Grandioso Overview
| Plan ID H4004-070-0 Overview | |
|---|---|
| Health Plan ID: | H4004-070-0 |
| Medicare Advantage Plan Type: | HMO-POS |
| Plan Year: | 2026 |
| Monthly Premium: | $0.00 Plus your Medicare Part B premium. |
| Health Plan Deductible: | $0.00 |
| Annual Out-of-Pocket Maximum: | $3250.00 (In-Network) |
| Part B Give Back: | −$7.00 reduction |
| Part D Drug Plan Benefit: | Enhanced, $0.00 deductible |
| Additional Benefits: | Dental, Vision, Hearing |
| Availability: | Las Piedras Municipio, PR |
| Insured By: | Medicare y Mucho Mas (MMM) |
Why Choose MMM Grandioso?
This Medicare Advantage MAPD HMO-POS plan offers both structure and flexibility — including hospital, medical, and prescription drug coverage. With a monthly premium of $0.00, it covers Medicare Part A and Part B benefits, along with built-in drug coverage to help manage ongoing prescriptions. The annual Part D deductible is $0.00. You can get care in or out of network, but you’ll usually pay less when sticking with in-network providers.
Primary care visits have a $0 copay | Out-of-network: 20% coinsurance, specialist visits come with a $0-$5 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 plan’s maximum out-of-pocket (MOOP) limit of $3250.00. Once that limit is reached, your in-network healthcare is covered at 100% for the rest of the year.
You’ll find this plan listed by CMS as H4004-070-0. A cost-sharing summary appears below with details on what you’ll pay for common services. Still have questions? Check the FAQ section for more answers.
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Out-of-Pocket Expenses
MMM Grandioso has cost-sharing, meaning you'll have out-of-pocket costs when using approved healthcare services. The table below details the most common in-network out-of-pocket expenses for plan H4004-070-0.
Find out the costs for visiting your primary care doctor and specialists, as well as coverage for wellness and preventive programs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Primary: | In-network: $0 copay | Out-of-network: 20% coinsurance |
| Specialist: | In-network: $0-$5 copay | Out-of-network: 20% coinsurance |
Medicare Advantage plans often include preventive and wellness benefits designed to help members stay healthy, identify risks early, and maintain an active lifestyle.
| Service | Enrollee Cost (in-network) |
|---|---|
| Annual wellness exam: | Not covered |
| Telehealth benefit: | In-network: $0 copay |
| Routine chiropractic: | In-network: $5 copay | Out-of-network: 20% coinsurance |
| Fitness benefits: | In-network: $0 copay |
| Health education: | In-network: $0 copay |
| Counseling services: | Not covered |
| Over the counter drug benefits: | In-network: $0 copay |
| Health transportation (non-emergency): | In-network: $0 copay |
Review the costs for emergency services, urgent care, ambulance services, inpatient hospital stays, and skilled nursing facility care.
| Service | Enrollee Cost |
|---|---|
| Emergency room care: | $75 copay |
| Wordwide emergency care: | $100 copay |
| Urgent care: | $0 copay |
| Inpatient hospital care: | In-network: | Tier 1 | $0 per stay | Tier 2 | $50 per stay | Out-of-network: | 20% per stay |
| Skilled Nursing Facility: | In-network: | Tier 1 | Tier 2 | $0 copay | Out-of-network: | 20% per stay |
| Ground ambulance: | In-network: $0 copay | Out-of-network: 20% coinsurance |
This section explains the costs for mental health services, including individual and group therapy, and inpatient care.
| Service | Enrollee Cost (in-network) |
|---|---|
| Outpatient individual therapy: | In-network: $0-$5 copay | Out-of-network: 20% coinsurance |
| Outpatient group therapy: | In-network: $0-$5 copay | Out-of-network: 20% coinsurance |
| Inpatient psychiatric hospital care: | In-network: | Tier 1 | $0 per stay | Tier 2 | $50 per stay | Out-of-network: | 20% per stay |
See the cost details for rehabilitation services, including physical therapy, speech therapy, and occupational therapy.
| Service | Enrollee Cost (in-network) |
|---|---|
| Physical therapy and speech and language therapy: | In-network: $5 copay | Out-of-network: 20% coinsurance |
| Occupational therapy: | In-network: $5 copay | Out-of-network: 20% coinsurance |
Learn about the costs associated with medical equipment and supplies, including diabetes supplies, durable medical equipment, and prosthetics.
| Service | Enrollee Cost (in-network) |
|---|---|
| Diabetes supplies: | In-network: $0 copay | Out-of-network: 20% coinsurance |
| Durable medical equipment: | In-network: 20% coinsurance | Out-of-network: 20% coinsurance |
| Prosthetics: | In-network: 20% coinsurance | Out-of-network: 20% coinsurance |
This section outlines the costs for diagnostic services, lab tests, x-rays, and other imaging services.
| Service | Enrollee Cost (in-network) |
|---|---|
| Diagnostic radiology services: | In-network: $0-$50 copay | Out-of-network: 20% coinsurance |
| Lab services: | In-network: 0%-20% coinsurance | Out-of-network: 20% coinsurance |
| Outpatient x-rays: | In-network: $0 copay | Out-of-network: 20% coinsurance |
| Diagnostic tests and procedures: | In-network: $0 copay | Out-of-network: 20% coinsurance |
Review the cost-sharing details for chemotherapy and other Medicare Part B-covered drugs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Chemotherapy: | In-network: 0%-20% coinsurance | Out-of-network: 20% coinsurance |
| Other Part B drugs (Medicare-covered): | In-network: $0-$15 copay, 0%-20% coinsurance | Out-of-network: 20% coinsurance |
This section details the dental services covered under your plan including Medicare-covered preventive dental, oral exams, x-rays, dental cleanings, and comprehensive dental.
| Service | Member Cost (in-network) |
|---|---|
| Oral exam: | In-network: $0 copay | Out-of-network: 20% coinsurance |
| Dental x-rays: | In-network: $0 copay | Out-of-network: 20% coinsurance |
| Cleaning: | In-network: $0 copay | Out-of-network: 20% coinsurance |
| Periodontics: | In-network: 0%-20% coinsurance | Out-of-network: 20% coinsurance |
| Endodontics: | In-network: 0%-20% coinsurance | Out-of-network: 20% coinsurance |
| Restorative services: | In-network: 0%-20% coinsurance | Out-of-network: 20% coinsurance |
| Implant services: | In-network: 0%-20% coinsurance | Out-of-network: 20% coinsurance |
| Orthodontics: | Not covered |
| Oral/Maxillofacial surgery: | In-network: 0%-20% coinsurance | Out-of-network: 20% coinsurance |
This section outlines the coverage for hearing-related services, including exams, fittings, and hearing aids.
| Service | Member Cost (in-network) |
|---|---|
| Hearing exam: | In-network: $0 copay | Out-of-network: 20% coinsurance |
| Fitting/evaluation: | Not covered |
| Prescription hearing aids: | Not covered |
| OTC hearing aids: | Not covered |
Learn about the costs for vision-related services, including eye exams, eyeglasses, and contact lenses.
| Service | Member Cost (in-network) |
|---|---|
| Routine eye exam: | In-network: $0 copay | Out-of-network: 20% coinsurance |
| Contact lenses: | In-network: $0 copay | Out-of-network: 20% coinsurance |
| Eyeglass frames only: | Not covered |
| Eyeglass lenses only: | Not covered |
| Eyeglasses (frames & lenses): | In-network: $0 copay | Out-of-network: 20% coinsurance |
| Upgrades: | Not covered |
Medicare Advantage plans may include extra benefits and special needs services designed to support members with chronic conditions, mobility limitations, or other complex health needs.
| Service | Enrollee Cost (in-network) |
|---|---|
| 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 hair loss: | Not covered |
| Alternative therapies: | In-network: $0 copay |
| Massage therapy: | Not covered |
| Home/bathroom safety devices: | In-network: $0 copay |
Certain preventive services are covered 100% by MMM Grandioso as a Part B benefit.
Part D Prescription Drug Costs & Benefits
MMM Grandioso includes an enhanced benefit Medicare Part D plan (PDP), which offers greater coverage than basic plans. An enhanced benefit plan has a higher actuarial value, meaning it covers a larger percentage of your healthcare costs.
Part D Plan Premium
The Part D prescription drug plan premium is included in your overall Medicare Advantage plan cost. However, additional expenses or subsidies may apply through the Low-Income Subsidy (LIS) program, also known as Extra Help. LIS, provided by Social Security, helps those with limited income and resources to lower or eliminate Part D costs. LIS benefits are not part of Medicare Advantage coverage.
| Basic Part D Premium: | $-70.60 |
|---|---|
| Supplemental Part D Premium: | $70.60 |
| 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 $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 Grandioso may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.
| Drug Tier | Retail | Mail Order |
|---|---|---|
| Preferred Generic | $0.00 copay | Coming soon |
| Generic | $0.00 copay | Coming soon |
| Preferred Brand | $5.00 copay | Coming soon |
| Non-Preferred Drug | $15.00 copay | Coming soon |
| Preferred Specialty Tier | 25% coinsurance | Coming soon |
| Specialty Tier | 33% coinsurance | Coming soon |
| Select Care Drugs | $0.00 copay | Coming soon |
| *Deductible does not apply. | ||
Understanding CMS Star Ratings
Each year, the Centers for Medicare & Medicaid Services (CMS) assesses health plans (Part C) and drug plans (Part D) based on a 5-star rating system. These ratings provide an overview of the plan’s performance in areas such as preventive care, managing chronic conditions, and member experience.
Considering a plan’s star rating can be an important part of your decision-making process, as higher ratings often reflect stronger performance in key areas of healthcare and customer service.
| 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 |
If you are new to Medicare or Medicare Advantage plans, the following information will help you understand the enrollment process and restrictions.
Am I Eligible for MMM Grandioso?
To enroll in MMM Grandioso, you must meet the following criteria:
- Be eligible for Medicare Part A and Part B.
- Reside in the plan’s service area.
If you meet these requirements, you are eligible to enroll in MMM Grandioso and benefit from its comprehensive coverage options.
When Can I Enroll in MMM Grandioso?
To ensure you don’t miss your chance to enroll in MMM Grandioso, be aware of these important enrollment periods:
- Initial Enrollment Period (IEP): Your IEP offers a seven-month window around your 65th birthday to sign up for Medicare.
- Annual Enrollment Period (AEP): The AEP, occurring from October 15 to December 7 each year, allows you to enroll in or make changes to your Medicare Advantage plan if you are currently enrolled in a Medicare Advantage plan.
- Medicare Advantage Open Enrollment Period (MA OEP): From January 1 to March 31, the MA OEP provides an opportunity to switch Medicare Advantage plans or return to Original Medicare.
- Special Enrollment Periods (SEPs): Certain life changes, like moving or losing insurance coverage, may qualify you for a SEP, giving you a chance to make adjustments outside the standard periods.
Need help figuring out the right time to enroll? Call HealthCompare (our trusted enrollment partner) at 1-833-748-3201 (TTY 711) to get assistance from a licensed insurance agent.
Steps to Enroll in MMM Grandioso
Joining MMM Grandioso is straightforward. Here are the steps you can take:
- Online: Use our online enrollment partner's Secure Online Enrollment Form to sign up.
- By Phone: Reach out to HealthCompare (our trusted enrollment partner) at 1-833-748-3201 (TTY 711). A licensed insurance agent will help you with the enrollment process and answer any questions you might have.
- Through Medicare.gov: Enroll directly through the official Medicare website. Visit Medicare.gov, log in or create an account, and follow the steps to join MMM Grandioso.
- Direct Enrollment: You can also choose to enroll directly with MMM Grandioso. The contact information can be found below in the "Contact" section.
Make sure you enroll during the appropriate period to activate your coverage as soon as possible.
Here are some of the most frequently asked questions people have about plan ID H4004-070-0:
How much does H4004-070-0 cost per month?
For 2026, the monthly premium is $0.00, and you still pay your Part B premium to Medicare.
What’s the MOOP for MMM Grandioso in 2026?
The annual in-network MOOP is $3250.00, protecting you from larger bills once you hit that limit.
How much do I pay before drug coverage starts?
The 2026 drug deductible is $0.00.
Is this a 4-star or 5-star plan?
CMS rates it ★5.0 out of 5 stars for 2026.
How many people are enrolled in this plan?
Enrollment stands at roughly 3,130 members.
Contact Medicare y Mucho Mas (MMM)
| 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 |
If you're eligible for Medicare but haven't enrolled or need to verify your enrollment status, visit the Social Security Administration website. For more information about Medicare Advantage, visit medicare.gov.
- CMS.gov, Landscape Source Files — Last accessed September 26, 2025
- CMS.gov, Medicare Part C & D Performance — Last accessed October 10, 2025
- CMS.gov, Plan Benefits Package — Last accessed October 14, 2025
- CMS.gov, Monthly Enrollment by Contract/Plan/State/County — Last accessed October 13, 2025
Learn more about how we use CMS data.
- Medicare y Mucho Mas (MMM), http://www.mmmpr.com — Last accessed October 13, 2025
- Medicare.gov, "Compare types of Medicare Advantage Plans" — Last accessed 25 May, 2025
- NCOA.org, "5 Steps to Choosing the Right Medicare Plan for You" — Last accessed 25 May, 2025
- Medicare.gov, "Compare Original Medicare & Medicare Advantage" — Last accessed 25 May, 2025
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Page content managed by David Bynon, Medicare Analyst.
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