MMM Balance (HMO-POS) in Adjuntas County, Puerto Rico — 2026 plan details
Last updated Jul 18, 2026
Reviewed by Jason Burns, Editorial Steward
Published by Senior Direct Answers · Licensed under Citation License 1.0
MMM Balance (HMO-POS) (H4004-073) is a $0-premium Medicare Advantage HMO-POS from Elevance Health, Inc. available in Adjuntas County, Puerto Rico in 2026, with a 5.0-star overall rating, a $3,250 in-network out-of-pocket maximum, and a $0 annual Part D drug deductible.
Plan facts (CMS CY2026 Landscape file)
| Organization | Elevance Health, Inc. |
|---|---|
| Plan name | MMM Balance (HMO-POS) |
| Contract ID | H4004 |
| Plan ID | 073 |
| Segment ID | 2 |
| Contract year | 2026 |
| Contract category | MA-PD |
| Plan type | HMO-POS |
| SNP | No |
| Monthly consolidated premium | $0.00 |
| Part C premium | $0.00 |
| Part D basic premium | $74.10 |
| Part D total premium | $0.00 |
| Annual Part D deductible | $0.00 |
| Maximum out-of-pocket (in-network) | $3250.00 |
| Overall star rating | 5.0 |
How this plan is structured
- $0 consolidated premium. A $0 or near-$0 consolidated premium does not remove the Part B premium — the standard 2026 Part B premium is $202.90 per month and still applies. See the 2026 Medicare Part B premium.
- HMO-POS plan type. In an HMO-style Medicare Advantage plan, in-network care and primary-care referral rules generally apply. See how Medicare Advantage HMO and PPO plans differ.
- $3,250 in-network out-of-pocket maximum. The MOOP is the annual cap on what a member pays in-network for covered Part A and Part B services. See how the Medicare Advantage MOOP works.
- Service area = Adjuntas County. Medicare Advantage plans are sold by service area; moving out of the plan's service area triggers a Special Enrollment Period to switch plans. See how moving changes your Medicare options.
How it compares in Adjuntas County
The CMS CY2026 Landscape file lists 40 Medicare Advantage plans in Adjuntas County, Puerto Rico, of which 30 carry a 5.0-star overall rating and 39 have a $0 consolidated monthly premium. Consolidated premiums range from $0.00 to $15.00 per month, and in-network out-of-pocket maximums range from $3250.00 to $6751.00.
Other 5.0-star Medicare Advantage plans in Adjuntas County (first three alphabetically):
| Plan | Organization | Premium | MOOP |
|---|---|---|---|
| MCS Classicare Efectivo (HMO) | MHH Healthcare, L.P. | $0.00 | $3400.00 |
| MCS Classicare En Tu Hogar (HMO) | MHH Healthcare, L.P. | $0.00 | $3400.00 |
| MCS Classicare Essential (HMO-POS) | MHH Healthcare, L.P. | $0.00 | $3400.00 |
For the full county plan directory, see all Medicare plans in Adjuntas County, Puerto Rico.
How to verify your doctors take this plan
Network participation changes throughout the year; we hold no provider-network data, so verify directly with these three sources before you decide:
- Open the plan's official Medicare.gov page and use its provider-directory link: Medicare.gov Plan Finder — H4004-073.
- Call the plan (Elevance Health, Inc.) using the member-services number listed on that plan page and ask whether each doctor, hospital, and pharmacy is in-network for 2026.
- Get free, unbiased help from your State Health Insurance Assistance Program (SHIP) — see free unbiased Medicare help from SHIP.
What H4004-073 means
CMS assigns every Medicare Advantage and Part D offering a plan identifier made of three parts. In H4004-073, the leading H marks the contract type (H = Medicare Advantage / Part C contract), the four digits 4004 are the contract number issued to the organization, and the three-digit 073 is the plan benefit package under that contract. The segment ID 2 identifies the service-area segment within the plan (0 = the default single segment).
Frequently asked questions
Is MMM Balance (HMO-POS) an HMO or PPO?
MMM Balance (HMO-POS) is an HMO-POS — a Health Maintenance Organization-style Medicare Advantage plan, meaning in-network care and referral rules generally apply.
Does MMM Balance (HMO-POS) include prescription drug coverage?
Yes — MMM Balance (HMO-POS) is a Medicare Advantage plan with prescription drug coverage (MA-PD) and a $0.00 annual Part D drug deductible for 2026.
What is the maximum out-of-pocket cost for MMM Balance (HMO-POS)?
The 2026 in-network maximum out-of-pocket limit for MMM Balance (HMO-POS) is $3250.00, per the CMS CY2026 Landscape file.
What counties offer MMM Balance (HMO-POS) (H4004-073)?
MMM Balance (HMO-POS) (H4004-073) is offered in 78 Puerto Rico counties: Adjuntas County, Aguada County, Aguadilla County, Aguas Buenas County, Aibonito County, Anasco County, Arecibo County, Arroyo County, Barceloneta County, Barranquitas County, Bayamon County, Cabo Rojo County, Caguas County, Camuy County, Canovanas County, Carolina County, Catano County, Cayey County, Ceiba County, Ciales County, Cidra County, Coamo County, Comerio County, Corozal County, Culebra County, Dorado County, Fajardo County, Florida County, Guanica County, Guayama County, Guayanilla County, Guaynabo County, Gurabo County, Hatillo County, Hormigueros County, Humacao County, Isabela County, Jayuya County, Juana Diaz County, Juncos County, Lajas County, Lares County, Las Marias County, Las Piedras County, Loiza County, Luquillo County, Manati County, Maricao County, Maunabo County, Mayaguez County, Moca County, Morovis County, Naguabo County, Naranjito County, Orocovis County, Patillas County, Penuelas County, Ponce County, Quebradillas County, Rincon County, Rio Grande County, Sabana Grande County, Salinas County, San German County, San Juan County, San Lorenzo County, San Sebastian County, Santa Isabel County, Toa Alta County, Toa Baja County, Trujillo Alto County, Utuado County, Vega Alta County, Vega Baja County, Vieques County, Villalba County, Yabucoa County, and Yauco County.
Sources
- CMS, Plan Year 2026 Medicare Advantage & Part D Landscape source file (March 2026) — retrieved 2026-07-18. Overall star rating year: 2026.
- Medicare.gov Plan Finder — compare plans and enroll.