MCS Classicare
MCS Classicare, operated by MCS Advantage, Inc., is the largest and only 5-Star (three consecutive years) Medicare Advantage health plan in Puerto Rico, serving individual Medicare beneficiaries, dual-eligible Medicaid/Medicare members, Puerto Rico government retirees, and corporate retiree groups across all 78 municipalities with a 13,000+ provider network.
- Company typePrivate
- Founded1983
- HeadquartersParadinas De San Juan, Spain
- Headcount1,001–5,000
- GTM typeB2C
- OfferingServices
What MCS Classicare does
MCS Classicare is a Medicare Advantage health plan operated by MCS Advantage, Inc., a privately held insurance carrier headquartered in San Juan, Puerto Rico. The company administers Part C Medicare Advantage coverage for Medicare-eligible residents across all 78 municipalities of Puerto Rico, including specialized Dual-Eligible Special Needs Plans (D-SNP, branded Platino) for beneficiaries qualifying for both Medicare and Medicaid, individual HMO and HMO-POS plans, group plans for private-sector employers, and a dedicated line of HMO-POS plans for Puerto Rico government retirees (ELA). The carrier holds a CMS contract (H5577) and is the only plan in Puerto Rico — and one of only nine of 521 Medicare Advantage plans nationally — to achieve three consecutive years (2023–2025) of the highest CMS 5-Star quality rating.
The product portfolio spans roughly 20 plan variants across four channels (Individual, Platino, ELA, Grupal), with materially differentiated supplementary benefits including the Te Paga Card (OTCs, utilities, gas), Healthy Food Boxes for chronically ill members, non-emergency medical and social-destination transportation, home assistance services, and annual dental, vision, and hearing aid allowances. Operational capabilities are anchored to a multi-channel service infrastructure (contact center, in-person service centers, brokers, CMS portal), a delegated services layer (mental health via First Healthcare, dental via Netclaims, transportation via TransCita and Ida y Vuelta Inc.), and a member mobile app (Mi MCS). No proprietary technology platform, AI/ML system, or developer-facing APIs are disclosed.
The business model is capitation-based: MCS Classicare receives per-member monthly payments from CMS for Medicare Advantage coverage and from Puerto Rico Medicaid for dual-eligible enrollees. Most Platino plans charge dual-eligible members no premium, while individual HMO plans range from $0 to higher premium tiers with Part B premium reduction give-backs up to $720 annually and ELA plans offering reductions up to $2,096.40. Customer acquisition runs through the annual Medicare election period (October 15 – December 7), with broker/agent and direct contact-center enrollment supplemented by in-person service centers and community outreach. Revenue figures are not publicly disclosed.
MCS Classicare firmographics
Firmographics- Name
- MCS Classicare
- Legal name
- MCS Advantage, Inc.
- Website
- https://mcsclassicare.com
- Company type
- Private
- Founded year
- 1983
- Operating status
- Operating
- Headcount range
- 1,001–5,000 employees
- Short description
- MCS Classicare, operated by MCS Advantage, Inc., is the largest and only 5-Star (three consecutive years) Medicare Advantage health plan in Puerto Rico, serving individual Medicare beneficiaries, dual-eligible Medicaid/Medicare members, Puerto Rico government retirees, and corporate retiree groups across all 78 municipalities with a 13,000+ provider network.
- Ownership category
- akta.pro rank
MCS Classicare industry classification
Industry- Product category
- Medicare Advantage Health Insurance
- NAICS
- Direct Life, Health, and Medical Insurance Carriers (52411), HMO Medical Centers (621491)
- SIC
- Accident & Health Insurance (6321)
- akta.pro primary industry
- Medicare Advantage HMOs (HMO/HMO-POS) (HLAEAMAH)
- akta.pro secondary industries
- MA HMO Plans (HLAEACAA), D-SNP Supplemental Benefits & Flex Card/OTC Administration (HLAEAFAN), MA Chronic Condition Management & Supplemental Benefits (SSBCI) (HLAEACAI), MA Prescription Drug Plans (MA-PD) (HLAEACAF), Standard POS Plans (HMO-POS) (HLAEAOAA), Group HMO Plans (FSAIAFAK)
Keywords
Where MCS Classicare is headquartered
LocationHeadquarters
- HQ city
- Paradinas De San Juan
- HQ country
- Spain
- HQ region
- Europe
Offices2 records
Markets served
MCS Classicare business model
Business model- GTM type
- B2C
- Offering type
- Services
- Cost components
- Personnel, Operations, Supply Chain, Marketing or Sales, Technology or R&D, Infrastructure
Revenue model
- Medicare Premiums (Capitation): MCS Classicare receives capitation payments from Medicare (CMS) for providing Part C Medicare Advantage benefits to enrolled members. The company also receives Medicaid payments for dual-eligible beneficiaries in their Platino plans.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Subscription | Monthly | Platino Plans (D-SNP) - For dual-eligible beneficiaries (Medicare + Medicaid) |
| Subscription | Monthly | Individual Plans (HMO/HMO-POS) - For Medicare beneficiaries |
| Subscription | Monthly | ELA Plans - For Puerto Rico government retired employees |
| Subscription | Annual | Group Plans - For employer-sponsored retired employees |
Go-to-market motion1 record
Distribution channels4 records
Marketing channels6 records
MCS Classicare product offering
Product offeringCore offering
MCS Classicare is a Medicare Advantage (Part C) health insurance plan offered by MCS Advantage, Inc. that delivers hospital, medical, and Part D prescription drug coverage to Medicare-eligible beneficiaries in Puerto Rico. Its portfolio includes individual HMO/HMO-POS plans, Dual-Eligible Special Needs Plans (Platino D-SNP), a Chronic Condition SNP (Primero C-SNP), Puerto Rico government retiree (ELA) HMO-POS plans, and group plans for private employers, each bundled with supplemental benefits such as dental, vision, hearing aids, the Te Paga OTC card, transportation, home assistance, and a Healthy Food Box.
Product overview
MCS Classicare is a Medicare Advantage plan offered by MCS Advantage, Inc. that provides health coverage for Medicare and Medicaid beneficiaries in Puerto Rico. The product portfolio consists of multiple plan tiers organized into three main categories: Individual Plans (10+ HMO/HMO-POS plans including Essential, Efectivo, Firme, InteliCare, Patriot, RxMax, Primero C-SNP, Estrella, En Tu Hogar, and regional Excede plans), Platino Plans (Dual-Eligible SNP plans including Platino Total, Platino Progreso, Platino Ideal, Platino Máximo with 3 regional variants, Platino 185, and Platino Superior), and ELA Plans (6 HMO-POS plans for Puerto Rico Government retired employees). Key supplementary benefits across plans include the Te Paga OTC/Card benefit, Healthy Food Box, transportation, home assistance, comprehensive dental, vision and hearing aid coverage. The company also offers wellness programs (MCS Centro Educativo de Salud, MCS En Alerta, MCS Club Te Paga, MCS Medilínea, MCS Solutions, MCS medilíneaMD, Care Management Program) and a member portal (Mi MCS App). Plans operate primarily as HMO with some HMO-POS options, and the company has achieved a 5-star Medicare quality rating for 3 consecutive years.
Differentiator
Problem solved
Functional benefit
Brands
- MCS Classicare Platino: Dual-eligible Special Needs Plans (D-SNP) for beneficiaries with both Medicare and Medicaid eligibility
- MCS Classicare Individual Plans
- MCS Classicare Grupal
- MCS Classicare ELA
Products and services
- MCS Classicare Essential (HMO-POS) HMO-POS individual Medicare Advantage plan with $0 copays for primary care and specialists, plus eyewear, comprehensive dental, and hearing aid benefits. Targeted at Medicare beneficiaries in Puerto Rico seeking point-of-service flexibility.
- MCS Classicare Efectivo (HMO) Individual HMO Medicare Advantage plan with a $660 annual Medicare Part B premium reduction and comprehensive dental coverage, designed for budget-focused Medicare beneficiaries.
- MCS Classicare Firme (HMO) Individual HMO Medicare Advantage plan available in 39 Puerto Rico municipalities, with a Te Paga OTC card, comprehensive dental, and combined vision/hearing benefits.
- MCS Classicare InteliCare (HMO) Individual HMO Medicare Advantage plan providing a Te Paga OTC allowance and comprehensive dental coverage with $0 primary care and specialist copays.
- MCS Classicare Patriot (HMO) Individual HMO Medicare Advantage plan tailored to veteran Medicare beneficiaries, with a Te Paga OTC card, transportation benefits including 40 trips to veteran facilities, and combined vision/hearing coverage.
- MCS Classicare RxMax (HMO) Individual HMO Medicare Advantage plan emphasizing prescription drug savings with a Te Paga OTC card, hearing aid coverage, and home assistance visits.
- MCS Classicare Primero (HMO C-SNP) Chronic Condition Special Needs Plan (C-SNP) Medicare Advantage plan for Medicare beneficiaries with eligible chronic conditions, offering a Te Paga card, Part B premium reduction, and home assistance visits.
- MCS Classicare Estrella (HMO) Individual HMO Medicare Advantage plan available in 37 Puerto Rico municipalities, with a Te Paga OTC card, a quarterly Healthy Food Box for chronically ill members, and home assistance visits.
- MCS Classicare En Tu Hogar (HMO) Individual HMO Medicare Advantage plan centered on at-home care, providing a quarterly home package allowance for medical supplies and quarterly $0 copay home foot care visits.
- MCS Classicare Excede (HMO) Regional individual HMO Medicare Advantage plan with three regional variants (Regions 1, 2, 3) covering a combined 45 Puerto Rico municipalities, with Te Paga OTC cards, Part B premium reductions, and vision/hearing benefits.
- MCS Classicare Platino Total (HMO D-SNP) Dual-Eligible Special Needs Plan (D-SNP) for beneficiaries with both Medicare and Puerto Rico Medicaid (Platino/MiSalud), providing a Te Paga OTC card and dental, vision, and hearing aid benefits.
- MCS Classicare Platino Progreso (HMO D-SNP) Dual-Eligible Special Needs Plan (D-SNP) offering enhanced dental coverage (up to $4,500), eyewear up to $1,000, transportation, and $0 copays for primary care and specialists.
- MCS Classicare Platino Ideal (HMO D-SNP) Dual-Eligible Special Needs Plan (D-SNP) with a $1,452 annual Part B premium reduction, $960 Te Paga card, and $3,500 in comprehensive dental coverage.
- MCS Classicare Platino Máximo (HMO D-SNP)
- MCS Classicare Platino 185 (HMO D-SNP) New Dual-Eligible Special Needs Plan (D-SNP) for 2026 featuring a $185/month Part B premium buy-down, a quarterly Healthy Food Box, $0 copays across all care settings, and transportation benefits.
- MCS Classicare Platino Superior (HMO D-SNP) New regional Dual-Eligible Special Needs Plan (D-SNP) for 2026 serving 37 eligible Puerto Rico municipalities, with $4,000 comprehensive dental, a $1,080 Te Paga card, and $600 in combined vision/hearing benefits.
- MCS Classicare ELA Gobierno Ahorro (HMO-POS) HMO-POS Medicare Advantage plan for Puerto Rico government retired employees, with $2,500 comprehensive dental, $500 combined hearing/eyewear benefits, transportation, and home assistance.
- MCS Classicare ELA Sólido (HMO-POS) HMO-POS Medicare Advantage plan for Puerto Rico government retired employees, featuring a $1,212 annual Part B premium reduction, $1,440 Te Paga card, $2,500 comprehensive dental, and transportation/home assistance.
- MCS Classicare ELA Crédito Rubí (HMO-POS) HMO-POS Medicare Advantage plan for Puerto Rico government retired employees, with $3,500 comprehensive dental, $1,260 Te Paga card, $800 eyewear, and $2,500 in hearing aids.
- MCS Classicare ELA Enlace Acero (HMO-POS) HMO-POS Medicare Advantage plan for Puerto Rico government retired employees, with the highest ELA Te Paga card ($1,980), $4,000 comprehensive dental, and combined hearing/eyewear benefits.
- MCS Classicare ELA Te Ayuda (HMO-POS) HMO-POS Medicare Advantage plan for Puerto Rico government retired employees, with a $1,212 Part B premium reduction, $540 Te Paga card, $2,000 comprehensive dental, and combined hearing/eyewear benefits.
- MCS Classicare ELA Máximo (HMO-POS) HMO-POS Medicare Advantage plan for Puerto Rico government retired employees, with the highest ELA Part B premium reduction ($2,096.40 annually), $2,000 comprehensive dental, and combined hearing/eyewear benefits.
- MCS Classicare Grupal Patronal Medicare Advantage group health plan designed for retired employees of private and public employers with Medicare Parts A and B, offering employer-customizable benefits, pharmacy enhancements, and US coverage. Requires a minimum of 5 enrolled members.
Quantifiable outcome
- Only Medicare Advantage plan in Puerto Rico with 5-star rating for 3 consecutive years
- +2 more outcomes
Companies that use MCS Classicare
Customer profileSegments4 records
Ideal customer profiles3 records
MCS Classicare technology and API
TechnologyTechnology focussed No
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Integration4 records
MCS Classicare partnerships and signals
Strategic signalScale indicators4 records
Recent moves6 records
Expansion highlights6 records
MCS Classicare competitors and assessment
Company assessmentBroad incumbents
- Molina Healthcare: National managed care company with strong D-SNP and dual-eligible focus. Comparable target segment (dual-eligible beneficiaries) and government-program managed care model parallel MCS Classicare's Platino franchise.
- Centene (Wellcare): Large Medicaid and Medicare managed care operator with Wellcare MA brand. Comparable dual-eligible focus and government-program managed care model, particularly relevant for the Platino/D-SNP segment.
- Elevance Health (Anthem): Large national health insurer with growing MA focus across multiple state Blue plans. Comparable MA + D-SNP product portfolio and scale of supplemental benefits, though Puerto Rico presence is limited.
- CVS Health (Aetna): Major national Medicare Advantage carrier through Aetna, with broad portfolio including D-SNP. Although not as concentrated in Puerto Rico, it is a comparable MA carrier with significant scale and supplemental benefits expertise.
- Cigna (Medicare): National health insurer with Medicare Advantage and Medicare Supplement offerings. Comparable member experience and provider-network model, though typically less D-SNP-heavy than MCS Classicare.
Direct peers
- Humana: One of the largest Medicare Advantage carriers in the US with a presence in Puerto Rico. Competes directly on HMO and D-SNP products and benefits packages, and is a comparable large-scale MA operator with strong emphasis on quality ratings.
- Triple-S (BlueCross BlueShield of Puerto Rico): Direct competitor in Puerto Rico Medicare Advantage market operating as BlueCross BlueShield licensee. Competes head-to-head with MCS Classicare for the same Medicare-eligible beneficiaries in PR, offering comparable HMO and D-SNP plans.
- UnitedHealthcare (Medicare & Retirement): Largest US Medicare Advantage insurer with operations in Puerto Rico. Offers comparable HMO and D-SNP plans and competes directly with MCS Classicare for individual and dual-eligible beneficiaries in PR.
Regional players
- Highmark Health: Regional Blue Cross Blue Shield licensee with significant MA presence in PA, WV, DE, and NY. Comparable regional MA carrier model with strong quality ratings and supplemental benefits focus, analogous to a regional incumbent.
Others
- Medical Card System (MCS) Life Insurance Company: Parent/affiliated entity of MCS Classicare offering life and other insurance products in Puerto Rico. Connected through the MCS group branding and management, providing strategic and administrative synergies though it is a separate line of business.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat5 records
Key risks6 records
Key highlights7 records
Customer concentration
MCS Classicare social profiles
Digital presenceMCS Classicare compliance and trust
Trust signalCompliance3 records
MCS Classicare financial estimates
Financial estimateRevenue estimate
Valuation estimate
MCS Classicare leadership team
Management profileNumber of profiles
Profiles3 records
MCS Classicare funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
MCS Classicare M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about MCS Classicare
What does MCS Classicare do?
MCS Classicare is a Medicare Advantage (Part C) health insurance plan offered by MCS Advantage, Inc. that delivers hospital, medical, and Part D prescription drug coverage to Medicare-eligible beneficiaries in Puerto Rico. Its portfolio includes individual HMO/HMO-POS plans, Dual-Eligible Special Needs Plans (Platino D-SNP), a Chronic Condition SNP (Primero C-SNP), Puerto Rico government retiree (ELA) HMO-POS plans, and group plans for private employers, each bundled with supplemental benefits such as dental, vision, hearing aids, the Te Paga OTC card, transportation, home assistance, and a Healthy Food Box.
Is MCS Classicare a public or private company?
MCS Classicare is a private company. It is classified as unknown and is currently operating.
When was MCS Classicare founded?
MCS Classicare was founded in 1983. It employs 1,001 to 5,000 people.
Where is MCS Classicare based?
MCS Classicare is headquartered in Paradinas De San Juan, Spain, in the Europe region.
How does MCS Classicare make money?
One revenue line is on record: medicare Premiums (Capitation).
Who are MCS Classicare's main competitors?
Broad incumbents on record are Molina Healthcare, Centene (Wellcare), Elevance Health (Anthem), CVS Health (Aetna) and Cigna (Medicare). Direct peers are Humana, Triple-S (BlueCross BlueShield of Puerto Rico) and UnitedHealthcare (Medicare & Retirement). Highmark Health is listed as a regional player. Medical Card System (MCS) Life Insurance Company is listed as an others.
Does MCS Classicare have an API?
No public API is recorded for MCS Classicare.
What industry is MCS Classicare in?
MCS Classicare's product category is Medicare Advantage Health Insurance. Its primary akta.pro industry code is HLAEAMAH, Medicare Advantage HMOs (HMO/HMO-POS), with a secondary code of HLAEACAA, MA HMO Plans. Its NAICS code is 52411 and its SIC code is 6321.