Óptimo Plus (PPO)
Available to residents of Toa Baja County, PR for 2026. Contract H4005, plan 004, segment 0.
Plan details
| Monthly drug premium | $0.00 |
|---|---|
| Drug deductible | $0.00 |
| Plan type | Medicare Advantage |
| Contract / plan | H4005-004-0 |
| Offered by | Triple-S Advantage |
| Parent organization | Guidewell Mutual Holding Corporation |
| Formulary drugs | 3,148 |
CMS star ratings
- Overall
- 3.5 out of 5 stars for Overall
- Health plan (Part C)
- 3.5 out of 5 stars for Health plan (Part C)
- Drug plan (Part D)
- 4.5 out of 5 stars for Drug plan (Part D)
Published per contract — every plan under contract H4005 shares this rating.
Drug tiers — preferred pharmacy, initial coverage
| Tier | Cost-sharing |
|---|---|
| Tier 1 | $0.00 |
| Tier 2 | $0.00 |
| Tier 3 | $30.00 |
| Tier 4 | $50.00 |
| Tier 5 | 33% |
| Tier 6 | $0.00 |
Also available in 77 other PR counties
- Adjuntas
- Aguada
- Aguadilla
- Aguas Buenas
- Aibonito
- Anasco
- Arecibo
- Arroyo
- Barceloneta
- Barranquitas
- Bayamon
- Cabo Rojo
- Caguas
- Camuy
- Canovanas
- Carolina
- Catano
- Cayey
- Ceiba
- Ciales
- Cidra
- Coamo
- Comerio
- Corozal
- Culebra
- Dorado
- Fajardo
- Florida
- Guanica
- Guayama
- Guayanilla
- Guaynabo
- Gurabo
- Hatillo
- Hormigueros
- Humacao
- Isabela
- Jayuya
- Juana Diaz
- Juncos
- Lajas
- Lares
- Las Marias
- Las Piedras
- Loiza
- Luquillo
- Manati
- Maricao
- Maunabo
- Mayaguez
- Moca
- Morovis
- Naguabo
- Naranjito
- Orocovis
- Patillas
- Penuelas
- Ponce
- Quebradillas
- Rincon
Plan facts come from the CMS quarterly prescription drug plan public use files.