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CareComplete Platinum (HMO-POS C-SNP) - H1019-130-000
$0.00
Monthly Premium
CareComplete Platinum (HMO-POS C-SNP) is a HMO-POS C-SNP Medicare Advantage (Medicare Part C) plan offered by Humana Inc.
Plan ID: H1019-130-000
* Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system.
$0.00
Monthly Premium
Florida Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. A Medicare Advantage plan combines your Original Medicare (Part A and Part B) benefits into a single plan.
Most Medicare Advantage plans cover prescription drugs, and many plans may offer other additional benefits Original Medicare doesn’t cover.
Learn more about Florida Medicare Advantage plans like the one below and find a plan that offers the benefits you want at an affordable price.
Basic Costs and Coverage
| Coverage | Details |
|---|---|
| Monthly plan premium | $0.00 |
| Vision coverage | |
| Dental coverage | |
| Hearing coverage | |
| Prescription drugs | |
| Medical deductible | $700.00 |
| Out-of-pocket maximum | $3,400.00 |
| Initial drug coverage limit | $0.00 |
| Catastrophic drug coverage limit | $2,100.00 |
| Primary care doctor visit | In-Network: Doctor Office Visit: Copayment for Primary Care Office Visit $0 |
| Specialty doctor visit | In-Network: Doctor Specialty Visit: Copayment for Physician Specialist Office Visit $20 Prior Authorization Required for Doctor Specialty Visit Referral Required for Doctor Specialty Visit |
| Inpatient hospital care | In-Network: Acute Hospital Services: $150 per day for days 1 to 7 $0 per day for days 8 to 90 Prior Authorization Required for Acute Hospital Services Referral Required for Acute Hospital Services |
| Urgent care | Urgent Care: Copayment for Urgent Care $20 Worldwide Coverage: Copayment for Worldwide Urgent Coverage $20 |
| Emergency room visit | Emergency Care: Copayment for Emergency Care $150 Copayment for Medicare Covered Emergency Care waived if you are admitted to the hospital with in 24 hours Worldwide Coverage: Copayment for Worldwide Emergency Coverage $150 Copayment for Worldwide Emergency Transportation $250 |
| Ambulance transportation | Out-of-Network: Ambulance Services: Copayment for Ambulance Services - Ground $250 Coinsurance for Ambulance Services - Air 20% $250 Ambulance Emergency - Ground Ambulance$0 Ambulance Non-Emergency - Ground Ambulance |
Health Care Services and Medical Supplies
CareComplete Platinum (HMO-POS C-SNP) covers a range of additional benefits. Learn more about CareComplete Platinum (HMO-POS C-SNP) benefits, some of which may not be covered by Original Medicare (Part A and Part B).
| Coverage | Details |
|---|---|
| Chiropractic services | Out-of-Network: Medicare Covered Chiropractic Services: Copayment for Medicare Covered Chiropractic Services $35 |
| Diabetes supplies, training, nutrition therapy and monitoring | Out-of-Network: Medicare Covered Diabetic Supplies and Services: Copayment for Medicare Covered Diabetic Supplies $0 Copayment for Medicare Covered Diabetic Therapeutic Shoes or Inserts $35 |
| Durable medical equipment (DME) | In-Network: Durable Medical Equipment: Coinsurance for Medicare-covered Durable Medical Equipment 20% Prior Authorization Required for Durable Medical Equipment |
| Diagnostic tests, lab and radiology services, and X-rays | Out-of-Network: Medicare Covered Diagnostic Procedures/Tests Services: Copayment for Medicare Covered Diagnostic Procedures/Tests $0 to $175 Copayment for Medicare Covered Lab Services $0 to $25 Copayment for Medicare Covered Diagnostic Radiological Services $0 to $300 Copayment for Medicare Covered Therapeutic Radiological Services $0 to $35 Coinsurance for Medicare Covered Therapeutic Radiological Services 20% Copayment for Medicare Covered Outpatient X-Ray Services $20 to $175 $20 OP Diag Proc & Tests - OPH$0 OP Diag Proc & Tests - PCP$20 OP Diag Proc & Tests - SPC$20 OP Diag Proc & Tests - UCC$175 Sleep Study (Fac Based) - OPH$20 Sleep Study (Fac Based) - SPC$0 Sleep Study (Home Based) - Mbr's Home |
| Home health care | In-Network: Home Health Services: Copayment for Medicare-covered Home Health Services $0 Prior Authorization Required for Home Health Services Referral Required for Home Health Services |
| Mental health inpatient care | Out-of-Network: Psychiatric Hospital Services: Copayment for Psychiatric Hospital $0 |
| Mental health outpatient care | Out-of-Network: Medicare Covered Mental Health Services: Copayment for Medicare Covered Individual Sessions $35 Copayment for Medicare Covered Group Sessions $35 |
| Outpatient services/surgery | Out-of-Network: Medicare Covered Outpatient Hospital Services: Copayment for Medicare Covered Outpatient Hospital Services $0 to $275 Copayment for Medicare Covered Ambulatory Surgical Center Services $0 to $250 $0 Diag Colonoscopy - OPH$175 Hyperbaric Oxygen Treatment - OPH$20 Mental Health - OPH$200 Surgery Svcs - OPH$20 Wound Care - OPH |
| Outpatient substance abuse care | In-Network: Outpatient Substance Abuse Services: Copayment for Medicare-covered Individual Sessions $20 Copayment for Medicare-covered Group Sessions $20 Prior Authorization Required for Outpatient Substance Abuse Services Referral Required for Outpatient Substance Abuse Services |
| Over-the-counter items | In-Network: $30 monthly allowance on a prepaid spending card. All plan members receive this amount to buy approved over the counter (OTC) health and wellness products at participating retailers or through the plan’s approved OTC mail order vendor. Plus, members may also use this money for eligible groceries, utilities, rent, and more if they have certain qualifying chronic condition(s) and meet other program criteria. Any unused amount rolls over each month and expires at the end of the plan year or upon disenrollment, whichever occurs first. |
| Podiatry services | Out-of-Network: Medicare Covered Podiatry Services: Copayment for Medicare Covered Podiatry Services $35 |
| Skilled Nursing Facility (SNF) care | In-Network: Skilled Nursing Facility Services: $0 per day for days 1 to 20 $160 per day for days 21 to 100 Prior Authorization Required for Skilled Nursing Facility Services Referral Required for Skilled Nursing Facility Services |
Dental Benefits
The following dental services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
| Coverage | Details |
|---|---|
| Dental care | In-Network: 0% coinsurance for scaling and root planing (deep cleaning) up to 1 per quadrant per year. 0% coinsurance for root canal, scaling for moderate inflammation up to 1 per year. 0% coinsurance for oral surgery up to 2 per year. 0% coinsurance for amalgam and/or composite filling, periodontal maintenance up to 4 per year. 0% coinsurance for simple or surgical extraction up to 5 per year. 0% coinsurance for necessary anesthesia with covered service up to as needed with covered codes per year. 0% coinsurance for extractions for dentures up to unlimited per year. $0 copayment for comprehensive oral exam up to 1 every 3 years. $0 copayment for panoramic film up to 1 per year. $0 copayment for bitewing x-rays, emergency diagnostic exam, periodic oral exam, prophylaxis (cleaning) up to 2 per year. 30% coinsurance for complete or partial dentures up to 1 every 5 years. 30% coinsurance for denture adjustments, rebase, reline up to 1 per year. Unlimited extractions are covered only for the purpose of member receiving dentures, all other extractions are limited to 5 per year. |
Vision Benefits
The following vision services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage
| Coverage | Details |
|---|---|
| Vision care | In-Network: Eye Exams: Copayment for Medicare Covered Benefits $0 to $20 Copayment for Routine Eye Exams $0
Referral Required for Eye Exams $0 Diab Eye Exam - All POTs$20 Vision Svcs (MC) - SPC Eyewear: Copayment for Medicare-Covered Benefits $0 Copayment for Contact Lenses $0 Copayment for Eyeglasses (lenses and frames) $0 Maximum Plan Benefit of $200 every year Plan covers up to $200 for supplemental eyeglasses (frames, lenses) or contact lenses per year or 2 pairs of select eyeglasses at no cost. |
Hearing Benefits
The following hearing services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
| Coverage | Details |
|---|---|
| Hearing care | Out-of-Network: Medicare Covered Hearing Exams Services: Copayment for Medicare Covered Hearing Exams $35 |
Preventive Services and Health/Wellness Education Programs
The following services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
| Coverage | Details |
|---|---|
| Preventive services and health/wellness education programs | In-Network: $0.00 copay for Medicare Covered Preventive Services: Abdominal aortic aneurysm screening Alcohol misuse screenings & counseling Bone mass measurements (bone density) Cardiovascular disease screenings Cardiovascular disease (behavioral therapy) Cervical & vaginal cancer screening Colorectal cancer screenings Depression screenings Diabetes screenings Diabetes self-management training Glaucoma tests Hepatitis B (HBV) infection screening Hepatitis C screening test HIV screening Lung cancer screening Mammograms (screening) Nutrition therapy services Obesity screenings & counseling One-time Welcome to Medicare preventive visit Prostate cancer screenings(PSA) Sexually transmitted infections screening & counseling Shots:
Yearly "Wellness" visit |
When reviewing Florida Medicare plans, be sure to find out if your doctors are part of the plan network. If a Medicare Advantage plan covers prescription drugs, make sure the plan formulary (list of drugs covered by the plan) includes your drugs.
You may be able to find plans in your part of Florida that offer similar benefits at similar or lower prices than the plan above. Call 1-800-557-6059 TTY 711, 24/7 to speak with a licensed insurance agent who can help you compare plans.
Plan Documents
| Links to plan documents |
Florida Counties Served
We offer plans from Humana, UnitedHealthcare®, Anthem Blue Cross and Blue Shield*, Aetna, HealthspringSM or Kaiser Permanente.