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CareOne Plus (HMO-POS) - H1019-001-000
$0.00
Monthly Premium
CareOne Plus (HMO-POS) is a HMO-POS Medicare Advantage (Medicare Part C) plan offered by Humana Inc.
Plan ID: H1019-001-000
* 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.
Enrollment may be limited to certain times of the year. See why you may be able to enroll today.
Basic Costs and Coverage
| Coverage | Details |
|---|---|
| Monthly plan premium | $0.00 |
| Vision coverage | |
| Dental coverage | |
| Hearing coverage | |
| Prescription drugs | |
| Medical deductible | $0.00 |
| Out-of-pocket maximum | $2,000.00 |
| 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 $0 Prior Authorization Required for Doctor Specialty Visit Referral Required for Doctor Specialty Visit |
| Inpatient hospital care | Out-of-Network: Acute Hospital Services: Copayment for Acute Hospital Services $0 |
| Urgent care | Urgent Care: Copayment for Urgent Care $0 Worldwide Coverage: Copayment for Worldwide Urgent Coverage $35 to $150 |
| 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 $150 |
| Ambulance transportation | Out-of-Network: Ambulance Services: Copayment for Ambulance Services - Ground $0 Coinsurance for Ambulance Services - Air 20% |
Health Care Services and Medical Supplies
CareOne Plus (HMO-POS) covers a range of additional benefits. Learn more about CareOne Plus (HMO-POS) benefits, some of which may not be covered by Original Medicare (Part A and Part B).
| Coverage | Details |
|---|---|
| Chiropractic services | In-Network: Chiropractic Services: Copayment for Medicare-covered Chiropractic Services $0 Copayment for Routine Care $0
|
| 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 $10 |
| Durable medical equipment (DME) | In-Network: Durable Medical Equipment: Copayment for Medicare-covered Durable Medical Equipment $0 Coinsurance for Medicare-covered Durable Medical Equipment 20% Prior Authorization Required for Durable Medical Equipment $0 Continuous Glucose Monitor - DME Prov$0 Continuous Glucose Monitor - Pharmacy20% DME-All Other - DME Prov20% DME-All Other - Pharmacy20% DME-High Cost - DME Prov20% DME-High Cost - Pharmacy |
| 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 $35 Copayment for Medicare Covered Lab Services $0 to $25 Copayment for Medicare Covered Diagnostic Radiological Services $0 to $200 Copayment for Medicare Covered Therapeutic Radiological Services $25 Copayment for Medicare Covered Outpatient X-Ray Services $35 $25 OP Diag Proc & Tests - OPH$0 OP Diag Proc & Tests - PCP$0 OP Diag Proc & Tests - SPC$0 OP Diag Proc & Tests - UCC$25 Sleep Study (Fac Based) - OPH$0 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 | In-Network: Psychiatric Hospital Services: Copayment for Psychiatric Hospital Services per Stay $0 Prior Authorization Required for Psychiatric Hospital Services Referral Required for Psychiatric Hospital Services |
| Mental health outpatient care | In-Network: Outpatient Mental Health Services: Copayment for Medicare-covered Individual Sessions $0 Copayment for Medicare-covered Group Sessions $0 |
| Outpatient services/surgery | In-Network: Outpatient Hospital Services: Copayment for Medicare Covered Outpatient Hospital Services $0 to $50 Prior Authorization Required for Outpatient Hospital Services Referral Required for Outpatient Hospital Services $0 Diag Colonoscopy - OPH$25 Hyperbaric Oxygen Treatment - OPH$0 Mental Health - OPH$50 Surgery Svcs - OPH$25 Wound Care - OPH Outpatient Observation Services: Copayment for Medicare Covered Observation Services - Per stay $0 Prior Authorization Required for Outpatient Observation Services Referral Required for Outpatient Observation Services Ambulatory Surgical Center Services: Copayment for Ambulatory Surgical Center Services $0 Prior Authorization Required for Ambulatory Surgical Center Services Referral Required for Ambulatory Surgical Center Services |
| Outpatient substance abuse care | Out-of-Network: Medicare Covered Outpatient Substance Abuse Services: Copayment for Medicare Covered Individual Sessions $35 Copayment for Medicare Covered Group Sessions $35 |
| Over-the-counter items | CareEssentials Allowance: $105 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 | Out-of-Network: Skilled Nursing Facility Services: $0 per day for days 1 to 20 $60 per day for days 21 to 100 |
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 | $0 copayment for comprehensive oral exam up to 1 every 3 years. $0 copayment for complete or partial dentures up to 1 set(s) every 5 years. $0 copayment for bridge recementation, bridges-pontic up to 1 every 5 years. $0 copayment for bridges-crown up to 2 every 5 years. $0 copayment for scaling and root planing (deep cleaning) up to 1 per quadrant per year. $0 copayment for denture reline, panoramic film, root canal up to 1 per year. $0 copayment for bitewing x-rays up to 2 set(s) per year. $0 copayment for emergency diagnostic exam, oral surgery, periodic oral exam, prophylaxis (cleaning) up to 2 per year. $0 copayment for amalgam and/or composite filling, periodontal maintenance up to 4 per year. $0 copayment for simple or surgical extraction up to 5 per year. $0 copayment for necessary anesthesia with covered service up to as needed with covered codes per year. $0 copayment for extractions for dentures up to unlimited 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 Copayment for Routine Eye Exams $0
Referral Required for Eye Exams Eyewear: Copayment for Medicare-Covered Benefits $0 Copayment for Contact Lenses $0 Copayment for Eyeglasses (lenses and frames) $0 Maximum Plan Benefit of $300 every year Plan covers up to $300 for supplemental contact lenses or eyeglasses- lenses and frames, fitting or 3 pairs of select eyeglasses per year 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 | In-Network: Hearing Exams: Copayment for Medicare Covered Benefits $0 Copayment for Routine Hearing Exams $0
Referral Required for Hearing Exams Hearing Aids: Copayment for Hearing Aids $0
|
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 | Out-of-Network: Medicare Covered Medicare-covered Preventive Services: Copayment for Medicare Covered Medicare-covered Preventive Services $0 Coinsurance for Medicare Covered Medicare-covered Preventive Services 50% |
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 1-888-876-5731 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, Healthspring, Wellcare, or Kaiser Permanente.
Enrollment may be limited to certain times of the year. See why you may be able to enroll today.