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CareOne Plus (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for CareOne Plus (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on CareOne Plus (HMO-POS) in 2026, please refer to our full plan details page.
CareOne Plus (HMO-POS) is a HMO-POS plan offered by Humana Inc. available for enrollment in 2025 to people living in Broward and Palm Beach Counties. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that CareOne Plus (HMO-POS) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about CareOne Plus (HMO-POS).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For CareOne Plus (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $6.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a combined Maximum Out-Of-Pocket cost of $2000.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $2000.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The CareOne Plus (HMO-POS) Medicare plan features a $0 drug deductible, meaning your prescription coverage begins immediately. For Tier 1 preferred generics, Tier 2 generics, and Tier 3 preferred brands, there is no copay for one-month or three-month supplies at standard pharmacies and through preferred mail order. If you utilize standard mail order, one-month copays range from $5 for preferred generics up to $47 for preferred brands. Higher-tier medications require coinsurance rather than fixed copays. Tier 4 non-preferred drugs carry a 50% coinsurance for both one-month and three-month supplies across standard pharmacies, preferred mail order, and standard mail order. Tier 5 specialty drugs require a 33% coinsurance for a one-month supply through all available retail and mail order options.
Additional Benefits
The CareOne Plus (HMO-POS) Medicare plan offers comprehensive medical coverage with exceptional cost savings, featuring no copays and no coinsurance for inpatient hospital stays, primary care, specialist visits, and preventive services. Outpatient hospital services carry a low copay of $0 to $50, while emergency room visits have a $150 copay that is waived upon hospital admission. Standard diagnostic labs, x-rays, and home health services are also covered with no copay or coinsurance. This plan also includes valuable supplemental benefits, such as preventive and comprehensive dental, vision, and hearing care with no copays or coinsurance. Members receive up to $1,000 per ear annually for prescription hearing aids, a $300 annual eyewear allowance, and up to 50 free one-way transportation trips to approved locations. While many services feature no copay, some benefits like durable medical equipment and dialysis require a 20% coinsurance, and prior authorizations or referrals are required for certain coverages.
Inpatient Hospital See details
CareOne Plus (HMO-POS) covers inpatient hospital services with no copay and no coinsurance for Medicare-covered acute and psychiatric stays, though prior authorization and referrals are required. This benefit is partially covered because room upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
CareOne Plus (HMO-POS) covers outpatient services with no coinsurance, featuring a $0 to $50 copay for outpatient hospital services and no copay for ambulatory surgical center, observation, outpatient substance abuse, and blood services. Most of these covered outpatient services require prior authorization and a referral.
Partial Hospitalization See details
CareOne Plus (HMO-POS) covers partial hospitalization services with no copay and no coinsurance. Prior authorization and a referral are required to receive these covered services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by CareOne Plus (HMO-POS), with ground ambulance services requiring no copay but subject to coinsurance, and air ambulance services requiring a 20% coinsurance and a copay. Transportation benefits are partially covered, offering up to 50 one-way trips per year to plan-approved locations with no copay and no coinsurance, while trips to any health-related location are not covered.
Emergency Services See details
CareOne Plus (HMO-POS) offers emergency services coverage with a $150 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services are available with no copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no coinsurance and copays ranging from $35 to $150.
Primary Care See details
CareOne Plus (HMO-POS) covers primary care, specialist visits, therapy, and mental health services with no copays and no coinsurance. Chiropractic services are partially covered, offering up to 12 routine visits per year with no copay or coinsurance, though other chiropractic services are not covered.
Preventive Services See details
CareOne Plus (HMO-POS) covers preventive services—including annual physical exams, kidney disease education, glaucoma screenings, and a memory fitness benefit—with no copay and no coinsurance. However, these additional preventive benefits are only partially covered, with services such as health education, weight management, in-home safety assessments, and personal emergency response systems not covered.
Hearing Services See details
CareOne Plus (HMO-POS) covers hearing services with no copay, no coinsurance, and no deductible for exams, fittings, and hearing aids. Prescription hearing aids are partially covered up to $1,000 per ear annually, excluding inner ear, outer ear, and over-the-ear models. Unlimited OTC hearing aids are also covered with no copay or coinsurance.
Vision Services See details
Vision services are partially covered by CareOne Plus (HMO-POS) with no copay and no coinsurance, though prior authorization and referrals are required. Covered benefits include one routine eye exam per year and up to a $300 annual limit for contact lenses and eyeglasses (lenses and frames), while other eye exams, separate eyeglass lenses, separate eyeglass frames, and upgrades are not covered.
Dental Services See details
CareOne Plus (HMO-POS) partially covers dental services with no copay and no coinsurance for preventive and comprehensive care. Fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered under this plan.
Home Infusion bundled Services See details
CareOne Plus (HMO-POS) covers home infusion bundled services with no copay, though prior authorization is required. Covered Medicare Part B chemotherapy, radiation, and other drugs require no copay and a coinsurance of no coinsurance to 20%, while Medicare Part B insulin drugs require a $35 copay and a coinsurance of no coinsurance to 20%.
Dialysis Services See details
Dialysis services are covered by CareOne Plus (HMO-POS) with no copay and a 20% coinsurance, though prior authorization and a referral are required.
Medical Equipment See details
CareOne Plus (HMO-POS) covers durable medical equipment (DME) with a 20% coinsurance and no copay, subject to prior authorization. Prosthetics, medical supplies, and diabetic equipment are also covered with no copay and no coinsurance, though prior authorization is required.
Diagnostic and Radiological Services See details
CareOne Plus (HMO-POS) covers diagnostic and radiological services with no coinsurance, though prior authorization and referrals are required. Lab and outpatient X-ray services have no copay, diagnostic procedures and tests range from a $0 to $25 copay, and therapeutic radiological services have a minimum copay of $25.
Home Health Services See details
Home health services are covered by CareOne Plus (HMO-POS) with no copay and no coinsurance, though prior authorization and a referral are required.
Cardiac Rehabilitation Services See details
CareOne Plus (HMO-POS) covers Cardiac Rehabilitation Services with no copay and no coinsurance, although prior authorization and referrals are required. While some services are covered, specific sub-services including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
CareOne Plus (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, featuring no copay for days 1 through 20 and a $60 daily copay for days 21 through 100. Prior authorization and referrals are required, and coverage is not provided for additional days beyond the standard Medicare-covered limit.
Other Services See details
Other Services are partially covered by CareOne Plus (HMO-POS), providing acupuncture, over-the-counter items, and chronic illness meal benefits with no copay and no coinsurance. Prior authorization is required for acupuncture and meals, while certain over-the-counter list drugs and other unspecified services are not covered.
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