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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 2025, 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 out of 5 stars in 2025.
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 $5.00. 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) plan has an enhanced alternative drug benefit with no deductible. During the initial coverage phase, you will pay a copay or coinsurance depending on the drug tier and pharmacy. For example, preferred generic drugs have no copay at standard pharmacies, while non-preferred drugs have 33% coinsurance. After your total drug costs reach $2,000, you enter the catastrophic coverage phase and pay nothing for covered Part D drugs. However, you may still pay a share of the costs for excluded drugs covered under any enhanced benefit.
Additional Benefits
The CareOne Plus (HMO-POS) plan offers comprehensive coverage with no copays for many services, including inpatient hospital stays, outpatient observation and blood services, partial hospitalization, ground ambulance, and many primary care and preventive services. The plan also provides coverage for hearing exams, vision services, and a wide range of dental services, all with no copays. Additional benefits include coverage for ambulance and transportation services, emergency services, and home health services, also with no copays for many of these services. The plan provides coverage for home infusion services, dialysis services, medical equipment, and diagnostic and radiological services. However, some services such as air ambulance, therapeutic radiological services, and skilled nursing facilities may have coinsurance or copays.
Inpatient Hospital See details
The CareOne Plus (HMO-POS) plan covers Inpatient Hospital services, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, with no copay for Medicare-covered stays. Additional Days for Inpatient Hospital-Acute are covered with no copay for days 91-999, while Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute, as well as Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric, are not covered.
Outpatient Services See details
Outpatient Services are covered by the CareOne Plus (HMO-POS) plan. Outpatient Hospital Services have a copay between $0 and $50, Observation Services and Ambulatory Surgical Center (ASC) Services have no copay, and Outpatient Blood Services have no copay. Individual and Group Sessions for Outpatient Substance Abuse have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the CareOne Plus (HMO-POS) plan with no copay; however, prior authorization and a doctor referral are required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with prior authorization required. Ground ambulance services have no copay, while air ambulance services have a 20% coinsurance. Transportation services to a plan-approved health-related location are covered, with no copay and up to 50 one-way trips per year, but transportation services to any health-related location is not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the CareOne Plus (HMO-POS) plan. Emergency Services and Worldwide Emergency Coverage have a $140 copay, Worldwide Urgent Coverage has a copay between $35 and $140, and Worldwide Emergency Transportation also has a $140 copay; all other services have no coinsurance.
Primary Care See details
Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Podiatry Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services are covered. Primary Care Physician Services, Chiropractic Services, Physician Specialist Services, Mental Health Specialty Services, Podiatry Services, Other Health Care Professional, Psychiatric Services, Additional Telehealth Benefits, and Opioid Treatment Program Services have no copay. Occupational Therapy Services, Physical Therapy and Speech-Language Pathology Services, have no copay. Routine Chiropractic Care has no copay for 12 visits per year.
Preventive Services See details
Preventive Services include Medicare-covered zero-dollar preventive services, annual physical exams with no copay, and additional preventive services. Health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, remote access technologies, home and bathroom safety devices and modifications, and counseling services are not covered. Kidney disease education services, glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a Welcome Visit have no copay.
Hearing Services See details
The CareOne Plus (HMO-POS) plan covers hearing exams, routine hearing exams, fitting/evaluation for hearing aids, and OTC hearing aids with no copay. Prescription hearing aids are covered with a maximum benefit of $1,000 per year. Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, and Prescription Hearing Aids - Over the Ear are not covered.
Vision Services See details
Vision services, including routine eye exams and eyewear, are covered by the CareOne Plus (HMO-POS) plan, with a $0 copay. However, eyeglass lenses, eyeglass frames, and upgrades are not covered, and there is a combined maximum benefit of $300 per year for eyewear.
Dental Services See details
CareOne Plus (HMO-POS) covers various dental services with no copay, including oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), oral and maxillofacial surgery, restorative services, endodontics, periodontics, and prosthodontics (removable). Fluoride treatment, maxillofacial prosthetics, implant services, prosthodontics (fixed), and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the CareOne Plus (HMO-POS) plan, and prior authorization is required. For Medicare Part B Insulin Drugs, there is a $35 copay and 0-20% coinsurance, and for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a 0-20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the CareOne Plus (HMO-POS) plan and require prior authorization and a doctor's referral. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits with the CareOne Plus (HMO-POS) plan include Durable Medical Equipment (DME) with 20% coinsurance and Prosthetic Devices and Medical Supplies, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts with no copay. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including diagnostic procedures and tests, are covered by CareOne Plus (HMO-POS), with a copay between $0 and $25. Lab services have no copay, while diagnostic radiological services have a copay of up to $50, and therapeutic radiological services have a copay of $25. Outpatient X-ray services have no copay.
Home Health Services See details
Home Health Services are covered under the CareOne Plus (HMO-POS) plan with no copay and no coinsurance. Additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the CareOne Plus (HMO-POS) plan. Prior authorization and a doctor referral are required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by CareOne Plus (HMO-POS) with prior authorization and a doctor's referral. You will have no copay for days 1-20, and a $50 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services includes acupuncture with no copay, up to 25 treatments per year, and requires prior authorization. Over-the-counter items are covered, with a maximum benefit of $175 every three months, including nicotine replacement therapy and naloxone, though not all CMS OTC drugs are covered. The plan also covers a meal benefit for chronic illness with no copay and requires prior authorization. Other services such as Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, private duty nursing services, and others are not covered.
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