A non-government entity
CareNeeds Platinum (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for CareNeeds Platinum (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on CareNeeds Platinum (HMO D-SNP) in 2025, please refer to our full plan details page.
CareNeeds Platinum (HMO D-SNP) is a HMO D-SNP plan offered by Humana Inc. available for enrollment in 2025 to people living in Broward, Miami-Dade, & Palm Beach Counties. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that CareNeeds Platinum (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
CareNeeds Platinum (HMO D-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about CareNeeds Platinum (HMO D-SNP).
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 CareNeeds Platinum (HMO D-SNP), 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.
This plan does not come with a Part B Premium reduction. You must continue to pay your 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 a $500.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $3400.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
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:
Sign up for CareNeeds Platinum (HMO D-SNP)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The CareNeeds Platinum (HMO D-SNP) plan has a $500 deductible for prescription drugs. After the deductible, you'll pay a copay or coinsurance depending on the drug tier and the pharmacy you use. For preferred generic drugs, you'll pay no copay at a preferred pharmacy or preferred mail order, and a $20 copay at a standard mail order pharmacy. For standard generic drugs, you'll pay a $47 copay at standard and preferred pharmacies and mail order. For preferred brand and non-preferred drugs, you'll pay 25% coinsurance. Once your total drug costs reach $2000, you enter the catastrophic coverage phase and pay nothing for covered drugs.
Additional Benefits
The CareNeeds Platinum (HMO D-SNP) plan offers comprehensive coverage with many services at no copay, including inpatient and outpatient hospital services, primary care, preventive services, hearing and vision exams, dental, and home health services. The plan also includes additional benefits such as ambulance and transportation services, emergency services, and coverage for durable medical equipment. However, some services like non-Medicare-covered stays, upgrades, and certain types of hearing aids and dental work are not covered by this plan.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered with no copay for Medicare-covered stays. Additional Days for Inpatient Hospital-Acute are also covered with no copay. Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute, and Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric, are not covered.
Outpatient Services See details
Outpatient Services are covered, including outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital services, observation services, ambulatory surgical center services, and outpatient blood services have no copay. Outpatient substance abuse services, including individual and group sessions, have no copay.
Partial Hospitalization See details
CareNeeds Platinum (HMO D-SNP) covers partial hospitalization with no copay, but requires prior authorization and a doctor's referral.
Ambulance and Transportation Services See details
The CareNeeds Platinum (HMO D-SNP) plan covers ambulance and transportation services, with prior authorization required. Ground ambulance services have a copay of $0-$200, while air ambulance services have a 20% coinsurance. Transportation services to plan-approved health-related locations are covered, with no copay and up to 50 one-way trips per year; transportation 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 CareNeeds Platinum (HMO D-SNP) plan. Emergency Services and Worldwide Emergency Coverage have a $140 copay, while Urgently Needed Services and Worldwide Urgent Coverage have no copay. Worldwide Emergency Transportation also has a $140 copay.
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 all have a $0 copay. Occupational Therapy Services has a copay, and Physical Therapy and Speech-Language Pathology Services has a $0 copay.
Preventive Services See details
Preventive Services include no copay for annual physical exams, Medicare-covered preventive services, and other services like glaucoma screening, and diabetes self-management training. Additional preventive services, including wigs for hair loss related to chemotherapy, and in-home support services are covered with no copay, and the plan also covers additional sessions for smoking cessation and fitness benefits with no copay. However, the plan does not cover health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, support for caregivers of enrollees, telemonitoring services, remote access technologies, home and bathroom safety devices, or counseling services.
Hearing Services See details
CareNeeds Platinum (HMO D-SNP) covers hearing exams with no copay, routine hearing exams with no copay, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids have a maximum benefit of $1,000 per year, and OTC hearing aids are covered up to $75 every three months. Prescription hearing aids - inner ear, outer ear, and over the ear are not covered.
Vision Services See details
Vision Services are covered, including eye exams and eyewear. Eye exams and eyewear have no copay. Contact lenses and eyeglasses (lenses and frames) are covered with no copay, while eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
The CareNeeds Platinum (HMO D-SNP) plan covers a range of dental services including oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable), and oral and maxillofacial surgery, all with no copay. 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 by the CareNeeds Platinum (HMO D-SNP) plan, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. Medicare Part B Insulin Drugs and Medicare Part B Chemotherapy/Radiation Drugs have no copay, and Other Medicare Part B Drugs have a copay of $0.
Dialysis Services See details
Dialysis Services are covered under the CareNeeds Platinum (HMO D-SNP) plan and require prior authorization and a doctor's referral. There is no copay for this service.
Medical Equipment See details
The CareNeeds Platinum (HMO D-SNP) plan covers durable medical equipment, prosthetics, medical supplies, and diabetic equipment. There is no coinsurance for durable medical equipment, prosthetics, and medical supplies, and there is no copay for durable medical equipment, prosthetic devices, diabetic supplies, and diabetic therapeutic shoes/inserts. Durable medical equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including all diagnostic services, diagnostic procedures/tests, lab services, all radiological services, diagnostic radiological services, therapeutic radiological services, and outpatient X-ray services. Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the CareNeeds Platinum (HMO D-SNP) 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 covered, but the plan does not cover any of the listed sub-services. Prior authorization and a doctor referral are required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the CareNeeds Platinum (HMO D-SNP) plan, but require prior authorization and a doctor's referral. The plan does not provide additional days beyond Medicare-covered, and non-Medicare-covered stays are not covered.
Other Services See details
The CareNeeds Platinum (HMO D-SNP) plan covers acupuncture with no copay, and a maximum of 25 treatments per year. The plan also covers over-the-counter (OTC) items up to $75 every three months, and meal benefits with no copay. However, the plan does not cover Dual Eligible SNPs with Highly Integrated Services, and many other services are not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved