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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 2026, 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 4.5 out of 5 stars in 2026.
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 no drug deductible. Your prescription medication coverage will start immediately.
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:
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Drug Coverage
The CareNeeds Platinum (HMO D-SNP) plan features a $0 drug deductible, meaning your prescription drug coverage begins immediately. For Tier 1 preferred generic and Tier 2 generic drugs, you will pay no copay when using standard pharmacies or preferred mail-order services for both 1-month and 3-month supplies. If you choose standard mail order for these generic tiers, copays range from $10 to $20 for a 1-month supply and $30 to $60 for a 3-month supply. For Tier 3 preferred brand and Tier 4 non-preferred drugs, the plan requires a 25% coinsurance across standard pharmacies, preferred mail order, and standard mail order options. Tier 5 specialty drugs incur a 33% coinsurance for a 1-month supply across all available pharmacy and mail-order channels. This straightforward cost-sharing structure helps you easily plan your healthcare budget for both daily generic medications and specialized prescriptions.
Additional Benefits
The CareNeeds Platinum (HMO D-SNP) plan offers comprehensive coverage with no copay and no coinsurance for the vast majority of essential medical services. This includes inpatient and outpatient hospital stays, primary care and specialist visits, preventive care, diagnostic testing, and home health services. Patients also benefit from no copay and no coinsurance for routine dental, vision, and hearing services, alongside annual allowances for eyewear and hearing aids. While most benefits require no copay or coinsurance, some emergency and transportation services do incur out-of-pocket costs. Emergency room visits require a $150 copay, which is waived if you are admitted, while ground ambulance services carry a copay ranging from no copay to $200. Additionally, air ambulance services require a 20% coinsurance, and cardiac rehabilitation services are not covered under this plan.
Inpatient Hospital See details
Inpatient hospital services are partially covered by CareNeeds Platinum (HMO D-SNP) with no copay and no coinsurance for Medicare-covered acute and psychiatric stays, though referrals and prior authorizations are required. Upgrades, non-Medicare-covered stays, and additional days for psychiatric care are not covered.
Outpatient Services See details
CareNeeds Platinum (HMO D-SNP) covers outpatient services—including outpatient hospital visits, observation services, ambulatory surgical center services, outpatient substance abuse treatment, and blood services—with no copay and no coinsurance. Prior authorization and referrals are required for these covered services.
Partial Hospitalization See details
Partial hospitalization is covered by CareNeeds Platinum (HMO D-SNP) with no copay and no coinsurance. Both a referral and prior authorization are required to receive these services.
Ambulance and Transportation Services See details
CareNeeds Platinum (HMO D-SNP) covers ground ambulance services with a $0 to $200 copay and air ambulance services with a 20% coinsurance, both requiring prior authorization. Transportation services are partially covered, offering unlimited rides to plan-approved locations with no copay and no coinsurance, though transportation to any health-related location is not covered.
Emergency Services See details
CareNeeds Platinum (HMO D-SNP) covers emergency services with a $150 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services feature no copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no coinsurance and copays ranging from $0 to $150.
Primary Care See details
CareNeeds Platinum (HMO D-SNP) 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
CareNeeds Platinum (HMO D-SNP) covers preventive services with no copay and no coinsurance, including annual physical exams and kidney disease education. The benefit is partially covered because sub-services such as health education, in-home safety assessments, personal emergency response systems (PERS), medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, caregiver support, disease management, telemonitoring, remote access, home safety devices, and counseling are not covered.
Hearing Services See details
CareNeeds Platinum (HMO D-SNP) partially covers hearing services with no copay and no coinsurance for routine exams, fittings, and hearing aids. While there is a $1,000 annual benefit per ear for prescription hearing aids, inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
CareNeeds Platinum (HMO D-SNP) offers partially covered vision services with no copay, no coinsurance, and no deductible, though prior authorization and referrals are required. Covered benefits include one routine eye exam per year and up to $300 annually for contact lenses and eyeglasses (lenses and frames), while other eye exam services, eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
CareNeeds Platinum (HMO D-SNP) offers partially covered dental services with no copay and no coinsurance for covered preventive and comprehensive care. While many diagnostic, restorative, and surgical services are covered, this plan does not cover fluoride treatments, maxillofacial prosthetics, implant services, fixed prosthodontics, or orthodontics.
Home Infusion bundled Services See details
CareNeeds Platinum (HMO D-SNP) covers Home Infusion bundled services with no copay and no coinsurance, though prior authorization is required and step therapy may apply. Under this benefit, Medicare Part B insulin, chemotherapy or radiation drugs, and other Part B drugs are covered with no copays and no coinsurance.
Dialysis Services See details
Dialysis Services are covered by CareNeeds Platinum (HMO D-SNP) with no copay and no coinsurance, although a referral and prior authorization are required.
Medical Equipment See details
CareNeeds Platinum (HMO D-SNP) covers medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic services, with no copay and no coinsurance. Prior authorization is required for these covered benefits, and some limitations on manufacturers or vendors may apply.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are fully covered under CareNeeds Platinum (HMO D-SNP) with no copay and no coinsurance for all lab services, X-rays, and diagnostic or therapeutic procedures. Prior authorization and referrals are required to access these covered services.
Home Health Services See details
Home Health Services are covered by CareNeeds Platinum (HMO D-SNP) with no copay and no coinsurance, though prior authorization and a referral are required.
Cardiac Rehabilitation Services See details
CareNeeds Platinum (HMO D-SNP) does not cover cardiac rehabilitation services, as intensive cardiac, pulmonary, and supervised exercise therapy (SET) rehabilitation services are all excluded from coverage.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are partially covered by CareNeeds Platinum (HMO D-SNP), offering coverage for days 1 through 100 with no copay and no coinsurance, though additional days beyond the Medicare-covered limit are not covered. Prior authorization and a referral are required for these services, but a three-day prior inpatient hospital stay is not.
Other Services See details
Other services covered by CareNeeds Platinum (HMO D-SNP) include acupuncture (up to 25 treatments per year) and meals for chronic illness with no copay, no coinsurance, and prior authorization required. Over-the-counter (OTC) items are also covered with no copay or coinsurance via reimbursement, while certain highly integrated dual-eligible services are not covered.
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