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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 Brevard and Indian River 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.
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 combined Maximum Out-Of-Pocket cost of $3500.00 (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 $3500.00 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. The plan has no deductible for prescription drugs. In the initial coverage phase, you will pay different copays or coinsurance amounts depending on the drug tier and pharmacy used. For example, preferred generic drugs have no copay at a standard pharmacy, and a $20 copay at a standard mail order pharmacy. After your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for Part D covered drugs.
Additional Benefits
The CareOne Plus (HMO-POS) plan offers a range of benefits with varying costs. Inpatient hospital stays have a copay, but many outpatient services, including primary care, preventive services, and home health, have no copay. The plan also covers hearing, vision, and dental services with copays or no copays, as well as medical equipment, and some transportation services. This plan provides coverage for emergency services, and offers benefits like hearing aids, and over-the-counter items. Some services, such as dialysis, and medical equipment, involve coinsurance or require prior authorization. The plan also includes benefits like a meal benefit for chronic illnesses, and a fitness benefit with no copay.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, with a $200 copay for days 1-7 and no copay for days 8-90. Additional days for Inpatient Hospital-Acute are covered with no copay, while non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute are not covered.
Outpatient Services See details
Outpatient Services are covered, including all outpatient hospital services with a copay of $0-$200. Observation services and Ambulatory Surgical Center (ASC) Services have no copay, while Outpatient Substance Abuse Services have a copay of $15 for both individual and group sessions. Outpatient Blood Services are covered with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the CareOne Plus (HMO-POS) plan and requires prior authorization and a doctor's referral. There is a $15 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the CareOne Plus (HMO-POS) plan. Ground ambulance services have a copay between $0 and $250, while air ambulance services have a 20% coinsurance; Transportation Services to a plan-approved health-related location are covered for 20 one-way trips per year with no copay, 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 have a $140 copay, and no coinsurance. Urgently Needed Services have a $15 copay, and no coinsurance. Worldwide Emergency Coverage has a $140 copay, and no coinsurance. Worldwide Urgent Coverage has a copay between $15 and $140, and no coinsurance. Worldwide Emergency Transportation has a $140 copay, and no coinsurance.
Primary Care See details
The CareOne Plus (HMO-POS) plan covers primary care physician services with no copay and chiropractic services with a $15 copay. Occupational therapy, physician specialist services, physical therapy, and speech-language pathology services have a $15 copay. Mental health specialty services, psychiatric services, and opioid treatment program services have a $15 copay for individual and group sessions. Additional telehealth benefits have a copay between $0 and $15.
Preventive Services See details
Preventive Services include an annual physical exam with no copay, and additional preventive services with a copay. Kidney Disease Education Services, and Other Preventive Services are covered with no copay. Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit have no copay. This plan also covers wigs for hair loss related to chemotherapy and a fitness benefit with no copay.
Hearing Services See details
The CareOne Plus (HMO-POS) plan covers hearing exams with a $15 copay, routine hearing exams with no copay, and fitting/evaluation for hearing aids with no copay, each limited to one visit per year. Prescription hearing aids are covered, with a maximum benefit of $500 per year. OTC hearing aids are also covered, up to $50 every three months.
Vision Services See details
Vision Services include coverage for eye exams with a copay between $0 and $15, and eyewear with no copay. Contact lenses and eyeglasses (lenses and frames) are covered with no copay, and there is a combined maximum of $350 per year for eyewear. Eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
CareOne Plus (HMO-POS) covers dental services, including Medicare Dental Services with a $15 copay, and other dental services like oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), and other preventive dental services, 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, but require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the CareOne Plus (HMO-POS) plan, but require prior authorization and a doctor's referral. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment, is covered. DME has a 20% coinsurance, and Durable Medical Equipment for use outside the home is not covered; Prosthetics and Medical Supplies have a 20% coinsurance; Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have a $10 copay.
Diagnostic and Radiological Services See details
The CareOne Plus (HMO-POS) plan covers diagnostic and radiological services, including diagnostic procedures/tests with a copay between $0 and $25, and lab services with no copay. Diagnostic radiological services have a copay up to $200, while therapeutic radiological services have a coinsurance up to 20% and a copay up to $15. Outpatient X-Ray services have no copay.
Home Health Services See details
Home Health Services are covered by 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's referral are required for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the CareOne Plus (HMO-POS) plan, but require prior authorization and a doctor's referral. You will pay a copay of $20 for days 1-20 and $203 for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
The CareOne Plus (HMO-POS) plan covers acupuncture with no copay, but requires prior authorization and is limited to 25 treatments per year. Over-the-counter items are covered, including nicotine replacement therapy and naloxone, with a maximum benefit of $50 every three months. The plan also covers a meal benefit with no copay for chronic illnesses. However, several other services are not covered.
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