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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 Orlando Area. 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 $2750.00 (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 $2750.00 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. This plan has no deductible. During the initial coverage phase, you will pay different copays or coinsurance amounts depending on the drug tier and pharmacy type. For example, you will pay no copay for preferred generic drugs at a standard pharmacy, but a $20 copay for the same drug through standard mail. After your total drug costs reach $2000, you enter the catastrophic coverage phase and pay nothing for Part D covered drugs.
Additional Benefits
The CareOne Plus (HMO-POS) plan offers a wide range of benefits with a focus on outpatient services. Many services, including primary care, preventive services, hearing, vision, and dental, have no copay. You'll also find coverage for ambulance and transportation, emergency services, and home health services. The plan has a copay for inpatient hospital stays, and some outpatient services. Additional benefits include coverage for medical equipment, diagnostic and radiological services, and skilled nursing facilities.
Inpatient Hospital See details
Inpatient Hospital benefits are covered by CareOne Plus (HMO-POS), including both Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute, you will pay a $60 copay for days 1-5, and no copay for days 6-90. For Inpatient Hospital Psychiatric, you will also pay a $60 copay for days 1-5, and no copay for days 6-90. Additional Days for Inpatient Hospital-Acute are covered with no copay for days 91-999. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute, and Additional Days and Non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services, are covered. Outpatient Hospital Services have a copay between $0 and $60, and Observation Services, Ambulatory Surgical Center Services, Individual Sessions for Outpatient Substance Abuse, Group Sessions for Outpatient Substance Abuse, and Outpatient Blood Services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered with no copay, but requires prior authorization and a doctor referral.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the CareOne Plus (HMO-POS) plan, including all ambulance services. Ground ambulance services have a copay between $0 and $200, and air ambulance services have a 20% coinsurance. Transportation Services to a Plan Approved Health-related Location are covered for up to 26 one-way trips per year with no copay, while Transportation Services to Any Health-related Location are 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 $100 copay and no coinsurance, while Urgently Needed Services have no copay and no coinsurance. Worldwide Emergency Coverage and Worldwide Emergency Transportation have a $100 copay and no coinsurance, and Worldwide Urgent Coverage has a copay between $0 and $100 with 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, Opioid Treatment Program Services have no copay. Occupational Therapy Services, Physical Therapy and Speech-Language Pathology Services have a $0 copay.
Preventive Services See details
Preventive Services include an annual physical exam with no copay. Other covered preventive services include Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit, all with no copay.
Hearing Services See details
CareOne Plus (HMO-POS) covers hearing exams with no copay, routine hearing exams, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids (all types) are covered with no copay, and OTC hearing aids are covered up to $75 every three months.
Vision Services See details
Vision services, including routine eye exams and eyewear, are covered by the CareOne Plus (HMO-POS) plan. Routine eye exams and eyewear have no copay. Contact lenses and eyeglasses (lenses and frames) are covered, while eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
CareOne Plus (HMO-POS) covers 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 with no copay; however, fluoride treatment, maxillofacial prosthetics, implant services, prosthodontics (fixed), and orthodontics are not covered. Oral exams are limited to 4 visits per year, dental x-rays are limited to 3 per year, other diagnostic dental services are limited to 1 visit every three years, prophylaxis (cleaning) is limited to 2 visits per year, other preventive dental services are limited to 4 visits per year, restorative services are limited to 4 visits per year, endodontics and periodontics are limited to 1 visit per year, prosthodontics (removable) is limited to 2 visits with part/comp dentures 1 set(s)/5 yrs, reline 1/yr, and oral and maxillofacial surgery has extractions for dentures unl/yr, extractions 5/yr, oral surg 2/yr.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and prior authorization is required. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 19%.
Dialysis Services See details
Dialysis Services are covered under the CareOne Plus (HMO-POS) plan, but require prior authorization and a doctor's referral. The coinsurance for dialysis services is 20%.
Medical Equipment See details
The CareOne Plus (HMO-POS) plan covers Durable Medical Equipment (DME) with 20% coinsurance, and Prosthetic Devices, 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 are covered under the CareOne Plus (HMO-POS) plan, with a doctor referral and prior authorization required. Diagnostic Procedures/Tests have a copay between $0 and $25, while Lab Services have no copay. Diagnostic Radiological Services have a copay of at most $60, and Therapeutic Radiological Services have a coinsurance of at most 20% and no copay. 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. However, 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 the CareOne Plus (HMO-POS) plan, but require prior authorization and a doctor's referral. You will have no copay for days 1-20, and a $160 copay per day for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
Other Services includes acupuncture with no copay, and a limit of 20 treatments per year, and a meal benefit with no copay. This plan also offers OTC items as a supplemental benefit with a maximum of $75 every three months. However, the plan does not cover Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, or Self-Directed Personal Assistance Services.
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