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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 2026, 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 4.5 out of 5 stars in 2026.
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 $9.00. 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 a $615.00 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 combined Maximum Out-Of-Pocket cost of $2500.00 (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 $2500.00 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) Medicare plan features an annual drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic drugs, you will pay no copay for one-month or three-month supplies filled at standard pharmacies or through preferred mail order. If you choose standard mail order for these generic tiers, copays range from $10 to $60 depending on the tier and supply length. For Tier 3 preferred brand drugs, copays start at $25 for a one-month supply at standard pharmacies and preferred mail order, but rise up to $141 for a three-month standard mail order. Higher tier medications are subject to coinsurance, with Tier 4 non-preferred drugs requiring a 50% coinsurance and Tier 5 specialty drugs requiring a 25% coinsurance.
Additional Benefits
The CareOne Plus (HMO-POS) plan offers robust coverage with no copays or coinsurance for primary care, specialist visits, preventive care, and home health services. For hospital stays, inpatient care requires a $60 daily copay for the first 5 days with no coinsurance, while outpatient hospital visits feature copays ranging from no copay up to $60. Emergency room visits carry a $100 copay that is waived upon admission, and urgent care services require no copay. Members also benefit from routine dental, vision, and hearing services with no copays or coinsurance, alongside a $300 annual eyewear allowance and coverage for prescription hearing aids. While many diagnostic tests and acupuncture sessions carry no copay, dialysis and durable medical equipment require a 20% coinsurance. Additionally, the plan includes up to 50 one-way transportation trips to approved locations and over-the-counter items with no copay.
Inpatient Hospital See details
CareOne Plus (HMO-POS) provides partially covered inpatient hospital services with no coinsurance, requiring a $60 daily copay for days 1 through 5 and no copay for days 6 through 90. Unlimited additional acute care days are covered at no copay, but upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
CareOne Plus (HMO-POS) covers outpatient services with no coinsurance, featuring no copays for ambulatory surgical center services, observation services, outpatient substance abuse sessions, and outpatient blood services. Outpatient hospital services are also covered with no coinsurance and a copay ranging from $0 to $60.
Partial Hospitalization See details
Partial hospitalization is covered by CareOne Plus (HMO-POS) with no copay and no coinsurance. Both prior authorization and a referral are required to receive these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by CareOne Plus (HMO-POS), with ground ambulance services requiring a copay of $0 to $200 and air ambulance services requiring a 20% coinsurance. Transportation benefits are partially covered with no copay or coinsurance for up to 50 one-way trips per year to plan-approved locations, though transportation to any health-related location is not covered.
Emergency Services See details
Emergency services under CareOne Plus (HMO-POS) are covered with a $100 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 $100.
Primary Care See details
CareOne Plus (HMO-POS) provides primary care, specialist, therapy, and mental health services with no copay and no coinsurance. Chiropractic services are partially covered with no copay or coinsurance for routine care up to 12 visits per year, though other chiropractic services are not covered.
Preventive Services See details
CareOne Plus (HMO-POS) preventive services are covered with no copay and no coinsurance, including annual physicals, kidney disease education, diabetes training, and glaucoma screenings. This benefit is partially covered, as memory fitness and chemotherapy wigs (up to $500) are included with no copays or coinsurance, but other services like health education, weight management, and in-home safety assessments are not covered.
Hearing Services See details
CareOne Plus (HMO-POS) hearing services are covered with no copays, no deductibles, and no coinsurance for routine exams, fittings, and over-the-counter hearing aids. Prescription hearing aids are partially covered with no copay or coinsurance up to $1,000 per ear annually, though inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
CareOne Plus (HMO-POS) offers partially covered vision services with no copay and no coinsurance, though prior authorization and referrals are required. Covered benefits include one routine eye exam per year and a combined $300 annual limit for contact lenses and eyeglasses (lenses and frames), while other eye exam services, separate eyeglass lenses, separate eyeglass frames, and upgrades are not covered.
Dental Services See details
CareOne Plus (HMO-POS) partially covers dental services with no copay and no coinsurance for covered preventive and comprehensive care. Fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
CareOne Plus (HMO-POS) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs carry no copay and 0% to 20% coinsurance, while covered Part B insulin drugs require a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
CareOne Plus (HMO-POS) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization and a referral are required to access these services.
Medical Equipment See details
CareOne Plus (HMO-POS) covers durable medical equipment (DME) with a 20% coinsurance and no copay, subject to prior authorization and vendor limitations. Prosthetics, medical supplies, and diabetic services are also covered with no copays and no coinsurance, though prior authorization is required.
Diagnostic and Radiological Services See details
CareOne Plus (HMO-POS) covers diagnostic services with no coinsurance, no copay for lab services, and a $0 to $25 copay for tests. Covered radiological services feature no copay for outpatient X-rays, no minimum copay for diagnostic radiology, and a minimum 20% coinsurance with no minimum copay for therapeutic radiology.
Home Health Services See details
CareOne Plus (HMO-POS) covers Home Health Services with no copay and no coinsurance, though prior authorization and a referral are required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered in practice under the CareOne Plus (HMO-POS) plan, as all sub-services—including intensive cardiac, pulmonary, and SET for PAD rehabilitation—are not covered. Although the plan technically features no copay and no coinsurance for this category, no rehabilitation services are actually covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by CareOne Plus (HMO-POS) with no coinsurance, featuring no copay for days 1 through 20 and a $160 daily copay for days 21 through 100. Prior authorization and referrals are required, but a three-day prior inpatient hospital stay is not required.
Other Services See details
CareOne Plus (HMO-POS) partially covers other services, providing acupuncture, over-the-counter (OTC) items, and chronic illness meals with no copay and no coinsurance, though prior authorization is required for meals and acupuncture. Certain OTC drugs on the CMS list and other miscellaneous services are not covered.
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