A non-government entity
CareNeeds Plus (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for CareNeeds Plus (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 Plus (HMO D-SNP) in 2026, please refer to our full plan details page.
CareNeeds Plus (HMO D-SNP) is a HMO D-SNP plan offered by Humana Inc. available for enrollment in 2025 to people living in Select Counties in Florida. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that CareNeeds Plus (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 Plus (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 Plus (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 Plus (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:
Sign up for CareNeeds Plus (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 Plus (HMO D-SNP) plan features a $0 drug deductible, meaning your prescription drug coverage begins immediately. For generic medications, you will pay no copay for Tier 1 preferred generics and Tier 2 generics when using a standard pharmacy or preferred mail order. If you choose standard mail order, copays range from $10 to $20 for a 1-month supply and $30 to $60 for a 3-month supply. Brand-name and specialty medications under this plan are covered via coinsurance. Tier 3 preferred brands and Tier 4 non-preferred drugs both require a 25% coinsurance for standard pharmacy and mail order fills. Specialty drugs in Tier 5 carry a 33% coinsurance for a 1-month supply.
Additional Benefits
The CareNeeds Plus (HMO D-SNP) plan offers comprehensive healthcare coverage with no copays and no coinsurance for a wide range of essential services. This includes inpatient and outpatient hospital stays, primary and specialist care, preventive screenings, and diagnostic testing. Although prior authorization and referrals are required for many benefits, members can also access skilled nursing, home health, and dialysis services at no cost. Supplemental benefits like dental, vision, and hearing care are also covered with no copays, featuring a $300 annual eyewear allowance and up to $1,000 per ear yearly for prescription hearing aids. Emergency room visits carry a $150 copay which is waived if admitted, while unlimited transportation to plan-approved locations is provided with no copay or coinsurance. Members also receive medical equipment, over-the-counter items, and acupuncture treatments with no copayments.
Inpatient Hospital See details
CareNeeds Plus (HMO D-SNP) covers inpatient hospital acute and psychiatric stays with no copay and no coinsurance, although prior authorization and referrals are required. This benefit is partially covered as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
CareNeeds Plus (HMO D-SNP) outpatient services are covered with no copays and no coinsurance, including outpatient hospital, ambulatory surgical center, outpatient substance abuse, and outpatient blood services. Prior authorization and referrals are required for these services, and there is no deductible for outpatient blood services.
Partial Hospitalization See details
CareNeeds Plus (HMO D-SNP) covers partial hospitalization services with no copay and no coinsurance, although prior authorization and a referral are required.
Ambulance and Transportation Services See details
CareNeeds Plus (HMO D-SNP) covers ground ambulance services with a copay ranging from no copay to $200 plus coinsurance, and air ambulance services with a 20% coinsurance plus a copay, both requiring prior authorization. Transportation services are partially covered, offering unlimited rides to plan-approved locations with no copay and no coinsurance, while transportation to any other health-related location is not covered.
Emergency Services See details
CareNeeds Plus (HMO D-SNP) covers emergency services with a $150 copay and no coinsurance, which is 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 Plus (HMO D-SNP) covers primary care benefits with no copay and no coinsurance for services including physician visits, specialist care, mental health, and physical therapy. These benefits are partially covered because other chiropractic services are not covered.
Preventive Services See details
CareNeeds Plus (HMO D-SNP) covers preventive services with no copays and no coinsurance, including annual physical exams, kidney disease education, and glaucoma screenings. Additional preventive services are partially covered under prior authorization with no copay or coinsurance, but services such as health education, personal emergency response systems, and medical nutrition therapy are not covered.
Hearing Services See details
CareNeeds Plus (HMO D-SNP) hearing services are covered with no copay, no coinsurance, and no deductible for routine exams, fitting evaluations, and OTC hearing aids. Prescription hearing aids are partially covered with no copay or coinsurance up to a $1,000 maximum per ear every year, though inner ear, outer ear, and over-the-ear types are not covered.
Vision Services See details
CareNeeds Plus (HMO D-SNP) provides partially covered vision services with no copay, no coinsurance, and no deductible, though prior authorization and referrals are required. This benefit includes one routine eye exam per year and up to a $300 annual allowance 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
CareNeeds Plus (HMO D-SNP) offers partially covered dental services with no copay and no coinsurance for covered preventive and comprehensive care, including exams, cleanings, and oral surgery. However, some services such as fluoride treatments, implants, fixed prosthodontics, and orthodontics are not covered.
Home Infusion bundled Services See details
CareNeeds Plus (HMO D-SNP) covers home infusion bundled services and associated Medicare Part B drugs, including chemotherapy and insulin, with no copay and no coinsurance. Prior authorization is required for these services, and step therapy may apply to certain Part B drugs.
Dialysis Services See details
Dialysis services are covered by CareNeeds Plus (HMO D-SNP) with no copay and no coinsurance, though prior authorization and a referral are required.
Medical Equipment See details
CareNeeds Plus (HMO D-SNP) covers medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic equipment, with no copay and no coinsurance. Prior authorization is required for these benefits, and some equipment may be limited to preferred vendors or manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by CareNeeds Plus (HMO D-SNP) with no copays and no coinsurance. These covered services, which include lab tests, x-rays, and therapeutic or diagnostic radiology, require prior authorization and a referral.
Home Health Services See details
CareNeeds Plus (HMO D-SNP) covers home health services with no copay and no coinsurance, though a referral and prior authorization are required.
Cardiac Rehabilitation Services See details
CareNeeds Plus (HMO D-SNP) covers Cardiac Rehabilitation Services with no copay and no coinsurance, although a referral and prior authorization are required. While some services are covered, specific options such as cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered.
Skilled Nursing Facility (SNF) See details
CareNeeds Plus (HMO D-SNP) partially covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance for days 1 through 100, though additional days beyond the Medicare-covered period are not covered. Prior authorization and referrals are required for these services, which do not require a three-day inpatient hospital stay prior to admission.
Other Services See details
CareNeeds Plus (HMO D-SNP) offers partially covered other services with no copay and no coinsurance for covered benefits, which include acupuncture up to 25 treatments per year, over-the-counter items, and meal benefits for chronic illnesses. Prior authorization is required for acupuncture and meals, while Dual Eligible SNPs with Highly Integrated Services and other miscellaneous 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