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CareFree Platinum Giveback (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for CareFree Platinum Giveback (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on CareFree Platinum Giveback (HMO) in 2025, please refer to our full plan details page.
CareFree Platinum Giveback (HMO) is a HMO plan offered by Humana Inc. available for enrollment in 2025 to people living in Clay, Duval, and St. Johns Counties. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that CareFree Platinum Giveback (HMO) 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 CareFree Platinum Giveback (HMO).
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 CareFree Platinum Giveback (HMO), 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 $120.00. 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 Maximum Out-Of-Pocket cost of $3900.00 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 CareFree Platinum Giveback (HMO) plan has a $0 deductible for prescription drugs. During the initial coverage phase, you will pay a copay or coinsurance depending on the drug tier and pharmacy type. For example, preferred generic drugs have no copay at a preferred pharmacy and a $20 copay at a standard mail pharmacy. Once your total drug costs reach $2000, you enter the catastrophic coverage phase, where you will pay nothing for covered drugs. This plan's premium may be reduced if you qualify for the low-income subsidy (LIS).
Additional Benefits
The CareFree Platinum Giveback (HMO) plan offers comprehensive coverage, including inpatient and outpatient hospital services, with varying copays depending on the specific service. This plan also covers a range of services such as primary care, preventive care, hearing, vision, and dental services, often with no copay or a modest copay. Additionally, the plan includes coverage for emergency services, ambulance services, and home health services, along with other benefits such as medical equipment and diagnostic services.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered. For Inpatient Hospital-Acute, you will pay a $300 copay for days 1-5, and no copay for days 6-90, with no coinsurance. For Inpatient Hospital Psychiatric, you will pay a $300 copay for days 1-5, and no copay for days 6-90, with no coinsurance. Additional days for Inpatient Hospital-Acute are covered with no copay. 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 are covered, including Outpatient Hospital Services with a copay between $0 and $300, Observation Services with no copay, Ambulatory Surgical Center (ASC) Services with no copay, Individual and Group Sessions for Outpatient Substance Abuse with a copay of $30, and Outpatient Blood Services with no copay. Prior authorization and a doctor referral are required for all services.
Partial Hospitalization See details
Partial Hospitalization is covered by the CareFree Platinum Giveback (HMO) plan, with a $30 copay. Prior authorization and a doctor referral are required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the CareFree Platinum Giveback (HMO) plan. Ground Ambulance Services have a copay of $0-$250, while Air Ambulance Services have a 20% coinsurance; however, Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services are covered, including emergency services, urgently needed services, and worldwide emergency services. Emergency services have a $140 copay, urgently needed services have a $30 copay, and worldwide emergency services have copays ranging from $30 to $140 depending on the service.
Primary Care See details
The CareFree Platinum Giveback (HMO) plan covers primary care physician services with no copay, and chiropractic services with a $20 copay. Occupational therapy services have a $30 copay, and physician specialist services have a $30 copay. Mental health specialty services, podiatry services, psychiatric services, and other health care professional services have a $30 copay. Physical therapy and speech-language pathology services have a $30 copay, while additional telehealth benefits have a copay between $0 and $30. Opioid treatment program services have a $30 copay.
Preventive Services See details
The CareFree Platinum Giveback (HMO) plan covers preventive services, including an annual physical exam with no copay. Additional preventive services, including Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit, are covered with no copay. However, Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), and other services are not covered.
Hearing Services See details
CareFree Platinum Giveback (HMO) covers hearing exams with a $30 copay, routine hearing exams with no copay, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids are covered up to $500 per year, and OTC hearing aids are covered up to $50 every three months. Prescription hearing aids for the inner, outer, and over-the-ear are not covered.
Vision Services See details
The CareFree Platinum Giveback (HMO) plan covers vision services, including routine eye exams with a copay between $0 and $30, and eyewear with no copay and a combined maximum benefit of $180 per year. Eyeglasses (lenses and frames) and contact lenses are covered, but eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
The CareFree Platinum Giveback (HMO) plan covers Medicare Dental Services with a $30 copay, and other dental services including oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), restorative services, adjunctive general services, and oral and maxillofacial surgery with no copay. Fluoride treatment, endodontics, periodontics, prosthodontics (removable), maxillofacial prosthetics, implant services, prosthodontics (fixed), and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay and 0-20% coinsurance, Medicare Part B Chemotherapy/Radiation Drugs with 0-20% coinsurance, and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required for this benefit.
Dialysis Services See details
Dialysis Services are covered under the CareFree Platinum Giveback (HMO) plan, but require prior authorization and a doctor's referral. The coinsurance for these services is 20%.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance and Prosthetic Devices and Medical Supplies, also with 20% coinsurance. Diabetic Supplies have no copay, while Diabetic Therapeutic Shoes/Inserts have a $10 copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with a doctor referral and prior authorization required. Diagnostic Procedures/Tests have a copay between $0 and $110, Lab Services have no copay, Diagnostic Radiological Services have a copay of at most $300, Therapeutic Radiological Services have a coinsurance of at most 20% and a copay of at most $30, and Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the CareFree Platinum Giveback (HMO) 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 covered with prior authorization and a doctor's referral, however, Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services are not covered. The plan does not specify the cost sharing for the services, but indicates that there is a copay.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the CareFree Platinum Giveback (HMO) plan, but require prior authorization and a doctor's referral. For days 1-20, the copay is $10, and for days 21-100, the copay is $125; this plan does not cover additional days beyond Medicare-covered SNF stays or non-Medicare-covered SNF stays.
Other Services See details
The CareFree Platinum Giveback (HMO) plan covers acupuncture with a $30 copay, OTC items with a $50 maximum benefit every three months, and a meal benefit with no copay. Additionally, the plan does not cover Dual Eligible SNPs with Highly Integrated Services, and some other services such as Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, and more.
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