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CareOne Plus (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for CareOne Plus (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on CareOne Plus (HMO) in 2026, please refer to our full plan details page.
CareOne Plus (HMO) is a HMO plan offered by Humana Inc. available for enrollment in 2025 to people living in Tampa 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) 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).
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), 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 $4.00. 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 Maximum Out-Of-Pocket cost of $1600.00 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 CareOne Plus (HMO)
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Drug Coverage
The CareOne Plus (HMO) prescription drug plan features an annual drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic medications, there is 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 drugs, copays range from $10 to $20 for a one-month supply. For Tier 3 preferred brand drugs, you will pay a $5 copay for a one-month supply at standard pharmacies and preferred mail order, or $47 through standard mail order. Tier 4 non-preferred drugs require a 47% coinsurance, while Tier 5 specialty drugs require a 25% coinsurance across standard pharmacies, preferred mail order, and standard mail order. This structure offers competitive savings, particularly for members utilizing generic prescriptions and preferred mail order services.
Additional Benefits
The CareOne Plus (HMO) plan offers comprehensive coverage with many key services featuring no copays or coinsurance. Members enjoy no copays and no coinsurance for primary care, specialist visits, preventive care, and routine dental, vision, and hearing exams. For inpatient hospital stays, there is no coinsurance and a twenty-five dollar daily copay for the first five days, followed by no copay for days six through ninety. Emergency care is available with a one hundred fifty dollar copay, which is waived if you are admitted within twenty-four hours, while urgently needed services require no copay. Additionally, the plan provides generous allowances of up to fifteen hundred dollars per ear for prescription hearing aids and four hundred fifty dollars annually for eyewear. Durable medical equipment requires a twenty percent coinsurance with no copay, while home health and cardiac rehabilitation services are covered with no copay or coinsurance.
Inpatient Hospital See details
Inpatient hospital services are covered by CareOne Plus (HMO) with no coinsurance and a $25 daily copay for days 1 through 5, followed by no copay for days 6 through 90 for both acute and psychiatric stays. While acute care offers unlimited additional days with no copay, psychiatric additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
CareOne Plus (HMO) covers outpatient services with no coinsurance, including no copays for ambulatory surgical center visits, observation services, outpatient substance abuse sessions, and blood services. Outpatient hospital services have a copay of $0 to $25, and prior authorization and referrals are required for these services.
Partial Hospitalization See details
Partial hospitalization is covered by CareOne Plus (HMO) with no copay and no coinsurance, although prior authorization and a referral are required.
Ambulance and Transportation Services See details
CareOne Plus (HMO) covers ambulance services with prior authorization, offering ground ambulance with no copay and a coinsurance, and air ambulance with a 20% coinsurance and a copay. Transportation services are partially covered with no copay or coinsurance for up to 50 one-way trips per year to plan-approved locations, but transportation to any health-related location is not covered.
Emergency Services See details
CareOne Plus (HMO) 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 have 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
CareOne Plus (HMO) covers primary care, specialist visits, mental health, and therapy services with no copay and no coinsurance. Chiropractic care is partially covered, offering up to 12 routine visits per year with no copay or coinsurance, while other chiropractic services are not covered.
Preventive Services See details
CareOne Plus (HMO) preventive services are partially covered with no copay and no coinsurance for covered services like annual physical exams, kidney disease education, memory fitness, glaucoma screenings, diabetes self-management, digital rectal exams, and post-welcome-visit EKGs. Supplemental benefits not covered under this plan include health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, remote access, home modifications, and counseling.
Hearing Services See details
Hearing services covered by CareOne Plus (HMO) feature no copays and no coinsurance for exams, fitting evaluations, and OTC hearing aids. Prescription hearing aids are partially covered with no copay or coinsurance up to a $1,500 annual limit per ear, though inner ear, outer ear, and over-the-ear types are not covered.
Vision Services See details
Vision services are partially covered by CareOne Plus (HMO) with no copay, no coinsurance, and no deductible, featuring one routine eye exam and up to $450 annually for contact lenses and eyeglasses (lenses and frames). Other eye exam services, eyeglass lenses, eyeglass frames, and upgrades are not covered, and prior authorization and referrals are required.
Dental Services See details
CareOne Plus (HMO) dental services are partially covered with no copay and no coinsurance for covered diagnostic, preventive, and comprehensive treatments. However, fluoride treatment, maxillofacial prosthetics, implant services, fixed prosthodontics, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by CareOne Plus (HMO) with no copay, though prior authorization is required. Covered Medicare Part B chemotherapy, radiation, and other drugs require no copay and no coinsurance to 20% coinsurance, while Medicare Part B insulin is available for a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by CareOne Plus (HMO) with no copay and a 20% coinsurance. Prior authorization and a referral are required to receive this benefit.
Medical Equipment See details
CareOne Plus (HMO) covers durable medical equipment with a 20% coinsurance and no copay, and prosthetic devices with no copay. Diabetic supplies are provided with no copay or coinsurance, while diabetic therapeutic shoes and inserts require a $10 copay and no coinsurance.
Diagnostic and Radiological Services See details
CareOne Plus (HMO) covers diagnostic and radiological services, though prior authorization and referrals are required. Diagnostic procedures and tests have no coinsurance and a copay of $0 to $50, while lab services, diagnostic radiology, and outpatient X-rays have no copay. Therapeutic radiological services require a minimum 20% coinsurance and no copay.
Home Health Services See details
Home health services are covered by CareOne Plus (HMO) with no copay and no coinsurance, although a referral and prior authorization are required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by CareOne Plus (HMO) with no copay and no coinsurance, though prior authorization and a referral are required. While some services are covered, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by CareOne Plus (HMO) 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, a prior three-day hospital stay is not necessary, and additional days beyond the 100-day Medicare limit are not covered.
Other Services See details
CareOne Plus (HMO) offers partial coverage for other services with no copay and no coinsurance for covered benefits, including acupuncture limited to 20 treatments per year, over-the-counter (OTC) items, and meal benefits for chronic illnesses. Prior authorization is required for acupuncture and meal benefits, while dual eligible SNP benefits and other unspecified services are not covered.
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