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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 2025, 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 out of 5 stars in 2025.
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.
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 $2000.00 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 CareOne Plus (HMO) plan has a $0 deductible for prescription drugs. In the initial coverage phase, you will pay different amounts for your prescriptions depending on the drug tier and the pharmacy you use. For example, you will pay no copay for preferred generic drugs at a standard pharmacy or through preferred mail order, while you will pay a $20.00 copay at a standard mail order pharmacy. Once your total drug costs reach $2,000.00, you enter the catastrophic coverage phase, where you will pay nothing for your Medicare Part D covered drugs. If you qualify for the low-income subsidy, you will pay $0.00 for your prescriptions.
Additional Benefits
The CareOne Plus (HMO) plan offers comprehensive coverage with a range of benefits. This plan includes no copay for many services, such as primary care, preventive services, vision, dental, and home health services. You will encounter copays for other services, like inpatient hospital stays, outpatient services, specialist visits, hearing exams, and prescription hearing aids. The plan also covers emergency services, ambulance and transportation services, and various therapies. Additionally, the plan includes coverage for hearing and vision services, along with dental benefits. The plan also includes extra benefits like an over-the-counter item allowance, and a meal benefit.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute, you pay a $75 copay for days 1-5, and no copay for days 6-90, and additional days 91-999 have no copay. For Inpatient Hospital Psychiatric, you pay a $75 copay for days 1-5, and no copay for days 6-90.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, are covered by the CareOne Plus (HMO) plan. Outpatient Hospital Services have a copay between $0 and $75, and Observation Services have no copay. Ambulatory Surgical Center (ASC) Services and Outpatient Blood Services have no copay. Outpatient Substance Abuse Services, including both individual and group sessions, have a copay of $5.
Partial Hospitalization See details
Partial Hospitalization is covered under the CareOne Plus (HMO) plan, requiring prior authorization and a doctor referral. The copay for this benefit is $5.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with prior authorization required. Ground ambulance services have a copay between $0-$200, while air ambulance services have a 20% coinsurance. Transportation services to a plan-approved health-related location have no copay and are limited to 50 one-way trips per year, but transportation to any health-related location is not covered.
Emergency Services See details
Emergency Services, including Urgent and Worldwide Emergency Services, are covered. Emergency Services and Worldwide Emergency Coverage have a $140 copay, Urgently Needed Services have a $5 copay, and Worldwide Urgent Coverage has a copay between $5 and $140.
Primary Care See details
The CareOne Plus (HMO) plan covers Primary Care, including Primary Care Physician Services with no copay, Chiropractic Services with a $5 copay, Occupational Therapy Services with a $5 copay, Physician Specialist Services with a $5 copay, and Mental Health Specialty Services with a $5 copay for individual and group sessions. The plan also covers Podiatry Services with a $5 copay, Other Health Care Professional with a copay between $0 and $5, Psychiatric Services with a $5 copay for individual and group sessions, Physical Therapy and Speech-Language Pathology Services with a $5 copay, Additional Telehealth Benefits with a copay between $0 and $5, and Opioid Treatment Program Services with a $5 copay.
Preventive Services See details
Preventive Services include an annual physical exam with no copay. Additional preventive services, including fitness benefits, are covered. Other covered services include kidney disease education services, glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a welcome visit, all with no copay. Health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, remote access technologies, home and bathroom safety devices and modifications, and counseling services are not covered.
Hearing Services See details
The CareOne Plus (HMO) plan covers hearing exams for a $5 copay, routine hearing exams with no copay, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids are covered up to $1750 per year, and OTC hearing aids are covered up to $50 per month.
Vision Services See details
CareOne Plus (HMO) covers vision services, including eye exams with a copay of $0-$5 and eyewear with no copay. Eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
CareOne Plus (HMO) covers a variety of dental services, including oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), other preventive dental services, restorative services, adjunctive general services, prosthodontics (removable), and oral and maxillofacial surgery, all with no copay; however, fluoride treatment, endodontics, periodontics, maxillofacial prosthetics, implant services, prosthodontics (fixed), and orthodontics are not covered. Medicare dental services require a $5 copay.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the CareOne Plus (HMO) plan, but require prior authorization. Medicare Part B Insulin Drugs have a $35 copay and a coinsurance between 0% and 20%. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the CareOne Plus (HMO) plan, but require prior authorization and a doctor's referral. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment with 20% coinsurance, Prosthetic Devices with no copay, and Medical Supplies with 20% coinsurance. Diabetic Equipment is covered, with no copay for Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for diagnostic procedures and tests with a copay between $0 and $30, lab services with no copay, diagnostic radiological services with a copay up to $75, therapeutic radiological services with a copay up to $5 and a coinsurance of 20%, and outpatient X-ray services with no copay. All services require prior authorization and a doctor referral.
Home Health Services See details
Home Health Services are covered under the CareOne Plus (HMO) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Authorization and referrals are required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization and a doctor referral are required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the CareOne Plus (HMO) plan, requiring prior authorization and a doctor's referral. There is no copay for days 1-20, and a $150 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services includes acupuncture with a $5 copay, and a meal benefit with no copay. The plan also covers over-the-counter items, with a maximum benefit coverage amount of $50.00 per month.
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