A non-government entity
CareComplete Platinum (HMO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for CareComplete Platinum (HMO C-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on CareComplete Platinum (HMO C-SNP) in 2025, please refer to our full plan details page.
CareComplete Platinum (HMO C-SNP) is a HMO C-SNP plan offered by Humana Inc. available for enrollment in 2025 to people living in Brevard, Flagler, Indian River, & Volusia Counties. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that CareComplete Platinum (HMO C-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
CareComplete Platinum (HMO C-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 CareComplete Platinum (HMO C-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 CareComplete Platinum (HMO C-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. Additionally, this plan comes with a Part B Premium reduction of $100.00. 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:
Sign up for CareComplete Platinum (HMO C-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 CareComplete Platinum (HMO C-SNP) 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. For example, for preferred generic drugs, you'll pay a $5 copay at preferred and mail order pharmacies and a $20 copay at a standard pharmacy. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase, where you pay nothing for covered Part D drugs. However, you may still pay a share of the costs for excluded drugs covered under any enhanced benefit. If you qualify for the low-income subsidy (LIS), you will pay $0.00 for Part D drugs.
Additional Benefits
The CareComplete Platinum (HMO C-SNP) plan offers a wide range of benefits with varying cost-sharing. You can expect no copay for many services, including primary care, preventive services, and home health services. Other services like inpatient hospital stays, outpatient services, and specialist visits have copays ranging from $30 to $225. This plan also includes additional benefits such as hearing, vision, and dental coverage. Hearing exams, routine hearing exams, and hearing aid fittings have no copay, and prescription hearing aids are covered up to $250 per year. Vision services include routine eye exams and eyewear with no copay up to a combined maximum of $150 per year.
Inpatient Hospital See details
Inpatient Hospital coverage includes Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services. For Inpatient Hospital-Acute, you will pay a $225 copay for days 1-6, and no copay for days 7-90, and for Inpatient Hospital Psychiatric, you will also pay a $225 copay for days 1-6, and no copay for days 7-90. Additional Days and Non-Medicare-covered Stay are not covered for either service.
Outpatient Services See details
Outpatient Services are covered, including all outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient Hospital Services have a copay between $0 and $225, while Observation Services and Ambulatory Surgical Center Services have no copay. Individual and Group Sessions for Outpatient Substance Abuse have a copay between $30 and $35, and Outpatient Blood Services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the CareComplete Platinum (HMO C-SNP) plan, with a $35 copay and requires prior authorization and a doctor referral.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the CareComplete Platinum (HMO C-SNP) plan. Ground ambulance services have a copay between $0 and $250, while air ambulance services have a 20% coinsurance. Transportation services to a plan-approved health-related location are covered with no copay, up to 26 one-way trips per year.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the CareComplete Platinum (HMO C-SNP) plan. Emergency Services have a $140 copay, and Urgently Needed Services have a $35 copay. Worldwide Emergency Services has a $140 copay for Worldwide Emergency Coverage and Worldwide Emergency Transportation, and a copay between $35 and $140 for Worldwide Urgent Coverage.
Primary Care See details
CareComplete Platinum (HMO C-SNP) covers primary care physician services with no copay, chiropractic services with a $20 copay, occupational therapy services with a $35 copay, physician specialist services with a $35 copay, and mental health specialty services with a $35 copay for individual and group sessions. Additionally, podiatry services and other health care professional services have a copay of $35, psychiatric services have a $35 copay for individual and group sessions, physical therapy and speech-language pathology services have a $35 copay, additional telehealth benefits have a $0-$35 copay, and opioid treatment program services have a $30-$35 copay.
Preventive Services See details
Preventive Services include coverage for Medicare-covered zero dollar preventive services, annual physical exams with no copay, and other preventive services like glaucoma screenings and diabetes self-management training with no copay. Health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, and other services are not covered.
Hearing Services See details
CareComplete Platinum (HMO C-SNP) covers hearing exams with a $35 copay and routine hearing exams with no copay, one visit per year, and fitting/evaluation for hearing aids with no copay, and one visit per year. Prescription hearing aids are covered with a maximum of $250 per year, and OTC hearing aids are covered up to $15 per month.
Vision Services See details
Vision services are covered by the CareComplete Platinum (HMO C-SNP) plan, including routine eye exams with a copay of $0-$35 and eyewear with no copay, up to a combined maximum of $150 per year. Eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
CareComplete Platinum (HMO C-SNP) covers Medicare Dental Services with a $35 copay, and other dental services including oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), and other preventive dental services with no copay, but fluoride treatment, maxillofacial prosthetics, implant services, prosthodontics, and orthodontics are not covered. Orthodontic services are 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 these services.
Dialysis Services See details
Dialysis Services are covered by the CareComplete Platinum (HMO C-SNP) plan, but require prior authorization and a doctor's referral. You will pay 20% coinsurance for these services.
Medical Equipment See details
The CareComplete Platinum (HMO C-SNP) plan covers Durable Medical Equipment (DME) with 20% coinsurance and requires prior authorization, but does not have a copay. Prosthetic Devices have no copay, while Medical Supplies have a 20% coinsurance. Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with a doctor's referral and prior authorization required. Diagnostic Procedures/Tests have a copay of $0 to $150, while Lab Services have no copay. Diagnostic Radiological Services have a maximum copay of $225, and Therapeutic Radiological Services have a maximum copay of $35 and at least 20% coinsurance. Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the CareComplete Platinum (HMO C-SNP) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the CareComplete Platinum (HMO C-SNP) plan. Though the plan lists "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", none of these services are covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the CareComplete Platinum (HMO C-SNP) plan. There is no copay for days 1-20, and a $150 copay for days 21-100. Additional days beyond Medicare-covered for SNF, and non-Medicare-covered stays for SNF, are not covered.
Other Services See details
The CareComplete Platinum (HMO C-SNP) plan covers acupuncture with a $35 copay and a limit of 20 treatments per year. Over-the-counter items are covered with a monthly benefit of $15, and meal benefits are covered with no copay.
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