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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 2026, 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 North Florida. This plan received an overall rating of 4.5 out of 5 stars in 2026.
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 $113.00. 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 $3800.00 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 CareComplete Platinum (HMO C-SNP) plan features an annual drug deductible of $615. For Tier 1 preferred generic and Tier 6 select care drugs, you will pay no copay at standard pharmacies or through preferred mail order. Tier 2 generic drugs carry a $5 copay for a one-month supply, with no copay for a three-month supply when using preferred mail order. Tier 3 preferred brand drugs carry copays starting at $45 for a one-month supply at standard pharmacies and preferred mail order. Higher-tier medications require coinsurance, with a 50% coinsurance for Tier 4 non-preferred drugs and a 25% coinsurance for Tier 5 specialty drugs. Utilizing preferred mail-order services generally offers the most cost-effective way to fill multi-month prescriptions under this plan.
Additional Benefits
CareComplete Platinum (HMO C-SNP) offers comprehensive coverage with no copay for essential services like primary care, preventive care, home health, and diabetic supplies. Members can also access specialists, routine dental, and vision and hearing exams with low to no copays. Most diagnostic tests, lab work, and outpatient X-rays are also covered with no copay, making everyday healthcare highly affordable. For more intensive medical needs, inpatient hospital stays require a $275 daily copay for the first five days, while skilled nursing facility stays feature no copay for the first 20 days. Emergency room visits carry a $150 copay, which is waived upon hospital admission, and urgent care is available for a $25 copay. Specialized services like dialysis and durable medical equipment generally require a 20% coinsurance with no deductible.
Inpatient Hospital See details
CareComplete Platinum (HMO C-SNP) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $275 daily copay for days 1 through 5 and no copay for days 6 through 90. Unlimited additional acute care days are covered with no copay, but additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
CareComplete Platinum (HMO C-SNP) covers outpatient services with no coinsurance, including ambulatory surgical center, observation, and blood services with no copay. Outpatient hospital services have a copay ranging from $0 to $200, while individual and group outpatient substance abuse sessions require a $20 copay.
Partial Hospitalization See details
CareComplete Platinum (HMO C-SNP) covers partial hospitalization services with a $25.00 copay and no coinsurance. Prior authorization and a referral are required to access this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered under CareComplete Platinum (HMO C-SNP), with ground ambulance services requiring a $0 to $250 copay and coinsurance, and air ambulance services requiring a 20% coinsurance and a copay. Transportation services are partially covered with no copay or coinsurance for up to 26 one-way trips per year to plan-approved locations, while transportation to any health-related location is not covered.
Emergency Services See details
CareComplete Platinum (HMO C-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 have a $25 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no coinsurance and copays ranging from $25 to $150.
Primary Care See details
CareComplete Platinum (HMO C-SNP) covers primary care physician services with no copay and no coinsurance, while specialists and therapy services require a $20 to $25 copay and no coinsurance. Chiropractic services are partially covered, featuring a $20 copay and no coinsurance for up to 12 routine visits per year, though other chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by CareComplete Platinum (HMO C-SNP) with no copay and no coinsurance for covered options like annual physicals, kidney disease education, and memory fitness. Several supplemental services are not covered under this plan, including health education, in-home safety assessments, nutritional therapy, and personal emergency response systems.
Hearing Services See details
CareComplete Platinum (HMO C-SNP) covers hearing services with no deductible, offering routine hearing exams, fitting evaluations, and OTC hearing aids with no copay and no coinsurance. Medicare-covered exams require a $20 copay and no coinsurance, while prescription hearing aids are partially covered up to $250 per ear annually with no copay and no coinsurance, excluding inner ear, outer ear, and over the ear hearing aids.
Vision Services See details
CareComplete Platinum (HMO C-SNP) offers partially covered vision services with no deductibles, no coinsurance, and no copays for covered services, though prior authorization and referrals are required. One routine eye exam per year and eyewear—including contact lenses and eyeglasses (lenses and frames)—are covered up to a $150 annual limit, while other eye exams, individual eyeglass lenses, individual eyeglass frames, and upgrades are not covered.
Dental Services See details
CareComplete Platinum (HMO C-SNP) offers partially covered dental services, featuring a $20 copay and no coinsurance for Medicare-covered dental, and no copay or coinsurance for covered preventive and comprehensive services. Fluoride treatments, other preventive services, endodontics, maxillofacial prosthetics, implant services, fixed prosthodontics, and orthodontics are not covered under this plan.
Home Infusion bundled Services See details
CareComplete Platinum (HMO C-SNP) covers home infusion bundled services with no copay and no coinsurance, although prior authorization is required. Associated Medicare Part B drugs, including chemotherapy and radiation, carry a coinsurance ranging from no coinsurance to 20%, while Part B insulin has a $35 copay and a coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
CareComplete Platinum (HMO C-SNP) covers dialysis services with no copay and a 20% coinsurance. Prior authorization and a referral are required to receive these covered services.
Medical Equipment See details
CareComplete Platinum (HMO C-SNP) covers durable medical equipment and prosthetic devices with a 20% coinsurance and no copay, while medical supplies are covered with no copay. Diabetic supplies feature no copay and no coinsurance, whereas diabetic therapeutic shoes and inserts require a $10 copay and no coinsurance.
Diagnostic and Radiological Services See details
CareComplete Platinum (HMO C-SNP) covers diagnostic and radiological services, with prior authorization and referrals required for all services. Members pay no copay for lab services, outpatient X-rays, and diagnostic radiology, while diagnostic tests have a copay between $0 and $110 with no coinsurance, and therapeutic radiology requires a minimum $20 copay and 20% coinsurance.
Home Health Services See details
Home health services are covered by CareComplete Platinum (HMO C-SNP) with no copay and no coinsurance. Prior authorization and a referral are required to receive these services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by CareComplete Platinum (HMO C-SNP) with no coinsurance, though prior authorization and a referral are required. While some services are covered, specific sub-services—including standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation—are not covered and carry a $20 copay.
Skilled Nursing Facility (SNF) See details
CareComplete Platinum (HMO C-SNP) covers skilled nursing facility (SNF) services with no coinsurance, offering no copay for days 1 through 20 and a $160 copay for days 21 through 100. Prior authorization and referrals are required, though a prior three-day inpatient hospital stay is not.
Other Services See details
CareComplete Platinum (HMO C-SNP) covers acupuncture with a $20 copay and no coinsurance for up to 20 treatments per year, requiring prior authorization. Over-the-counter items and chronic illness meal benefits are also covered with no copay and no coinsurance, though prior authorization is required for meals and not all CMS OTC list drugs are covered.
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