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CareBreeze Platinum (HMO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for CareBreeze 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 CareBreeze Platinum (HMO C-SNP) in 2026, please refer to our full plan details page.
CareBreeze 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 CareBreeze 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:
CareBreeze 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 CareBreeze 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 CareBreeze 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 $118.00. 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 CareBreeze Platinum (HMO C-SNP) Medicare plan features an annual drug deductible of $615. For Tier 1 preferred generics and Tier 6 select care drugs, members pay no copay at standard pharmacies and through preferred mail order. Generic Tier 2 drugs are also highly affordable, costing as little as a $5 copay for a one-month supply at standard pharmacies, or no copay for a three-month supply when using preferred mail order. Tier 3 preferred brand drugs require a $45 copay for a one-month supply at standard pharmacies and preferred mail order. Higher-tier prescriptions involve coinsurance, with Tier 4 non-preferred drugs requiring a 50% coinsurance and Tier 5 specialty drugs carrying a 25% coinsurance across all fulfillment options. Choosing preferred mail order or standard pharmacies helps maximize your savings on this plan's prescription drug benefits.
Additional Benefits
The CareBreeze Platinum (HMO C-SNP) plan offers comprehensive medical coverage with no copay and no coinsurance for primary care visits, preventive services, and home health services. For inpatient hospital stays, members pay a $200 daily copay for days 1 through 5 and no copay for days 6 through 90, while specialist visits require low copays ranging from $0 to $25. Emergency room visits carry a $150 copay, which is waived if you are admitted, and urgently needed care is available with a $25 copay. Routine dental, vision, and hearing exams are highly accessible with no copay or coinsurance, alongside coverage for eyewear up to $115 annually and prescription hearing aids up to $500 per ear. Additionally, medical supplies, over-the-counter items, and up to 26 one-way transportation trips per year to approved locations are covered with no copay or coinsurance. Durable medical equipment and dialysis services generally require a 20% coinsurance with no copay, ensuring affordable support for your essential healthcare needs.
Inpatient Hospital See details
CareBreeze Platinum (HMO C-SNP) covers inpatient hospital care with no coinsurance and a $200 daily copay for days 1 through 5, followed by no copay for days 6 through 90. The benefit is partially covered because upgrades, non-Medicare-covered stays, and additional psychiatric hospital days are not covered, though unlimited additional acute care days are covered with no copay.
Outpatient Services See details
CareBreeze Platinum (HMO C-SNP) covers outpatient services with no coinsurance, including ambulatory surgical center, observation, and blood services with no copay. Outpatient hospital services require a copay ranging from $0 to $200, while outpatient substance abuse individual and group sessions have a $20 copay.
Partial Hospitalization See details
CareBreeze Platinum (HMO C-SNP) covers partial hospitalization services with a $25.00 copay and no coinsurance. Prior authorization and a referral are required for these covered services.
Ambulance and Transportation Services See details
CareBreeze Platinum (HMO C-SNP) covers ambulance and transportation services with prior authorization, featuring a copay of $0.00 to $250.00 plus coinsurance for ground ambulance services, and a 20% coinsurance plus a copay for air ambulance services. Transportation services are partially covered with no copay or coinsurance for up to 26 one-way trips per year to plan-approved health-related locations, while trips to any health-related location are not covered.
Emergency Services See details
CareBreeze 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 are covered with a $25 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are available with no coinsurance and copays ranging from $25 to $150.
Primary Care See details
CareBreeze Platinum (HMO C-SNP) covers primary care physician services with no copay and no coinsurance, while specialist, therapy, podiatry, and mental health services require copays ranging from $0 to $25 and no coinsurance. Chiropractic care is partially covered, offering up to 12 routine visits per year for a $20 copay and no coinsurance, while other chiropractic services are not covered.
Preventive Services See details
Preventive services are covered by CareBreeze Platinum (HMO C-SNP) with no copay and no coinsurance for annual physicals, kidney disease education, memory fitness, and screenings for diabetes and glaucoma. However, additional preventive benefits are only partially covered, excluding services such as health education, in-home safety assessments, personal emergency response systems, and medical nutrition therapy.
Hearing Services See details
CareBreeze Platinum (HMO C-SNP) covers hearing services with no exam deductible, a $20 copay and no coinsurance for Medicare-covered exams, and no copay or coinsurance for routine annual exams, fittings, and unlimited over-the-counter hearing aids. Prescription hearing aids are partially covered with no copay or coinsurance up to $500 per ear annually, although inner ear, outer ear, and over-the-ear models are not covered.
Vision Services See details
CareBreeze Platinum (HMO C-SNP) offers partially covered vision services with no deductibles and no coinsurance, although prior authorization and referrals are required. Routine eye exams, contact lenses, and eyeglasses (lenses and frames) are covered with no copay, with a combined $115 annual limit for eyewear, while other eye exams, separate eyeglass lenses, separate frames, and upgrades are not covered.
Dental Services See details
CareBreeze Platinum (HMO C-SNP) provides partially covered dental services, featuring a $20 copay and no coinsurance for Medicare-covered dental, and no copay and no coinsurance for other covered preventive and comprehensive services. Uncovered dental services under this plan include fluoride treatments, maxillofacial prosthetics, implant services, fixed prosthodontics, and orthodontics.
Home Infusion bundled Services See details
CareBreeze Platinum (HMO C-SNP) covers Home Infusion bundled services with no copay, though prior authorization is required. Medicare Part B chemotherapy, radiation, and other infusion drugs carry a 0% to 20% coinsurance, while Part B insulin drugs require a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
CareBreeze 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
CareBreeze Platinum (HMO C-SNP) covers durable medical equipment and prosthetic devices with a 20% coinsurance and no copay, while medical supplies and diabetic supplies are covered with no copay and no coinsurance. Diabetic therapeutic shoes and inserts are covered with a $10 copay and no coinsurance, with prior authorization required for these benefits.
Diagnostic and Radiological Services See details
CareBreeze Platinum (HMO C-SNP) covers diagnostic and radiological services with required referrals and prior authorizations. Diagnostic services feature no coinsurance, with no copay for lab services and a $0 to $110 copay for procedures, while radiological services range from no copay for outpatient X-rays to a minimum $20 copay and 20% coinsurance for therapeutic radiology.
Home Health Services See details
Home Health Services are covered by CareBreeze Platinum (HMO C-SNP) with no copay and no coinsurance. Prior authorization and a referral are required to obtain this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by CareBreeze Platinum (HMO C-SNP) with no copay and no coinsurance, but only some services are covered as cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
CareBreeze Platinum (HMO C-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, offering no copay for days 1 through 20 and a $160 daily copay for days 21 through 100. Prior authorization and referrals are required for this benefit, though a prior three-day inpatient hospital stay is not.
Other Services See details
Other services covered under CareBreeze Platinum (HMO C-SNP) include acupuncture for a $20 copay and no coinsurance, up to 20 treatments per year with prior authorization. Over-the-counter (OTC) items and chronic illness meal benefits are also covered with no copay and no coinsurance, though meals require prior authorization.
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