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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 Miami-Dade County. 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 $162.00. 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 $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 CareComplete Platinum (HMO C-SNP) Medicare plan features a $0 drug deductible, allowing your prescription drug coverage to begin immediately with no upfront costs. Under this plan, you will pay no copay for Tier 1 preferred generics and Tier 6 select care drugs at standard pharmacies or through preferred mail order. Tier 2 generic drugs are also highly budget-friendly, costing as little as no copay for a 3-month supply through preferred mail order or a low $5 copay for a 1-month supply. For Tier 3 preferred brand drugs, copays start at $25 for a 1-month supply at standard pharmacies and preferred mail order. Higher-tier medications transition to coinsurance, with Tier 4 non-preferred drugs requiring a 50% coinsurance and Tier 5 specialty drugs requiring a 33% coinsurance. These predictable drug tiers and cost-sharing phases make it easy to manage your healthcare budget with CareComplete Platinum (HMO C-SNP).
Additional Benefits
CareComplete Platinum (HMO C-SNP) offers comprehensive medical coverage with low out-of-pocket costs, including no copay for primary care visits and routine preventive services. Inpatient hospital stays require a $50 daily copay for the first five days and no copay thereafter, while emergency room visits have a $150 copay that is waived if admitted. Most outpatient services, including ambulatory surgical center visits and home health care, are also covered with no copay. The plan also provides valuable supplemental benefits, including routine dental, vision, and hearing exams with no copay. Members receive a $200 annual limit for eyewear, up to $750 per ear annually for prescription hearing aids, and up to 26 one-way transportation trips per year to plan-approved locations with no copay. Additionally, there is no copay for over-the-counter items, acupuncture, and diabetic supplies, while durable medical equipment requires a 20% coinsurance.
Inpatient Hospital See details
CareComplete Platinum (HMO C-SNP) partially covers inpatient hospital services with no coinsurance, requiring a $50 daily copay for days 1 to 5 and no copay for days 6 to 90 for both acute and psychiatric stays. While acute care includes unlimited additional days with no copay, psychiatric additional 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, though prior authorization and referrals are required for most care. Under this plan, there is no copay for ambulatory surgical center, observation, and blood services, while outpatient hospital visits have a $0 to $75 copay and outpatient substance abuse sessions require a $10 copay.
Partial Hospitalization See details
CareComplete Platinum (HMO C-SNP) covers partial hospitalization services with a $10.00 copay and no coinsurance. Prior authorization and a referral are required to access this benefit.
Ambulance and Transportation Services See details
CareComplete Platinum (HMO C-SNP) covers ambulance services with a $0 to $150 copay and coinsurance for ground transport, and a 20% coinsurance and copay for air transport. Transportation services are partially covered, offering up to 26 one-way trips per year to plan-approved locations with no copay and no coinsurance, though 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, which is waived if admitted to the hospital within 24 hours, and urgently needed services with a $10 copay, both featuring no coinsurance. Worldwide emergency, urgent, and transportation services are also covered with no coinsurance and copays ranging from $10 to $150, and none of these emergency cost shares count toward the plan-level deductible.
Primary Care See details
CareComplete Platinum (HMO C-SNP) covers primary care physician services with no copay and no coinsurance, and telehealth benefits with a $0 to $10 copay and no coinsurance. Specialist visits, physical therapy, podiatry, and mental health services require a $10 copay and no coinsurance, while chiropractic benefits are partially covered because other chiropractic services are not covered.
Preventive Services See details
CareComplete Platinum (HMO C-SNP) covers preventive services, including annual physical exams, kidney disease education, and memory fitness, with no copay and no coinsurance. However, additional preventive services are only partially covered, as sub-services like health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, and weight management are not covered.
Hearing Services See details
CareComplete Platinum (HMO C-SNP) partially covers hearing services, offering Medicare-covered exams for a $10 copay and no coinsurance, while routine exams, fittings, and OTC hearing aids have no copay and no coinsurance. Prescription hearing aids are covered up to $750 per ear every year with no copay or coinsurance, but inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Vision services are partially covered by CareComplete Platinum (HMO C-SNP), offering no copays and no coinsurance for one routine eye exam per year and contact lenses or eyeglasses up to a $200 annual limit. Prior authorization and referrals are required, and benefits do not cover other eye exams, separate eyeglass lenses, separate eyeglass frames, or upgrades.
Dental Services See details
CareComplete Platinum (HMO C-SNP) dental services are partially covered, with a $10 copay and no coinsurance for Medicare-covered dental services, and no copay and no coinsurance for most other preventive and comprehensive dental services. Fluoride treatment, maxillofacial prosthetics, implant services, fixed prosthodontics, and orthodontics are not covered under this plan.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by CareComplete Platinum (HMO C-SNP) with no copay, although prior authorization is required. Medicare Part B chemotherapy, radiation, and other drugs carry no coinsurance to 20% coinsurance, while Part B insulin drugs require a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under CareComplete Platinum (HMO C-SNP) with no copay and a 20% coinsurance. Prior authorization and a referral are required to receive these services.
Medical Equipment See details
CareComplete Platinum (HMO C-SNP) covers durable medical equipment (DME) with a 20% coinsurance and no copay, and prosthetic devices with no copay. Diabetic supplies are covered with no copay and no coinsurance, while diabetic therapeutic shoes or inserts require a $10 copay and no coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by CareComplete Platinum (HMO C-SNP) with no coinsurance and a $0 to $40 copay for diagnostic tests, alongside no copays for lab services, diagnostic radiology, and outpatient X-rays. Therapeutic radiological services require a minimum 20% coinsurance and a minimum $10 copay, with referrals and prior authorizations required for all services.
Home Health Services See details
CareComplete Platinum (HMO C-SNP) covers home health services with no copay and no coinsurance. Prior authorization and a referral are required to receive these covered services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under CareComplete Platinum (HMO C-SNP) with no coinsurance, though in practice, key sub-services like cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered and carry a $10 copay. Prior authorization and referrals are required for these services.
Skilled Nursing Facility (SNF) See details
CareComplete Platinum (HMO C-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, featuring no copay for days 1 through 20 and a $75 daily copay for days 21 through 100. Prior authorization and referrals are required, though a prior three-day hospital stay is not necessary, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
CareComplete Platinum (HMO C-SNP) covers other services including acupuncture, over-the-counter items, and chronic illness meal benefits with no copay and no coinsurance. Prior authorization is required for acupuncture, which is limited to 25 treatments per year, and meal benefits, while some other services are not covered.
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