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 Miami-Dade County. 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 $150.00. 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 $3400.00 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 an enhanced alternative drug benefit. There is no deductible for prescription drugs. In the initial coverage phase, you will pay a copay for your prescriptions. For preferred generic drugs, you will pay a $5 copay at preferred pharmacies and $6 at standard mail order. For specialty tier drugs, there is no copay. After your yearly out-of-pocket drug costs reach $2000, you will pay nothing for Medicare Part D covered drugs.
Additional Benefits
The CareComplete Platinum (HMO C-SNP) plan offers a range of benefits with varying costs. Many services have no copay, including preventive services, routine vision and dental care, and home health services. You can expect copays for services like inpatient hospital stays, outpatient services, doctor visits, and hearing exams. The plan provides additional benefits like hearing aids, eyewear, and dental services with specific coverage limits and copays. Emergency services, ambulance, and transportation services are covered, with copays and coinsurance depending on the service. Be aware that certain services, such as cardiac rehabilitation and some dental procedures, may not be covered.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered. For Inpatient Hospital-Acute, you pay a $50 copay for days 1-5, and no copay for days 6-90, while additional days (91-999) have no copay; Non-Medicare-covered stays and upgrades are not covered. Inpatient Hospital Psychiatric has a $50 copay for days 1-5, and no copay for days 6-90, while additional days and Non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, observation services, Ambulatory Surgical Center (ASC) Services, and outpatient blood services, are covered by the CareComplete Platinum (HMO C-SNP) plan. Outpatient hospital services have a copay between $0 and $50, observation services and ASC services have no copay, and outpatient blood services have no copay. Individual and group sessions for outpatient substance abuse have a copay of $10.
Partial Hospitalization See details
Partial Hospitalization is covered by the CareComplete Platinum (HMO C-SNP) plan, with a $10 copay. Prior authorization and a doctor referral are required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the CareComplete Platinum (HMO C-SNP) plan. Ground ambulance services have a copay between $0 and $120, 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 CareComplete Platinum (HMO C-SNP). Emergency Services has a $140 copay, Urgently Needed Services has a $10 copay, and Worldwide Emergency Coverage and Worldwide Emergency Transportation have a $140 copay. Worldwide Urgent Coverage has a copay between $10 and $140. There is no coinsurance for any of these services.
Primary Care See details
Primary Care Physician Services are covered with no copay, and Chiropractic Services are covered with a $10 copay. Occupational Therapy Services, Physician Specialist Services, Physical Therapy and Speech-Language Pathology Services, Mental Health Specialty Services, Psychiatric Services, and Opioid Treatment Program Services are covered with a $10 copay. Additional Telehealth Benefits have a copay between $0 and $10. Podiatry Services and Other Health Care Professional have a $10 copay.
Preventive Services See details
Preventive Services, including Medicare-covered preventive services and annual physical exams, are covered with no copay. Additional preventive services, including the fitness benefit, are covered with no copay. Some services are not covered including Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), 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 Benefit, 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 (including Web/Phone-based technologies and Nursing Hotline), Home and Bathroom Safety Devices and Modifications, and Counseling Services.
Hearing Services See details
Hearing exams, including services not usually covered by Medicare, have a $10 copay, while routine hearing exams and fitting/evaluation for hearing aids have no copay. Prescription hearing aids are covered with a plan-specified amount per period, up to $750, and OTC hearing aids are covered up to $50 per month. Prescription hearing aids for the inner ear, outer ear, and over the ear are not covered.
Vision Services See details
The CareComplete Platinum (HMO C-SNP) plan covers vision services, including eye exams with a copay of $0-$10, and eyewear with a $0 copay, but eyeglass lenses, eyeglass frames, and upgrades are not covered. Routine eye exams are covered with no copay, and a limit of one exam per year. Eyewear has a combined maximum benefit of $200 per year.
Dental Services See details
CareComplete Platinum (HMO C-SNP) covers dental services, including oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), and other preventive dental services with no copay. Medicare dental services require a $10 copay, and fluoride treatment, maxillofacial prosthetics, implant services, prosthodontics (fixed), and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%, while for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0% and 20%.
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
Medical Equipment is covered under the CareComplete Platinum (HMO C-SNP) plan. Durable Medical Equipment (DME) has a 20% coinsurance, and Prosthetic Devices have no copay. Medical Supplies have a 20% coinsurance, and Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures and tests with a copay between $0 and $40, lab services with no copay, and outpatient X-ray services with no copay. Therapeutic Radiological Services have a copay between $10 and $25, and coinsurance of at least 20%, while Diagnostic Radiological Services have a copay of up to $50.
Home Health Services See details
Home Health Services are covered under the CareComplete Platinum (HMO C-SNP) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Authorization and a referral are required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the CareComplete Platinum (HMO C-SNP) plan. Prior authorization and a doctor's referral are required for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the CareComplete Platinum (HMO C-SNP) plan, with a doctor referral and prior authorization required. There is no copay for days 1-20, and a $75 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 no copay, but requires prior authorization and is limited to 25 treatments per year. Over-the-counter (OTC) items are covered with a $50 monthly maximum, and the plan offers a meal benefit with no copay and prior authorization required. However, some other services, including Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, are not covered.
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