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CareBreeze Platinum (HMO-POS C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for CareBreeze Platinum (HMO-POS 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-POS C-SNP) in 2026, please refer to our full plan details page.
CareBreeze Platinum (HMO-POS C-SNP) is a HMO-POS C-SNP plan offered by Humana Inc. available for enrollment in 2025 to people living in Broward and Palm Beach Counties. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that CareBreeze Platinum (HMO-POS 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-POS 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-POS 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-POS 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 $156.00. 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 combined Maximum Out-Of-Pocket cost of $3400.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $3400.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
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-POS C-SNP) Medicare plan features a $0 drug deductible, meaning your prescription coverage begins immediately. You will pay no copay for Tier 1 preferred generic and Tier 6 select care drugs across standard pharmacies and mail-order services. Tier 2 generic drugs are also highly affordable, starting at a $5 copay for a one-month supply at standard pharmacies and no copay for a three-month supply through preferred mail order. For Tier 3 preferred brand drugs, copays start at $45 for a one-month supply, with savings available through preferred mail order for three-month supplies. Tier 4 non-preferred drugs require a 50% coinsurance, while Tier 5 specialty drugs have a 33% coinsurance for a one-month supply. These structured costs help you easily estimate your out-of-pocket prescription expenses under this plan.
Additional Benefits
The CareBreeze Platinum (HMO-POS C-SNP) plan offers comprehensive medical coverage featuring no copay for primary care doctor visits, routine preventive services, and home health care. Inpatient hospital stays require a $150 daily copay for the first seven days and no copay for days 8 through 90, while emergency room visits carry a $150 copay. Most outpatient services, specialist visits, and urgent care needs are highly affordable, typically requiring a low $20 copay and no coinsurance. Members also enjoy valuable dental, vision, and hearing benefits, including no copay for routine exams, preventive dental care, and generous allowances for eyewear and hearing aids. While diagnostic lab work and x-rays require no copay, durable medical equipment and dialysis services generally require a 20% coinsurance. Additionally, the plan supports daily wellness with no copay for over-the-counter items, acupuncture, and up to 50 one-way transportation trips per year.
Inpatient Hospital See details
Inpatient hospital services are covered by CareBreeze Platinum (HMO-POS C-SNP) with no coinsurance, requiring a $150 daily copay for days 1 to 7 and no copay for days 8 to 90. This benefit is partially covered, as upgrades and non-Medicare-covered stays are excluded, and additional days beyond 90 days are not covered for psychiatric care.
Outpatient Services See details
CareBreeze Platinum (HMO-POS C-SNP) covers outpatient services with no coinsurance, including no copay for ambulatory surgical center, observation, and blood services. Outpatient hospital services require a copay of $0 to $200, and outpatient substance abuse sessions have a $20 copay.
Partial Hospitalization See details
Partial hospitalization services are covered by CareBreeze Platinum (HMO-POS C-SNP) with a $25.00 copay and no coinsurance. Prior authorization and a referral are required to receive this benefit.
Ambulance and Transportation Services See details
CareBreeze Platinum (HMO-POS C-SNP) covers ambulance services with a ground copay ranging from no copay to $250 and a 20% air coinsurance, subject to prior authorization. Transportation services are partially covered with no copay or coinsurance for up to 50 yearly one-way trips to plan-approved locations, though trips to any health-related location are not covered.
Emergency Services See details
CareBreeze Platinum (HMO-POS 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 require a $20 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no coinsurance and copays ranging from $20 to $150.
Primary Care See details
CareBreeze Platinum (HMO-POS C-SNP) covers primary care physician services with no copay and no coinsurance, while specialist, therapy, and mental health services generally require a $20 copay and no coinsurance. Chiropractic services are partially covered with a $20 copay and no coinsurance for routine care, though other chiropractic services are not covered.
Preventive Services See details
CareBreeze Platinum (HMO-POS C-SNP) covers preventive services with no copay and no coinsurance, including annual physical exams, kidney disease education, glaucoma screenings, and a memory fitness benefit. However, the plan only partially covers additional preventive services, excluding options such as health education, in-home safety assessments, and weight management programs.
Hearing Services See details
Hearing services covered by CareBreeze Platinum (HMO-POS C-SNP) include Medicare-covered exams for a $20 copay and no coinsurance, alongside routine exams, fittings, and OTC hearing aids with no copay and no coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to $750 per ear annually, though inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
Vision services are partially covered by CareBreeze Platinum (HMO-POS C-SNP) with no copay, no coinsurance, and no deductible for covered benefits, which include one routine eye exam annually and contact lenses or eyeglasses up to a $400 yearly limit. Other eye exam services, separate eyeglass lenses, separate eyeglass frames, and upgrades are not covered under this plan.
Dental Services See details
Dental services are partially covered by CareBreeze Platinum (HMO-POS C-SNP), requiring a $20 copay and no coinsurance for Medicare-covered dental, and no copay and no coinsurance for covered preventive and comprehensive services. Fluoride treatments, maxillofacial prosthetics, implant services, fixed prosthodontics, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by CareBreeze Platinum (HMO-POS C-SNP) with no copay, though prior authorization and step therapy are required. Associated Medicare Part B drugs, such as chemotherapy and insulin, have a coinsurance ranging from no coinsurance to 20%, with insulin also requiring a $35 copay.
Dialysis Services See details
CareBreeze Platinum (HMO-POS C-SNP) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization and a referral are required to receive these services.
Medical Equipment See details
Medical equipment is covered by CareBreeze Platinum (HMO-POS C-SNP), featuring durable medical equipment with a 20% coinsurance and no copay. Prosthetic devices require no copay, medical supplies have a 20% coinsurance, and diabetic equipment features no coinsurance, with diabetic supplies requiring no copay and therapeutic shoes or inserts requiring a $10 copay.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by CareBreeze Platinum (HMO-POS C-SNP) with prior authorization and referrals required. Diagnostic procedures and tests have no coinsurance and a copay of $0 to $175, lab and outpatient X-ray services have no copay, and therapeutic radiological services require a 20% coinsurance and no copay.
Home Health Services See details
CareBreeze Platinum (HMO-POS C-SNP) covers home health services with no copay and no coinsurance, although a referral and prior authorization are required.
Cardiac Rehabilitation Services See details
CareBreeze Platinum (HMO-POS C-SNP) covers some Cardiac Rehabilitation Services with no coinsurance, but standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered and require a $20 copay.
Skilled Nursing Facility (SNF) See details
CareBreeze Platinum (HMO-POS C-SNP) covers Skilled Nursing Facility (SNF) care 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, and while a prior three-day hospital stay is not necessary, additional days beyond the standard Medicare-covered period are not covered.
Other Services See details
CareBreeze Platinum (HMO-POS C-SNP) covers acupuncture limited to 25 treatments per year, over-the-counter items, and meals for chronic illness with no copay and no coinsurance. Prior authorization is required for acupuncture and meal benefits, and some other services are not covered.
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