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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 2025, 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 Broward and Palm Beach Counties. This plan received an overall rating of 4 out of 5 stars in 2025.
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 $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:
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Drug Coverage
The CareBreeze Platinum (HMO C-SNP) plan has a $0 deductible for prescription drugs. In the initial coverage phase, you will pay different copays or coinsurance amounts depending on the drug tier and pharmacy. For example, standard generic drugs have a $5 copay, while preferred brand drugs have a 50% coinsurance. Once your total drug costs reach $2000, you enter the catastrophic coverage phase, where you pay nothing for covered drugs.
Additional Benefits
The CareBreeze Platinum (HMO C-SNP) plan offers a range of benefits with varying costs. Hospital stays have a copay, while outpatient services and emergency services have copays depending on the specific service. Many primary care, preventive, and hearing services are available with either a copay or no copay. This plan also covers vision, dental, and home health services, with some services having a copay. Additional benefits include transportation, medical equipment, and certain diagnostic services. However, some services such as cardiac rehabilitation, certain vision and dental services, and home modifications are not covered.
Inpatient Hospital See details
Inpatient Hospital services, including acute and psychiatric care, are covered with a $150 copay for days 1-6 and no copay for days 7-90. Additional days for Inpatient Hospital-Acute are covered with no copay, while Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute are not covered, and Additional days and Non-Medicare-covered stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services are covered by the CareBreeze Platinum (HMO C-SNP) plan, including all outpatient hospital services. Outpatient Hospital Services have a copay between $0 and $175, while Observation Services, Ambulatory Surgical Center (ASC) Services, and Outpatient Blood Services have no copay. Outpatient Substance Abuse Services have a $20 copay for both individual and group sessions.
Partial Hospitalization See details
Partial Hospitalization is covered, requiring prior authorization and a doctor referral. You will have a $20 copay for this benefit.
Ambulance and Transportation Services See details
The CareBreeze Platinum (HMO C-SNP) plan covers ambulance services, with a coinsurance for Medicare-covered ground ambulance services and a copay for Medicare-covered air ambulance services. Transportation services to a plan-approved health-related location are covered with no copay and are limited to 50 one-way trips per year, but transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the CareBreeze Platinum (HMO C-SNP) plan. Emergency Services have a $140 copay with no coinsurance, Urgently Needed Services have a $20 copay with no coinsurance, and Worldwide Emergency Services have a $140 copay for Worldwide Emergency Coverage and Worldwide Emergency Transportation, and a $20-$140 copay for Worldwide Urgent Coverage.
Primary Care See details
Primary Care benefits include Primary Care Physician Services with no copay, Chiropractic Services with a $20 copay, Occupational Therapy Services with a $20 copay, Physician Specialist Services with a $20 copay, and Mental Health Specialty Services with a $20 copay for individual and group sessions. Also covered are Podiatry Services with a $20 copay, Other Health Care Professional services with a copay between $0 and $20, Psychiatric Services with a $20 copay for individual and group sessions, Physical Therapy and Speech-Language Pathology Services with a $20 copay, Additional Telehealth Benefits with a copay between $0 and $20, and Opioid Treatment Program Services with a $20 copay.
Preventive Services See details
The CareBreeze Platinum (HMO C-SNP) plan covers preventive services including an annual physical exam with no copay. Kidney Disease Education Services, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following a Welcome Visit are covered with no copay. Some additional preventive services are covered. 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 are not covered.
Hearing Services See details
CareBreeze Platinum (HMO C-SNP) covers Hearing Services, including hearing exams with a $20 copay, routine hearing exams with no copay, and fitting/evaluation for hearing aids with no copay. Prescription Hearing Aids are covered with a plan-specified amount of $250 per year, and OTC Hearing Aids are covered with a maximum amount of $10 per month. Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, and Prescription Hearing Aids - Over the Ear are not covered.
Vision Services See details
CareBreeze Platinum (HMO C-SNP) covers vision services, including eye exams with a copay of $0-$20, and eyewear with no copay and a combined maximum benefit of $200 per year. Eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
CareBreeze Platinum (HMO C-SNP) covers Medicare Dental Services with a $20 copay, and other dental services including oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), and other preventive dental services with no copay. This plan does not cover fluoride treatment, maxillofacial prosthetics, implant services, prosthodontics (fixed), or orthodontics.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, but require prior authorization. This plan has a $35 copay for Medicare Part B Insulin Drugs and a coinsurance between 0% and 20% for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs.
Dialysis Services See details
Dialysis Services are covered under the CareBreeze 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, including durable medical equipment (DME), prosthetics, medical supplies, and diabetic equipment. DME has no copay and a 20% coinsurance, while medical supplies have a 20% coinsurance and diabetic supplies and therapeutic shoes/inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the CareBreeze Platinum (HMO C-SNP) plan, with a doctor referral and prior authorization required. Diagnostic Procedures/Tests have a copay between $0 and $175, Lab Services have no copay, and Outpatient X-Ray Services have no copay. Therapeutic Radiological Services have a copay of at most $65 and a coinsurance of at least 20%.
Home Health Services See details
Home Health Services are covered by the CareBreeze Platinum (HMO C-SNP) plan with no copay and no coinsurance. However, Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
CareBreeze Platinum (HMO C-SNP) does not cover Cardiac Rehabilitation Services, including Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. Prior authorization and a doctor referral are required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the CareBreeze Platinum (HMO C-SNP) plan, requiring prior authorization and a doctor's referral. You will have no copay for days 1-20, and a $150 copay for days 21-100, and additional days beyond Medicare-covered are not covered.
Other Services See details
The CareBreeze Platinum (HMO C-SNP) plan covers acupuncture with no copay, and OTC items with a $10 maximum benefit per month. The plan also covers a meal benefit with no copay. However, the plan does not cover Dual Eligible SNPs with Highly Integrated Services or several other services including Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services.
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