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CareComplete Platinum (HMO-POS C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for CareComplete 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 CareComplete Platinum (HMO-POS C-SNP) in 2026, please refer to our full plan details page.
CareComplete 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 CareComplete 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:
CareComplete 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 CareComplete 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 CareComplete 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 $157.00. 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 CareComplete Platinum (HMO-POS C-SNP) plan features a $0 drug deductible, meaning your prescription drug coverage begins immediately without any upfront out-of-pocket deductible costs. You will enjoy no copay for Tier 1 preferred generic drugs and Tier 6 select care drugs across all standard pharmacies and mail-order options. For Tier 2 generic drugs, copayments range from $5 to $12 for a one-month supply, while a three-month supply through preferred mail order carries no copay. Tier 3 preferred brand drugs have a copayment starting at $45 for a one-month supply, which can be optimized with a three-month preferred mail-order supply for a $90 copay. Higher-tier prescriptions require coinsurance, with Tier 4 non-preferred drugs set at 50% coinsurance and Tier 5 specialty drugs requiring 33% coinsurance. This plan offers a clear pathway to managing medication costs through strategic pharmacy and mail-order choices.
Additional Benefits
The CareComplete Platinum (HMO-POS C-SNP) plan offers robust medical coverage with no copay for primary care visits and a $20 copay for most specialist visits. Inpatient hospital stays require a $150 daily copay for the first seven days and no copay for days 8 through 90, while outpatient hospital services carry a $0 to $200 copay. Additionally, members benefit from no copay for home health services and routine diagnostic lab or X-ray services. For supplemental care, this plan features no copay for routine dental, vision, and hearing exams, alongside allowances for glasses and hearing aids. Emergency room visits require a $150 copay, which is waived if admitted, while urgent care services carry a $20 copay. Furthermore, members can access up to 50 plan-approved one-way transportation trips per year and acupuncture treatments with no copay.
Inpatient Hospital See details
CareComplete Platinum (HMO-POS C-SNP) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $150 daily copay for days 1 through 7 and no copay for days 8 through 90. Additional acute stay days are covered with no copay, but hospital upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by CareComplete Platinum (HMO-POS C-SNP) with no coinsurance, featuring a $0 to $200 copay for outpatient hospital services and a $20 copay for substance abuse sessions. Ambulatory surgical center, observation, and blood services are covered with no copay, though prior authorization and referrals are required.
Partial Hospitalization See details
CareComplete Platinum (HMO-POS C-SNP) covers partial hospitalization services with a $25.00 copay and no coinsurance. Prior authorization and a referral are required to access this benefit.
Ambulance and Transportation Services See details
CareComplete Platinum (HMO-POS C-SNP) covers ambulance services and partially covers transportation services, as trips to any health-related location that is not plan-approved are not covered. Ground ambulance services require a $0 to $250 copay and coinsurance, while air ambulance services require a 20% coinsurance and a copay. Plan-approved transportation is covered for up to 50 one-way trips per year with no copay and no coinsurance.
Emergency Services See details
Emergency services are covered by CareComplete Platinum (HMO-POS C-SNP) with a $150 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services have 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
CareComplete Platinum (HMO-POS C-SNP) offers primary care physician services with no copay and no coinsurance, while most specialist, therapy, and mental health services require a $20 copay and no coinsurance. Chiropractic benefits are partially covered, providing routine care for a $20 copay and no coinsurance, but other chiropractic services are not covered.
Preventive Services See details
Preventive services are covered by CareComplete Platinum (HMO-POS C-SNP) with no copay and no coinsurance for annual physical exams, kidney disease education, memory fitness, glaucoma screenings, diabetes self-management training, digital rectal exams, and post-welcome visit EKGs. This benefit is only partially covered because health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, smoking cessation counseling, disease management, telemonitoring, remote access technologies, home safety modifications, and counseling are not covered.
Hearing Services See details
CareComplete Platinum (HMO-POS C-SNP) covers Medicare-covered hearing exams with a $20 copay and no coinsurance, while routine exams, fitting evaluations, and OTC hearing aids have no copay and no coinsurance. Prescription hearing aids are partially covered up to $250 per ear annually with no copay and no coinsurance, though inner ear, outer ear, and over-the-ear types are not covered.
Vision Services See details
CareComplete Platinum (HMO-POS C-SNP) offers partially covered vision services with no deductible, no coinsurance, and copays ranging from $0 to $20, requiring prior authorization and referrals. One routine eye exam per year, contact lenses, and eyeglasses (lenses and frames) are covered with no copay up to a $200 annual limit, while other eye exams, eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
CareComplete Platinum (HMO-POS C-SNP) offers partially covered dental services with a $20 copay and no coinsurance for Medicare-covered dental, and no copay or coinsurance for most diagnostic, 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-POS C-SNP) with no copay, though prior authorization is required. Under this plan, Medicare Part B chemotherapy, radiation, and other drugs require no copay and no coinsurance to 20% coinsurance, while Part B insulin has a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by CareComplete Platinum (HMO-POS C-SNP) with no copay and a 20% coinsurance. Prior authorization and a referral are required to access this benefit.
Medical Equipment See details
CareComplete Platinum (HMO-POS C-SNP) covers durable medical equipment (DME) and medical supplies with a 20% coinsurance and no copay, subject to prior authorization. Diabetic supplies are available with no copay and no coinsurance, diabetic therapeutic shoes or inserts require a $10 copay and no coinsurance, and prosthetic devices are covered with no copay.
Diagnostic and Radiological Services See details
CareComplete Platinum (HMO-POS C-SNP) covers diagnostic and radiological services, requiring prior authorization and referrals. Members pay no copay for lab services or outpatient X-rays, a $0 to $175 copay with no coinsurance for diagnostic procedures, and a 20% coinsurance with copays starting at $0 for therapeutic radiological services.
Home Health Services See details
CareComplete Platinum (HMO-POS C-SNP) covers home health services with no copay and no coinsurance. Prior authorization and a referral are required to receive these services.
Cardiac Rehabilitation Services See details
CareComplete Platinum (HMO-POS C-SNP) offers cardiac rehabilitation services with no coinsurance, though prior authorization and referrals are required. While some services are covered, cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) services are not covered in practice and require a $20 copayment.
Skilled Nursing Facility (SNF) See details
CareComplete Platinum (HMO-POS C-SNP) covers skilled nursing facility (SNF) services with no coinsurance, featuring no copay for days 1 through 20 and a $160 copay for days 21 through 100. Prior authorization and referrals are required, and additional days beyond the standard 100-day Medicare benefit are not covered.
Other Services See details
Other services are partially covered by CareComplete Platinum (HMO-POS C-SNP), which provides acupuncture, over-the-counter (OTC) items, and chronic illness meal benefits with no copay and no coinsurance. Acupuncture is limited to 25 treatments per year, and prior authorization is required for both acupuncture and meal benefits.
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