A non-government entity
CareSalute (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for CareSalute (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on CareSalute (HMO) in 2025, please refer to our full plan details page.
CareSalute (HMO) is a HMO plan offered by Humana Inc. available for enrollment in 2025 to people living in Flagler and Volusia Counties. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that CareSalute (HMO) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about CareSalute (HMO).
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 CareSalute (HMO), 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 $80.00. 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.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $6350.00 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
Prescription drugs are not covered by CareSalute (HMO).
Additional Benefits
The CareSalute (HMO) plan offers comprehensive coverage, including inpatient and outpatient services, with varying copays. Emergency, primary care, and preventive services often have low or no copays. The plan also provides benefits for hearing, vision, and dental, with specific coverage limits and copays. Additional benefits include ambulance and transportation services, home health services, and medical equipment coverage. The plan also covers services like acupuncture and over-the-counter items, along with a meal benefit. However, it's important to note that some services, such as certain dental procedures and specific rehabilitation services, may not be covered or may have limitations.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, both of which require prior authorization and a doctor referral; for days 1-7, the copay is $250, and for days 8-90, there is no copay. Additional days for Inpatient Hospital-Acute are covered with no copay, but 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
The CareSalute (HMO) plan covers outpatient services including all outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient Hospital Services have a copay between $0 and $200, observation services, ambulatory surgical center services, and outpatient blood services have no copay, and individual and group outpatient substance abuse sessions have a copay of $40.
Partial Hospitalization See details
Partial Hospitalization is covered by CareSalute (HMO) with a $40 copay, but requires prior authorization and a doctor's referral.
Ambulance and Transportation Services See details
The CareSalute (HMO) plan covers ambulance and transportation services. Ground ambulance services have a copay between $0 and $175, 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. 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 under the CareSalute (HMO) plan. Emergency Services and Worldwide Emergency Coverage have a $115 copay, while Urgently Needed Services and Worldwide Urgent Coverage have copays of $40 and $115, respectively. Worldwide Emergency Transportation also has a $115 copay. There is no coinsurance for any of these services.
Primary Care See details
CareSalute (HMO) offers comprehensive primary care, including no copay for Primary Care Physician Services. Chiropractic services, routine chiropractic care, and podiatry services have a $20 copay, while physician specialist services, physical therapy, and speech-language pathology services have a $40 copay. Mental health specialty services, psychiatric services, and opioid treatment program services have a $40 copay.
Preventive Services See details
The CareSalute (HMO) plan covers preventive services including annual physical exams with no copay. Additional preventive services are covered, including fitness benefits such as memory fitness with no copay. Kidney disease education services are covered with no copay. Other preventive services are covered, including Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit, all with no copay.
Hearing Services See details
CareSalute (HMO) covers hearing exams with a $40 copay, and routine hearing exams and fitting/evaluation for hearing aids with no copay. Prescription Hearing Aids are covered with a plan-specified amount of $2000 per year, and OTC hearing aids are covered with a maximum of $50 per month.
Vision Services See details
CareSalute (HMO) covers vision services, including routine eye exams with no copay, and eyewear with no copay. The plan covers contact lenses and eyeglasses (lenses and frames) with a combined maximum of $400 per year, but does not cover eyeglass lenses, eyeglass frames, or upgrades.
Dental Services See details
CareSalute (HMO) covers dental services, including Medicare dental services with a $40 copay, and other services such as oral exams, dental x-rays, and other diagnostic dental services with no copay. Fluoride treatment, maxillofacial prosthetics, prosthodontics fixed, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay, with coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the CareSalute (HMO) plan, but require prior authorization and a doctor's referral. You will pay 20% coinsurance for these services.
Medical Equipment See details
The CareSalute (HMO) plan covers medical equipment, including Durable Medical Equipment (DME), with a 20% coinsurance and no copay. The plan also covers Prosthetics/Medical Supplies with a coinsurance for Medicare-covered medical supplies and copays for Medicare-covered prosthetic devices. Diabetic equipment is covered with copays for Medicare-covered diabetes supplies and diabetic therapeutic shoes or inserts, and no copay for diabetic supplies.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the CareSalute (HMO) plan. Diagnostic Procedures/Tests have a copay ranging from $0 to $250, while Lab Services have no copay. Diagnostic Radiological Services have a copay up to $200, and Therapeutic Radiological Services have a copay up to $40 and a coinsurance of at least 20%. Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the CareSalute (HMO) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered with prior authorization and a doctor referral, but none of the specific services are covered. This includes Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the CareSalute (HMO) plan with prior authorization and a doctor's referral required. You will have no copay for days 1-20, and a $188 copay for days 21-100; there is no coinsurance.
Other Services See details
The CareSalute (HMO) plan covers acupuncture with no copay, and a limit of 25 treatments per year, as well as over-the-counter items with a $0 copay and a maximum benefit coverage amount of $50.00 every month. The plan also covers a meal benefit with no copay. However, 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 are not covered.
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