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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 Orlando Area. 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 $90.00. 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 $6700.00 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 CareSalute (HMO)
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Drug Coverage
Prescription drugs are not covered by CareSalute (HMO).
Additional Benefits
The CareSalute (HMO) plan offers a range of benefits with varying costs. You can expect no copay for primary care physician services, preventive services like annual physical exams, and many dental services. Other services, such as specialist visits, hearing exams, and outpatient services, have copays ranging from $15 to $210 depending on the specific service. This plan provides coverage for inpatient hospital stays with a $210 copay for the first 7 days, and no copay for the rest of the stay, as well as coverage for ambulance, emergency, and home health services. You may also receive coverage for hearing aids up to $1000 per year and over-the-counter items up to $100 per month.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered. For Inpatient Hospital-Acute, you will pay a $210 copay for days 1-7, and no copay for days 8-90, and no coinsurance; for Inpatient Hospital Psychiatric, you will also pay a $210 copay for days 1-7, and no copay for days 8-90, and no coinsurance. Additional Days for Inpatient Hospital-Acute are covered with no copay, and no coinsurance. Non-Medicare-covered Stay for Inpatient Hospital-Acute, Upgrades for Inpatient Hospital-Acute, Additional Days for Inpatient Hospital Psychiatric, and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, are covered by CareSalute (HMO), with a copay of $0 to $210 depending on the service, and observation services and Ambulatory Surgical Center (ASC) Services have no copay. Outpatient Substance Abuse services have a $30 copay for both individual and group sessions, and Outpatient Blood Services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered with a $30 copay, and requires prior authorization and a doctor referral.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the CareSalute (HMO) plan, with prior authorization required. Ground ambulance services have a copay between $0 and $225, while air ambulance services have a 20% coinsurance. Transportation services to a plan-approved health-related location are covered for up to 26 one-way trips per year with no copay. 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 CareSalute (HMO) plan. Emergency Services and Worldwide Emergency Coverage have a $125 copay, Urgently Needed Services has a $30 copay, and Worldwide Urgent Coverage has a copay between $30 and $125. Worldwide Emergency Transportation has a $125 copay. There is no coinsurance for any of these services.
Primary Care See details
The CareSalute (HMO) plan covers Primary Care Physician Services with no copay, and Chiropractic Services, including routine care, with a $15 copay. Occupational Therapy Services have a $30 copay, and Physician Specialist Services, Mental Health Specialty Services, Podiatry Services, Psychiatric Services, Physical Therapy, and Speech-Language Pathology Services all have a $30 copay. Other Health Care Professional services have a copay between $0 and $30, and Additional Telehealth Benefits have a copay between $0 and $30.
Preventive Services See details
Preventive services are covered, including an annual physical exam with no copay. Additional preventive services are also covered, including Fitness Benefit, Kidney Disease Education Services, and Other Preventive Services, such as glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following Welcome Visit, all with no copay. However, 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, Home and Bathroom Safety Devices and Modifications, and Counseling Services are not covered.
Hearing Services See details
CareSalute (HMO) covers hearing exams with a $30 copay and no deductible, as well as routine hearing exams and fitting/evaluation for hearing aids with no copay. This plan also covers prescription hearing aids with a maximum benefit of $1000 per year, and OTC hearing aids up to $100 per month.
Vision Services See details
CareSalute (HMO) covers vision services, including eye exams with a copay between $0 and $30, and eyewear with no copay. Eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental services include coverage for oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), other preventive dental services, restorative services, adjunctive general services, periodontics, prosthodontics (removable), and oral and maxillofacial surgery, each with a $0 copay. Fluoride treatment, endodontics, maxillofacial prosthetics, implant services, prosthodontics (fixed), and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, but require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay, with a coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, the coinsurance is 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. There is a 20% coinsurance for this service.
Medical Equipment See details
Medical equipment is covered by the CareSalute (HMO) plan. Durable Medical Equipment (DME) has a 20% coinsurance, and Prosthetic Devices have a coinsurance of 20%. Diabetic Supplies have no copay, while Diabetic Therapeutic Shoes/Inserts have a $10 copay.
Diagnostic and Radiological Services See details
The CareSalute (HMO) plan covers diagnostic and radiological services. Diagnostic Procedures/Tests have a copay between $0 and $200, while Lab Services have no copay. Diagnostic Radiological Services have a copay up to $210, and Therapeutic Radiological Services have a copay up to $30 and coinsurance up to 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, but not in practice because the plan does not cover any of the sub-services. Prior authorization and a doctor referral are required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the CareSalute (HMO) plan, but require prior authorization and a doctor referral. For days 1-20, there is no copay, and for days 21-100, the copay is $160.
Other Services See details
The CareSalute (HMO) plan covers acupuncture with no copay, but requires prior authorization and is limited to 25 treatments per year. Over-the-counter items are covered up to $100 per month, and includes nicotine replacement therapy and Naloxone, but does not cover all drugs on the CMS OTC list. The plan also covers a meal benefit with no copay, for a chronic illness, and requires prior authorization. The plan does not cover Dual Eligible SNPs with Highly Integrated Services, or 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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