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CareFree Platinum Giveback (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for CareFree Platinum Giveback (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on CareFree Platinum Giveback (HMO) in 2025, please refer to our full plan details page.
CareFree Platinum Giveback (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 CareFree Platinum Giveback (HMO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about CareFree Platinum Giveback (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 CareFree Platinum Giveback (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 $100.00. 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 CareFree Platinum Giveback (HMO) plan has an enhanced alternative drug benefit with no deductible. During the initial coverage phase, you will pay no copay for preferred generic drugs at standard and mail order pharmacies. For standard generic drugs, you will pay a $30 copay. For preferred brand drugs and non-preferred drugs, you will pay 35% and 33% coinsurance, respectively. After your total drug costs reach $2,000, you enter the catastrophic coverage phase where you pay nothing for Part D covered drugs.
Additional Benefits
The CareFree Platinum Giveback (HMO) plan offers comprehensive coverage with a variety of benefits. This plan features no copays for many services, including primary care, preventive services like annual physical exams and fitness benefits, routine eye exams, and many dental services. The plan also covers inpatient hospital stays with a $250 copay for the first five days, as well as outpatient services, emergency services, and transportation services. Additionally, the plan includes coverage for hearing and vision services, with copays for hearing exams and eye exams.
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 $250 copay for days 1-5, and no copay for days 6-90, while for Inpatient Hospital Psychiatric, you will pay a $250 copay for days 1-5, and no copay for days 6-90.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services with a copay between $0 and $250, observation services with no copay, ambulatory surgical center (ASC) services with no copay, outpatient substance abuse services with a $40 copay for both individual and group sessions, and outpatient blood services with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the CareFree Platinum Giveback (HMO) plan, requiring prior authorization and a doctor referral. The copay for this service is $40.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the CareFree Platinum Giveback (HMO) plan. Ground ambulance services have a copay between $0 and $140, while air ambulance services have a 20% coinsurance, and transportation services to a plan-approved health-related location have no copay.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the CareFree Platinum Giveback (HMO) plan. Emergency Services have a $140 copay and no coinsurance, while Urgently Needed Services have a $40 copay and no coinsurance. Worldwide Emergency Coverage and Worldwide Emergency Transportation have a $140 copay, and Worldwide Urgent Coverage has a copay between $40 and $140; all have no coinsurance.
Primary Care See details
Primary Care Physician Services are covered with no copay. Chiropractic Services are covered with a $20 copay for routine care, and Occupational Therapy Services are covered with a $40 copay. Physician Specialist Services, Physical Therapy and Speech-Language Pathology Services are covered with a $40 copay, and Individual and Group Sessions for Mental Health and Psychiatric Services are covered with a $40 copay.
Preventive Services See details
The CareFree Platinum Giveback (HMO) plan covers preventive services, including an annual physical exam with no copay. It also covers additional preventive services, including fitness benefits with no copay, and kidney disease education services with no copay. Other preventive services, such as glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a Welcome Visit, are covered with no copay.
Hearing Services See details
The CareFree Platinum Giveback (HMO) plan covers hearing exams with a $40 copay, as well as Routine Hearing Exams and Fitting/Evaluation for Hearing Aid with no copay. The plan also covers Prescription Hearing Aids with a maximum benefit of $500 per year, and OTC Hearing Aids with a maximum benefit of $15 per month.
Vision Services See details
Vision services are covered, including eye exams and eyewear. Eye exams have a copay between $0 and $40, while routine eye exams, contact lenses, and eyeglasses (lenses and frames) have no copay, and a combined maximum of $150 per year is offered for eyewear.
Dental Services See details
The CareFree Platinum Giveback (HMO) plan covers Medicare Dental Services with a $40 copay, and other dental services including oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), restorative services, adjunctive general services, and oral and maxillofacial surgery with no copay. Fluoride treatment, endodontics, periodontics, maxillofacial prosthetics, implant services, prosthodontics fixed, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs, are covered under the CareFree Platinum Giveback (HMO) plan. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0-20%, while the coinsurance for Chemotherapy/Radiation and Other Medicare Part B Drugs is between 0-20%.
Dialysis Services See details
Dialysis Services are covered under the CareFree Platinum Giveback (HMO) plan, but require prior authorization and a doctor's referral. There is a 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME) with 20% coinsurance, Prosthetic Devices with 20% coinsurance, and Medical Supplies with 20% coinsurance. Diabetic Supplies have no copay, while Diabetic Therapeutic Shoes/Inserts have a $10 copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for diagnostic procedures/tests with a copay between $0 and $175, lab services with no copay, diagnostic radiological services with a copay up to $250, therapeutic radiological services with a copay up to $65 and 20% coinsurance, and outpatient x-ray services with no copay. All services require prior authorization and a doctor referral.
Home Health Services See details
Home Health Services are covered by the CareFree Platinum Giveback (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 none of the sub-services are covered. Prior authorization and a doctor referral are required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the CareFree Platinum Giveback (HMO) plan, requiring prior authorization and a doctor's referral. For days 1-20, there is no copay, and for days 21-100, the copay is $150.
Other Services See details
The CareFree Platinum Giveback (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 with a monthly maximum benefit of $15, including nicotine replacement therapy and naloxone. The plan also covers a meal benefit with no copay, but requires prior authorization.
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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
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