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CareNeeds Platinum (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for CareNeeds Platinum (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on CareNeeds Platinum (HMO D-SNP) in 2025, please refer to our full plan details page.
CareNeeds Platinum (HMO D-SNP) is a HMO D-SNP plan offered by Humana Inc. available for enrollment in 2025 to people living in Select Counties In Florida. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that CareNeeds Platinum (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
CareNeeds Platinum (HMO D-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 CareNeeds Platinum (HMO D-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 CareNeeds Platinum (HMO D-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.
This plan does not come with a Part B Premium reduction. You must continue to pay your 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 a $510.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
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 CareNeeds Platinum (HMO D-SNP) plan offers an enhanced alternative drug benefit. Before your coverage begins, you must meet a deductible of $510. Once the deductible is met, you will pay the costs associated with your prescriptions. During the initial coverage phase, you will pay varying copays or coinsurance depending on the drug tier and pharmacy. For example, you will pay no copay for preferred generic drugs at a standard pharmacy. After your total drug costs reach $2000, you enter the catastrophic coverage phase, where you will pay nothing for your Part D covered drugs.
Additional Benefits
The CareNeeds Platinum (HMO D-SNP) plan offers a wide range of benefits with a focus on low-cost access to care. Many services have no copay, including inpatient and outpatient hospital services, primary care, preventive services, hearing and vision exams, dental services, home health, and diagnostic services. The plan also provides allowances for hearing aids, prescription eyewear, and over-the-counter items. Emergency services, including worldwide coverage, are available with copays. Ambulance services have a copay, and air ambulance services have a 20% coinsurance. The plan also covers partial hospitalization, dialysis, cardiac rehabilitation, and skilled nursing facilities with prior authorization.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services, both with no copay for Medicare-covered stays. Additional days for Inpatient Hospital-Acute are covered, with no copay. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute, as well as additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services, including outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services, are covered. Outpatient Hospital Services, Observation Services, Ambulatory Surgical Center Services, and Outpatient Blood Services have no copay. Outpatient Substance Abuse Services, including individual and group sessions, have no copay.
Partial Hospitalization See details
CareNeeds Platinum (HMO D-SNP) covers partial hospitalization with no copay. Prior authorization and a doctor referral are required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including both ground and air ambulance services. Ground ambulance services have a copay between $0 and $200, while air ambulance services have a 20% coinsurance; Transportation Services to a plan-approved health-related location are also covered, with no copay and up to 50 one-way trips per year.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the CareNeeds Platinum (HMO D-SNP) plan. Emergency Services has a $140 copay, and Urgently Needed Services has no copay; both have no coinsurance. Worldwide Emergency Coverage and Worldwide Emergency Transportation have a $140 copay, and Worldwide Urgent Coverage has a copay between $0 and $140; all have no coinsurance.
Primary Care See details
Primary Care services include no copay for primary care physician services, chiropractic services, and routine chiropractic care (up to 12 visits per year). Occupational therapy services, physician specialist services, mental health specialty services (individual and group sessions), podiatry services, other health care professional services, psychiatric services (individual and group sessions), physical therapy and speech-language pathology services, additional telehealth benefits, and opioid treatment program services are also covered. A $0 copay is required for these services.
Preventive Services See details
Preventive Services include an annual physical exam with no copay, and additional services like wigs for hair loss related to chemotherapy, additional sessions of smoking cessation counseling, fitness benefits, glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a welcome visit, all with no copay. Health education, in-home safety assessments, personal emergency response systems (PERS), medical nutrition therapy (MNT), post-discharge in-home medication reconciliation, re-admission prevention, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, support for caregivers of enrollees, 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
CareNeeds Platinum (HMO D-SNP) covers hearing exams with no copay, routine hearing exams with no copay, and fitting/evaluation for hearing aids with no copay. The plan provides a $1,000 allowance per year for prescription hearing aids, and $75 every three months for OTC hearing aids.
Vision Services See details
Vision services are covered, including eye exams and eyewear. Eye exams and eyewear have no copay, and contact lenses and eyeglasses (lenses and frames) are covered with no copay. Eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental Services are covered, with no copay for Medicare Dental Services, Oral Exams, Dental X-Rays, Other Diagnostic Dental Services, Prophylaxis (Cleaning), Other Preventive Dental Services, Restorative Services, Adjunctive General Services, Prosthodontics (removable), and Oral and Maxillofacial Surgery. 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 are covered, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. There is no copay for Medicare Part B Insulin Drugs, or Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs.
Dialysis Services See details
Dialysis Services are covered by the CareNeeds Platinum (HMO D-SNP) plan, with no copay. Prior authorization and a doctor referral are required.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. Durable Medical Equipment has no coinsurance and a copay, and Diabetic Supplies and Therapeutic Shoes/Inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including diagnostic procedures/tests, lab services, diagnostic radiological services, therapeutic radiological services, and outpatient X-ray services, are covered. Diagnostic procedures/tests, lab services, diagnostic radiological services, therapeutic radiological services, and outpatient X-ray services have no copay.
Home Health Services See details
Home Health Services are covered by the CareNeeds Platinum (HMO D-SNP) plan with no copay and no coinsurance, although additional hours of care and personal care services are not covered. This benefit requires both authorization and a referral.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but not the sub-services. The plan requires prior authorization and a doctor's referral.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are covered under the CareNeeds Platinum (HMO D-SNP) plan, but prior authorization and a doctor referral are required. The plan does not cover additional days beyond Medicare-covered for SNF, nor does it cover non-Medicare-covered stays for SNF.
Other Services See details
Under "Other Services," the CareNeeds Platinum (HMO D-SNP) plan covers acupuncture with no copay, and a limit of 25 treatments per year, as well as a meal benefit with no copay. Over-the-counter items are covered up to $75 every three months, and the plan offers Nicotine Replacement Therapy (NRT) and Naloxone coverage as Part C OTC benefits. However, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), and many other services are not covered.
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