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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 2026, 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 4.5 out of 5 stars in 2026.
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 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 CareNeeds Platinum (HMO D-SNP) Medicare plan offers a $0 drug deductible, allowing your prescription coverage to start immediately with no upfront costs. For Tier 1 preferred generic and Tier 2 generic medications, you will pay no copay for 1-month and 3-month supplies filled at standard pharmacies or through preferred mail order. If you use standard mail order, Tier 1 drugs have a $10 to $30 copay, while Tier 2 drugs require a $20 to $60 copay depending on the supply. For brand-name and specialty medications, your costs are based on a percentage of the drug cost. Tier 3 preferred brand and Tier 4 non-preferred drugs both require a 25% coinsurance for 1-month and 3-month supplies at standard pharmacies and mail-order services. Tier 5 specialty drugs have a 33% coinsurance for a 1-month supply across standard pharmacies and mail order options.
Additional Benefits
The CareNeeds Platinum (HMO D-SNP) plan offers comprehensive medical coverage with no copays and no coinsurance for the vast majority of healthcare services. Members pay nothing for inpatient and outpatient hospital stays, primary and specialist doctor visits, diagnostic testing, and skilled nursing facility care. Additionally, essential services like home health, dialysis, and durable medical equipment are covered with no copay or coinsurance. This plan also includes key supplemental benefits such as routine dental care, hearing exams with hearing aid coverage, and routine vision care with no deductible and a $300 eyewear allowance. While most services are covered at no cost, ground ambulance services carry a copay of up to $200, air ambulance requires a 20% coinsurance, and emergency room visits have a $150 copay. Unlimited plan-approved health transportation, acupuncture, and over-the-counter items are also provided with no copay.
Inpatient Hospital See details
Inpatient hospital services are partially covered by CareNeeds Platinum (HMO D-SNP) with no copay and no coinsurance for Medicare-covered acute and psychiatric stays, though referrals and prior authorizations are required. While unlimited additional days are covered for acute care, non-Medicare-covered stays, hospital upgrades, and additional days for psychiatric stays are not covered.
Outpatient Services See details
CareNeeds Platinum (HMO D-SNP) covers outpatient services, including outpatient hospital, observation, ambulatory surgical center, substance abuse, and blood services, with no copay and no coinsurance. Prior authorization and referrals are required for these covered services.
Partial Hospitalization See details
CareNeeds Platinum (HMO D-SNP) covers partial hospitalization services with no copay and no coinsurance, although prior authorization and a referral are required.
Ambulance and Transportation Services See details
CareNeeds Platinum (HMO D-SNP) covers ground ambulance services with a $0 to $200 copay and air ambulance services with a 20% coinsurance, both requiring prior authorization. Transportation services are partially covered, offering unlimited one-way trips to plan-approved health-related locations with no copay and no coinsurance, while transportation to any health-related location is not covered.
Emergency Services See details
CareNeeds Platinum (HMO D-SNP) covers emergency services with a $150 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services have no copay and no coinsurance, while worldwide emergency and transportation services carry a $150 copay, and worldwide urgent care ranges from a $0 to $150 copay, all with no coinsurance.
Primary Care See details
CareNeeds Platinum (HMO D-SNP) covers primary care, specialist, mental health, therapy, and telehealth services with no copay and no coinsurance. Chiropractic care is partially covered, offering up to 12 routine visits per year with no copay or coinsurance, while other chiropractic services are not covered.
Preventive Services See details
Preventive Services are partially covered by CareNeeds Platinum (HMO D-SNP) with no copay and no coinsurance for covered services, which include annual physical exams, kidney disease education, memory fitness, glaucoma screenings, diabetes training, and smoking cessation. However, several sub-services are not covered, including health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, disease management, telemonitoring, remote access, home safety modifications, and counseling.
Hearing Services See details
CareNeeds Platinum (HMO D-SNP) covers hearing exams, fitting evaluations, and OTC hearing aids with no copay and no coinsurance. Prescription hearing aids are also covered up to $1,000 per ear annually with no copay or coinsurance, although inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
CareNeeds Platinum (HMO D-SNP) offers partially covered vision services with no copay, no coinsurance, and no deductible. Covered benefits include one routine eye exam per year and up to $300 annually for contact lenses and eyeglasses (lenses and frames), while other eye exams, individual eyeglass lenses, individual eyeglass frames, and upgrades are not covered.
Dental Services See details
CareNeeds Platinum (HMO D-SNP) offers partially covered dental services with no copay and no coinsurance for covered benefits, which include oral exams, cleanings, dental x-rays, restorative care, and oral surgery. However, fluoride treatment, endodontics, periodontics, maxillofacial prosthetics, implant services, fixed prosthodontics, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by CareNeeds Platinum (HMO D-SNP) with no copay and no coinsurance, which includes Medicare Part B chemotherapy, insulin, and other Part B drugs. Prior authorization is required for these services, and step therapy may apply.
Dialysis Services See details
Dialysis services are covered under the CareNeeds Platinum (HMO D-SNP) plan with no copay and no coinsurance, though prior authorization and a referral are required.
Medical Equipment See details
CareNeeds Platinum (HMO D-SNP) covers medical equipment, including durable medical equipment, prosthetics, and diabetic supplies, with no copays and no coinsurance. Prior authorization is required for these services, and some items may be limited to preferred vendors or specified manufacturers.
Diagnostic and Radiological Services See details
CareNeeds Platinum (HMO D-SNP) covers diagnostic and radiological services, including lab tests, X-rays, and therapeutic radiology, with no copay and no coinsurance. Prior authorization and referrals are required for these services.
Home Health Services See details
CareNeeds Platinum (HMO D-SNP) covers home health services with no copay and no coinsurance, though prior authorization and a referral are required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under CareNeeds Platinum (HMO D-SNP), as cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are all excluded from coverage.
Skilled Nursing Facility (SNF) See details
CareNeeds Platinum (HMO D-SNP) covers Skilled Nursing Facility (SNF) services for days 1 through 100 with no copay and no coinsurance, though prior authorization and referrals are required. Admission does not require a prior three-day inpatient hospital stay, but additional days beyond the Medicare-covered limit are not covered.
Other Services See details
CareNeeds Platinum (HMO D-SNP) partially covers other services, offering acupuncture up to 25 treatments per year, chronic illness meal benefits, and over-the-counter items with no copay and no coinsurance. Prior authorization is required for acupuncture and meal benefits, and certain other services are not covered.
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