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CareComplete Platinum (HMO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for CareComplete Platinum (HMO C-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on CareComplete Platinum (HMO C-SNP) in 2025, please refer to our full plan details page.
CareComplete Platinum (HMO C-SNP) is a HMO C-SNP plan offered by Humana Inc. available for enrollment in 2025 to people living in Orlando & Tampa Area. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that CareComplete Platinum (HMO C-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
CareComplete Platinum (HMO C-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 CareComplete Platinum (HMO C-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 CareComplete Platinum (HMO C-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. Additionally, this plan comes with a Part B Premium reduction of $160.00. 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 $2400.00 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 CareComplete Platinum (HMO C-SNP) plan has a $0 deductible for prescription drugs. In the initial coverage phase, you will pay different copays or coinsurance amounts depending on the drug tier and pharmacy type. For example, you may pay no copay for preferred generic drugs at a standard pharmacy, but a $16 copay at a standard mail pharmacy. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase, where you will pay nothing for covered drugs. If you qualify for the low-income subsidy, you pay $0.00.
Additional Benefits
The CareComplete Platinum (HMO C-SNP) plan offers a range of benefits with varying cost-sharing. Inpatient hospital stays have a copay, while outpatient services often have no copay, with some services like substance abuse treatment having a $10 copay. Emergency services and transportation are covered, and the plan also includes coverage for primary care, preventive services, hearing, vision, and dental, with copays ranging from $0-$10 for many services, and some services with no copay. Additional benefits include home health services with no copay, and coverage for medical equipment and diagnostic services with varying cost-sharing. The plan also covers acupuncture, over-the-counter items with a quarterly allowance, and meal benefits for chronic illnesses. However, certain services like cardiac rehabilitation and some dental and vision upgrades are not covered.
Inpatient Hospital See details
Inpatient Hospital coverage includes acute and psychiatric care, with a copay of $150 per day for days 1-7, and no copay for days 8-90; additional days have no copay, while non-Medicare-covered stays and upgrades are not covered. Inpatient Hospital Psychiatric care has a copay of $150 per day for days 1-7, and no copay for days 8-90; additional days and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered, 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 $150, while observation services, ambulatory surgical center services, and outpatient blood services have no copay. Individual and group sessions for outpatient substance abuse have a copay of $10.
Partial Hospitalization See details
Partial Hospitalization is covered by the CareComplete Platinum (HMO C-SNP) plan, but requires prior authorization and a doctor referral. The copay for this benefit is $10.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered. Ground ambulance services have a copay between $0 and $90, 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.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the CareComplete Platinum (HMO C-SNP) plan. Emergency Services have a $140 copay and no coinsurance, while Urgently Needed Services have a $10 copay and no coinsurance. Worldwide Emergency Coverage and Worldwide Emergency Transportation have a $140 copay and no coinsurance, and Worldwide Urgent Coverage has a $10 - $140 copay and no coinsurance.
Primary Care See details
The CareComplete Platinum (HMO C-SNP) plan covers primary care physician services with no copay, and chiropractic services with a $10 copay. Occupational therapy services and physical/speech therapy services have a $10 copay, while physician specialist and mental health specialty services have a $10 copay. Podiatry, other health care professional, psychiatric services, and opioid treatment program services have a copay of $10.
Preventive Services See details
Preventive Services include no copay for annual physical exams, glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a Welcome Visit. Additional preventive services include fitness benefits with no copay.
Hearing Services See details
Hearing Services include hearing exams with a $10 copay, routine hearing exams with no copay, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids are covered up to $500 per year, and OTC hearing aids are covered up to $125 every three months. Prescription hearing aids are partially covered; Inner Ear, Outer Ear, and Over the Ear hearing aids are not covered.
Vision Services See details
The CareComplete Platinum (HMO C-SNP) plan covers vision services, including eye exams and eyewear. Eye exams have a copay of $0-$10, and eyewear has a $0 copay, with a combined maximum benefit of $400 per year. The plan does not cover eyeglass lenses, eyeglass frames, and upgrades.
Dental Services See details
The CareComplete Platinum (HMO C-SNP) plan covers Medicare Dental Services with a $10 copay, and other dental services including Oral Exams, Dental X-Rays, Other Diagnostic Dental Services, Prophylaxis (Cleaning), Other Preventive Dental Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics, removable, and Oral and Maxillofacial Surgery with no copay, but does not cover Fluoride Treatment, Maxillofacial Prosthetics, Implant Services, Prosthodontics, fixed, and Orthodontics. Oral exams are limited to 4 visits per year, dental x-rays are limited to 3 per year, and prophylaxis (cleaning) is limited to 2 visits per year.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. For Medicare Part B Insulin Drugs, there is a $35 copay with 0-20% coinsurance; for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is 0-20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by the CareComplete Platinum (HMO C-SNP) plan, but require prior authorization and a doctor's referral. The coinsurance for these services is 20%.
Medical Equipment See details
The CareComplete Platinum (HMO C-SNP) plan covers medical equipment, including Durable Medical Equipment (DME) with a 20% coinsurance, and Prosthetics/Medical Supplies and Diabetic Equipment with no copay for some services. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered. Diagnostic Procedures/Tests have a copay between $0 and $100, and Lab Services have no copay. Diagnostic Radiological Services have a copay of up to $150, while Therapeutic Radiological Services have a copay of up to $50 and coinsurance of at least 20%. Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the CareComplete Platinum (HMO C-SNP) 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 not covered under the CareComplete Platinum (HMO C-SNP) plan. The plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the CareComplete Platinum (HMO C-SNP) plan, but require prior authorization and a doctor's referral. You will have no copay for days 1-20, and a $150 copay for days 21-100. Additional days beyond Medicare-covered for SNF and Non-Medicare-covered stays for SNF are not covered.
Other Services See details
The CareComplete Platinum (HMO C-SNP) plan covers acupuncture with no copay, but requires prior authorization and limits the number of treatments to 25 per year. Over-the-counter (OTC) items are covered, with a maximum benefit coverage amount of $125 every three months, and include nicotine replacement therapy and Naloxone. Meal benefits are also covered with no copay, and for a chronic illness, but require prior authorization. Other services such as Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, and others are not covered.
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