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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 2026, 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 4.5 out of 5 stars in 2026.
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 $182.00. 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 a $615.00 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 $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) Medicare plan features an annual drug deductible of $615. Beneficiaries can save significantly on Tier 1 preferred generics, Tier 2 generics, and Tier 6 select care drugs, which feature no copay at standard pharmacies and through preferred mail order. If you choose standard mail order for these lower tiers, copays remain low, ranging from no copay for select care drugs up to $16 for a 1-month supply of Tier 2 generics. For higher-tier medications, Tier 3 preferred brand drugs require a $30 copay for a 1-month supply at standard pharmacies and preferred mail order, or $47 through standard mail order. Tier 4 non-preferred drugs carry a 50% coinsurance across all standard, preferred mail, and standard mail options. Tier 5 specialty tier drugs require a 25% coinsurance for a 1-month supply.
Additional Benefits
The CareComplete Platinum (HMO C-SNP) plan offers comprehensive medical coverage with low out-of-pocket costs and no deductibles. Members enjoy no copay and no coinsurance for primary care visits, preventive care, and home health services, while specialist visits require a low $10 copay. For hospital stays, there is no coinsurance, with inpatient days requiring a $150 daily copay for the first seven days and outpatient hospital services ranging from no copay to a $100 copay. In addition to core medical care, this plan provides robust dental, vision, and hearing benefits with no copay or coinsurance for routine services, including a $400 annual allowance for eyewear and a $500 annual allowance per ear for prescription hearing aids. Members also benefit from up to 26 one-way transportation trips per year with no copay, while durable medical equipment is covered with a standard twenty percent coinsurance.
Inpatient Hospital See details
CareComplete Platinum (HMO C-SNP) covers inpatient hospital services with no coinsurance, requiring a $150 daily copay for days 1 to 7 and no copay for days 8 to 90. Unlimited additional acute care days are covered with no copay, but additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
CareComplete Platinum (HMO C-SNP) covers outpatient services with no coinsurance, featuring a $0 to $100 copay for outpatient hospital services and no copay for observation, ambulatory surgical center, and blood services. Outpatient substance abuse services require a $10 copay for individual or group sessions, and most covered services require prior authorization and referrals.
Partial Hospitalization See details
CareComplete Platinum (HMO C-SNP) covers partial hospitalization services with a $25.00 copay and no coinsurance. Prior authorization and a referral are required to access this benefit.
Ambulance and Transportation Services See details
CareComplete Platinum (HMO C-SNP) covers ambulance and transportation services with prior authorization, though transportation to any health-related location is not covered. Ground ambulance services require a $0 to $150 copay and coinsurance, air ambulance services require a 20% coinsurance and a copay, and plan-approved transportation offers up to 26 one-way trips per year with no copay or coinsurance.
Emergency Services See details
CareComplete Platinum (HMO C-SNP) covers emergency services with a $150 copay (waived if admitted to the hospital within 24 hours) and urgently needed services with a $10 copay, both with no coinsurance. Worldwide emergency, urgent, and transportation services are also covered with no coinsurance and copays ranging from $10 to $150.
Primary Care See details
CareComplete Platinum (HMO C-SNP) covers primary care physician services with no copay and no coinsurance, while specialist visits, therapy, and mental health services generally require a $10 copay and no coinsurance. Chiropractic services are partially covered, offering up to 12 routine visits per year for a $15 copay and no coinsurance, though other chiropractic services are not covered.
Preventive Services See details
CareComplete Platinum (HMO C-SNP) offers partially covered preventive services with no copay and no coinsurance for covered benefits like annual physical exams, kidney disease education, glaucoma screenings, and memory fitness. However, several additional preventive services are not covered, including health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, weight management, and alternative therapies.
Hearing Services See details
Hearing services covered by CareComplete Platinum (HMO C-SNP) include routine exams, fitting evaluations, and OTC hearing aids with no copay and no coinsurance, while Medicare-covered exams require a $10 copay and no coinsurance. Prescription hearing aids are partially covered with no copay and no coinsurance up to $500 per ear annually, excluding inner ear, outer ear, and over the ear devices which are not covered.
Vision Services See details
CareComplete Platinum (HMO C-SNP) partially covers vision services with no deductibles, no coinsurance, and copays ranging from $0 to $10, though referrals and prior authorizations are required. This benefit covers one routine eye exam per year and up to $400 annually for contact lenses and eyeglasses with no copay, while other eye exams, individual lenses or frames, and upgrades are not covered.
Dental Services See details
CareComplete Platinum (HMO C-SNP) provides partially covered dental services with a $10 copay and no coinsurance for Medicare-covered dental, and no copay or coinsurance for other covered preventive and comprehensive services. Sub-services that are not covered under this plan include fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics.
Home Infusion bundled Services See details
CareComplete Platinum (HMO C-SNP) covers home infusion bundled services with no copay, although prior authorization is required. Covered Medicare Part B drugs, including chemotherapy, radiation, and insulin, carry no coinsurance to 20% coinsurance, with insulin specifically requiring a $35 copay.
Dialysis Services See details
Dialysis services are covered under the CareComplete Platinum (HMO C-SNP) plan with no copay and a 20% coinsurance. Prior authorization and a referral are required to receive these services.
Medical Equipment See details
CareComplete Platinum (HMO C-SNP) covers durable medical equipment (DME) with a 20% coinsurance and no copay. Prosthetic devices, medical supplies, and diabetic supplies are covered with no coinsurance and no copay, while diabetic therapeutic shoes and inserts have a $10 copay and no coinsurance.
Diagnostic and Radiological Services See details
CareComplete Platinum (HMO C-SNP) covers diagnostic services with no coinsurance, featuring no copay for lab services and a copay of $0 to $100 for diagnostic procedures. Covered radiological services include outpatient X-rays with no copay and therapeutic radiology with a minimum $10 copay and minimum 20% coinsurance, with prior authorization and referrals required for both benefits.
Home Health Services See details
CareComplete Platinum (HMO C-SNP) covers Home Health Services with no copay and no coinsurance, although prior authorization and a referral are required.
Cardiac Rehabilitation Services See details
CareComplete Platinum (HMO C-SNP) does not cover Cardiac Rehabilitation Services, which includes no coverage for intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease.
Skilled Nursing Facility (SNF) See details
CareComplete Platinum (HMO C-SNP) covers skilled nursing facility (SNF) services with no coinsurance, requiring prior authorization and referrals but no prior three-day inpatient hospital stay. There is no copay for days 1 through 20 and a $160 daily copay for days 21 through 100, though additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by CareComplete Platinum (HMO C-SNP) with no copay and no coinsurance, including acupuncture limited to 25 treatments per year, over-the-counter items, and meals for chronic illness. Prior authorization is required for acupuncture and meals, while other miscellaneous services and highly integrated dual-eligible SNP services are not covered.
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