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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 $165.00. 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 $2500.00 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 an enhanced alternative drug benefit with no deductible. During the initial coverage phase, you'll pay varying copays or coinsurance depending on the drug tier and pharmacy. For example, standard generic drugs have a $0 copay, while preferred brand drugs have a 35% coinsurance at a preferred pharmacy. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase, where you pay nothing for Part D covered drugs. If you qualify for the low-income subsidy, you will pay $0.00 for your drugs. Review the plan's formulary for specific drug coverage details.
Additional Benefits
The CareComplete Platinum (HMO C-SNP) plan offers a range of benefits with varying costs. Inpatient hospital stays have a copay, while outpatient services and primary care visits often have no copay, and some have a small copay. The plan also includes coverage for emergency services, transportation, vision, dental, and hearing services, with copays and coinsurance applying to specific services. Additional benefits include coverage for home health, skilled nursing facilities, and some medical equipment. This plan also offers services like acupuncture, over-the-counter items, and meal benefits. Prior authorization and referrals are often required for many services.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered with a $50 copay for days 1-7 and no copay for days 8-90. Additional days for Inpatient Hospital-Acute are covered with no copay, while additional days for Inpatient Hospital Psychiatric are not covered. Non-Medicare-covered stays and upgrades are not covered.
Outpatient Services See details
The CareComplete Platinum (HMO C-SNP) plan covers outpatient services, including outpatient hospital services with a copay between $0 and $50, observation services with no copay, ambulatory surgical center (ASC) services with no copay, outpatient substance abuse services with a $10 copay for both individual and group sessions, and outpatient blood services with no copay. Prior authorization and a doctor referral are required for all services.
Partial Hospitalization See details
Partial Hospitalization is covered by the CareComplete Platinum (HMO C-SNP) plan, with a $10 copay. Prior authorization and a doctor referral are required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services includes coverage for ground ambulance services with a copay between $0 and $200, air ambulance services with 20% coinsurance, and transportation services to plan-approved health-related locations with no copay for up to 26 one-way trips per year. Transportation services to any health-related location are not covered.
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, while Urgently Needed Services have a $10 copay, and both have no coinsurance. Worldwide Emergency Coverage and Worldwide Emergency Transportation have a $140 copay, and Worldwide Urgent Coverage has a copay between $10 and $140. All worldwide services have no coinsurance.
Primary Care See details
CareComplete Platinum (HMO C-SNP) covers primary care physician services with no copay, chiropractic services with a $10 copay, occupational therapy services with a $10 copay, physician specialist services, physical therapy and speech-language pathology services with a $10 copay, mental health specialty services with a $10 copay, podiatry services with a $10 copay, other health care professional services with a copay between $0 and $10, psychiatric services with a $10 copay, additional telehealth benefits with a copay between $0 and $10, and opioid treatment program services with a $10 copay. Prior authorization and doctor referrals may be required for some services.
Preventive Services See details
Preventive Services include an annual physical exam with no copay, and some other services with a copay, including Medicare-covered Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following a Welcome Visit. Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Post-discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, 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
CareComplete Platinum (HMO C-SNP) covers hearing exams with a $10 copay, routine hearing exams with no copay, fitting/evaluation for hearing aids with no copay, and OTC hearing aids with a $50 maximum per year. Prescription hearing aids are partially covered, with a maximum benefit of $1500 per year, and Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, and Prescription Hearing Aids - Over the Ear 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 between $0 and $10, while routine eye exams and eyewear have no copay. Contact lenses and eyeglasses (lenses and frames) are covered with no copay, but eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
The CareComplete Platinum (HMO C-SNP) plan covers a variety of dental services, including oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), other preventive dental services, restorative services, adjunctive general services, periodontics, prosthodontics, removable, and oral and maxillofacial surgery, with a $10 copay for Medicare Dental Services. Fluoride Treatment, Endodontics, Maxillofacial Prosthetics, Implant Services, Prosthodontics, fixed, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered and require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is coinsurance between 0% and 20%.
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. There is a 20% coinsurance for these services.
Medical Equipment See details
Medical equipment benefits are covered, including Durable Medical Equipment (DME) with 20% coinsurance and Prosthetics/Medical Supplies with 20% coinsurance and copays for Medicare-covered medical supplies. Diabetic equipment is covered with copays for Medicare-covered diabetes supplies and therapeutic shoes/inserts, as well as Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts with no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including all diagnostic and radiological services. Diagnostic Procedures/Tests have a copay between $0 and $100, Lab Services have no copay, Diagnostic Radiological Services have a copay up to $50, Therapeutic Radiological Services have a copay up to $50 and a coinsurance of at least 20%, and 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 covered, but Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. Prior authorization and a doctor referral are required for the services that are covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the CareComplete Platinum (HMO C-SNP) plan. For days 1-20, there is no copay, and for days 21-100, the copay is $150. 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 is limited to 25 treatments per year. The plan also provides over-the-counter (OTC) items with a $50 monthly maximum, and meal benefits with no copay and prior authorization. Other services such as Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services, private duty nursing services, and more are not covered.
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