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CareComplete (HMO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for CareComplete (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 (HMO C-SNP) in 2025, please refer to our full plan details page.
CareComplete (HMO C-SNP) is a HMO C-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 CareComplete (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 (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 (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 (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 $4.00. 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 (HMO C-SNP) plan has a $0 deductible for prescription drugs. In the initial coverage phase, you'll pay varying copays or coinsurance depending on the drug tier and pharmacy type. For example, standard generic drugs have a $0 copay if you use a preferred pharmacy, but a $16 copay if you use standard mail order. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase and pay nothing for Part D covered drugs. If you qualify for the low-income subsidy (LIS), your drug costs may be reduced.
Additional Benefits
The CareComplete (HMO C-SNP) plan offers comprehensive coverage with a range of benefits. Inpatient hospital stays have a $50 copay for days 1-5, and no copay for days 6-90. Outpatient services like primary care, preventive services, and many dental and vision services have no copay. The plan also covers a variety of other services, including hearing, dental, and vision, with varying copays. Emergency, urgent, and worldwide emergency services are covered with copays ranging from $35-$140. Additionally, the plan provides coverage for ambulance and transportation, and offers benefits like home health, medical equipment, and skilled nursing facilities with copays or coinsurance depending on the service.
Inpatient Hospital See details
The CareComplete (HMO C-SNP) plan covers inpatient hospital services, including acute and psychiatric care, with a $50 copay for days 1-5 and no copay for days 6-90. Additional days for Inpatient Hospital-Acute have no copay. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute, and 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, and ambulatory surgical center (ASC) services, are covered. Outpatient hospital services have a copay between $0 and $100, while observation services and ASC services have no copay. Outpatient substance abuse services, including individual and group sessions, are covered with a copay between $30 and $35. Outpatient blood services are covered with no copay.
Partial Hospitalization See details
CareComplete (HMO C-SNP) covers partial hospitalization with a $10 copay, but prior authorization and a doctor referral are required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the CareComplete (HMO C-SNP) plan. Ground ambulance services have a copay between $0 and $300, while air ambulance services have a 20% coinsurance. Transportation services to a plan-approved health-related location have no copay, with a limit of 26 one-way trips per year.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the CareComplete (HMO C-SNP) plan. Emergency Services have a $140 copay with no coinsurance, Urgently Needed Services have a $35 copay with no coinsurance, and Worldwide Emergency Services have a copay ranging from $35 to $140 with no coinsurance.
Primary Care See details
CareComplete (HMO C-SNP) covers primary care physician services with no copay, and chiropractic services and routine chiropractic care with a $10 copay. The plan also covers occupational therapy services with a $10 copay, and physician specialist services, mental health specialty services, podiatry services, psychiatric services, physical therapy, speech-language pathology services, and opioid treatment program services with copays ranging from $10 to $35. Additional telehealth benefits are covered with a copay between $0 and $35.
Preventive Services See details
Preventive Services are covered by the CareComplete (HMO C-SNP) plan. The plan has no copay for an annual physical exam, and other preventive services such as Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit also have no copay.
Hearing Services See details
CareComplete (HMO C-SNP) covers 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 $250 per year, while OTC hearing aids, prescription hearing aids for the inner ear, outer ear, and over the ear are not covered.
Vision Services See details
The CareComplete (HMO C-SNP) plan covers vision services, including eye exams with a copay of $0-$10, and eyewear with no copay. Contact lenses and eyeglasses (lenses and frames) have no copay, while eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental services are covered, including Medicare Dental Services with a $10 copay, and other dental services. 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 have no copay. 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, including Medicare Part B Insulin Drugs, Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. For Medicare Part B Insulin Drugs, there is a $35 copay and between 0% to 20% coinsurance; other services have between 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the CareComplete (HMO C-SNP) plan, but require prior authorization and a doctor's referral. The coinsurance for these services is 20%.
Medical Equipment See details
Medical Equipment benefits for CareComplete (HMO C-SNP) include Durable Medical Equipment (DME) with 20% coinsurance, Prosthetic Devices with no copay, and Medical Supplies with 20% coinsurance. Diabetic Equipment has a copay for Medicare-covered supplies, and Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, diagnostic procedures and tests with a copay between $0 and $150, and lab services with no copay. Radiological services include coverage for diagnostic radiological services with a copay up to $100, therapeutic radiological services with a copay up to $35 and 20% coinsurance, and outpatient X-ray services with no copay.
Home Health Services See details
Home Health Services are covered by the CareComplete (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 the plan does not cover the specific sub-services of Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services. Prior authorization and a doctor referral are required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but require prior authorization and a doctor's referral. You will have no copay for days 1-20, and a $150 copay per day for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
CareComplete (HMO C-SNP) covers acupuncture with no copay, up to 25 treatments per year, and over-the-counter (OTC) items with a maximum benefit of $2580 per year, including nicotine replacement therapy and Naloxone. The plan also covers a meal benefit with no copay for chronic illnesses. However, the plan does not cover Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, or Self-Directed Personal Assistance Services.
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