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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 2026, 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 4.5 out of 5 stars in 2026.
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 $5.00. 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 $2000.00 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 features an annual drug deductible of $615. For Tier 1 preferred generics, Tier 2 generics, and Tier 6 select care drugs, you will pay no copay for 1-month and 3-month supplies filled at standard pharmacies or through preferred mail order. Standard mail-order costs for these tiers are also very low, starting at no copay for Tier 6 drugs and going up to a $16 copay for a 1-month supply of Tier 2 generics. For Tier 3 preferred brand drugs, standard pharmacies and preferred mail-order services offer a $40 copay for a 1-month supply. Higher-tier prescriptions require coinsurance, with Tier 4 non-preferred drugs costing 50% coinsurance and Tier 5 specialty drugs costing 25% coinsurance. These clear pricing tiers allow you to easily estimate your out-of-pocket prescription expenses.
Additional Benefits
The CareComplete (HMO C-SNP) plan offers comprehensive healthcare coverage with affordable out-of-pocket costs, featuring no copay and no coinsurance for primary care visits, preventive services, and home health care. Specialist visits and urgently needed care require a low $10 copay, while inpatient hospital stays cost a $50 copay for the first five days and no copay for subsequent days. Emergency room visits are covered with a $140 copay, which is waived if you are admitted to the hospital within 24 hours. Members also benefit from routine dental, vision, and hearing services, many of which are available with no copay and no coinsurance. Additionally, the plan covers up to 26 one-way transportation trips per year, acupuncture, and over-the-counter items with no copays. Durable medical equipment and dialysis services generally require coinsurance ranging from 10% to 20% with no copay.
Inpatient Hospital See details
Inpatient hospital care is partially covered by CareComplete (HMO C-SNP) with no coinsurance, requiring a $50 copay for days 1 to 5 and no copay for days 6 and beyond for acute stays (and up to 90 days for psychiatric stays). Prior authorization and referrals are required, while upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
CareComplete (HMO C-SNP) outpatient services are covered with no coinsurance, featuring a $0 to $50 copay for outpatient hospital services and a $10 copay for substance abuse sessions. There is no copay for ambulatory surgical center, observation, and outpatient blood services, though prior authorization and referrals are required for most care.
Partial Hospitalization See details
CareComplete (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
Ambulance and transportation services are partially covered by CareComplete (HMO C-SNP), as transportation to any health-related location is not covered. Ground ambulance services require a $0 to $250 copay and coinsurance, air ambulance services require a copay and 20% coinsurance, and approved transportation offers up to 26 one-way trips per year with no copay and no coinsurance.
Emergency Services See details
CareComplete (HMO C-SNP) covers emergency services with a $140 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with a $10 copay and no coinsurance, and worldwide emergency, urgent, and transportation services are available with no coinsurance and copays ranging from $10 to $140.
Primary Care See details
CareComplete (HMO C-SNP) provides 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 $20 copay and no coinsurance, though other chiropractic services are not covered. Prior authorization or referrals are required for most specialty and therapy services.
Preventive Services See details
CareComplete (HMO C-SNP) covers preventive services with no copay and no coinsurance, including annual physical exams, kidney disease education, glaucoma screenings, diabetes training, digital rectal exams, EKGs, and memory fitness. Additional preventive services are only partially covered, excluding health education, in-home safety assessments, PERS, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, remote access, home modifications, and counseling.
Hearing Services See details
CareComplete (HMO C-SNP) covers Medicare-covered hearing exams with a $10 copay and no coinsurance, while routine exams, fitting evaluations, and OTC hearing aids are available with no copay and no coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to $250 per ear annually, though inner ear, outer ear, and over the ear models are not covered.
Vision Services See details
Vision services are partially covered by CareComplete (HMO C-SNP), offering routine eye exams and select eyewear with no coinsurance and copays ranging from $0 to $10, up to a $200 annual maximum. Other eye exams, individual eyeglass lenses, individual eyeglass frames, and upgrades are not covered.
Dental Services See details
CareComplete (HMO C-SNP) offers partially covered dental services, featuring a $10.00 copay and no coinsurance for Medicare-covered dental, and no copay and no coinsurance for other covered preventive and comprehensive services. Fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
CareComplete (HMO C-SNP) covers Home Infusion bundled Services with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy and insulin, are covered with coinsurance ranging from no coinsurance up to 20%, with insulin requiring a $35 copay and no deductible.
Dialysis Services See details
CareComplete (HMO C-SNP) covers dialysis services with no copay and a 20% coinsurance. Prior authorization and a referral are required to receive these covered services.
Medical Equipment See details
CareComplete (HMO C-SNP) covers medical equipment, including durable medical equipment (DME) with a 10% to 20% coinsurance and no copay. Prosthetic devices and medical supplies require a 20% coinsurance and no copay, while diabetic supplies have no copay or coinsurance, and diabetic therapeutic shoes or inserts carry a $10 copay and no coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by CareComplete (HMO C-SNP) with prior authorization and referrals required. Diagnostic procedures and tests have no coinsurance and copays up to $150, lab and outpatient X-ray services have no copays, and therapeutic radiological services require a minimum $35 copay and 20% coinsurance.
Home Health Services See details
CareComplete (HMO C-SNP) covers home health services with no copay and no coinsurance. Both prior authorization and a referral are required to access this benefit.
Cardiac Rehabilitation Services See details
CareComplete (HMO C-SNP) covers Cardiac Rehabilitation Services with no coinsurance, though only some services are covered while cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered and require a $10 copay. Prior authorization and referrals are required to access these services.
Skilled Nursing Facility (SNF) See details
CareComplete (HMO C-SNP) partially covers Skilled Nursing Facility (SNF) services with no coinsurance, though additional days beyond the Medicare-covered limit are not covered. There is no copay for days 1 through 20 and a $150 copay for days 21 through 100, with prior authorization and a referral required.
Other Services See details
CareComplete (HMO C-SNP) provides partial coverage for other services, offering acupuncture, over-the-counter items, and chronic illness meal benefits with no copay and no coinsurance. Prior authorization is required for acupuncture (limited to 25 treatments per year) and meals, while other unspecified services are not covered.
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