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CareBreeze Platinum (HMO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for CareBreeze 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 CareBreeze Platinum (HMO C-SNP) in 2026, please refer to our full plan details page.
CareBreeze 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 CareBreeze 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:
CareBreeze 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 CareBreeze 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 CareBreeze 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 $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 CareBreeze Platinum (HMO C-SNP) prescription drug plan features an annual drug deductible of $615. You will pay no copay for Tier 1 preferred generic and Tier 6 select care drugs when filling a one-month supply at standard pharmacies or through preferred mail order. Tier 2 generic drugs are available for a $5 copay for a one-month supply at standard pharmacies, or with no copay for a three-month supply via preferred mail order. For brand-name and specialty medications, Tier 3 preferred brand drugs require a $47 copay for a one-month supply at standard pharmacies and mail order services. Higher-tier medications require coinsurance rather than flat copays, with Tier 4 non-preferred drugs carrying a 50% coinsurance and Tier 5 specialty drugs requiring a 25% coinsurance.
Additional Benefits
The CareBreeze Platinum (HMO C-SNP) plan offers comprehensive medical coverage with affordable out-of-pocket costs, including no copay for primary care physician visits and a low $10 copay for most specialist and mental health appointments. For hospital stays, members pay no coinsurance and a $75 daily copay for the first five days of inpatient care, while home health services and preventive care are available with no copay. Emergency room visits carry a $150 copay, which is waived if you are admitted, and urgent care is accessible with a low $10 copay. In addition to standard medical care, this plan provides valuable everyday benefits like routine dental, vision, and hearing care with no copay, including up to $200 annually for eyewear and up to $500 per ear for prescription hearing aids. Members also enjoy no copay for up to 26 one-way transportation trips to approved locations, as well as acupuncture, over-the-counter items, and chronic illness meal benefits with no copay. While some specialized services like durable medical equipment and dialysis require a 20% coinsurance, most diagnostic and routine services feature minimal or no copays.
Inpatient Hospital See details
Inpatient Hospital benefits under CareBreeze Platinum (HMO C-SNP) are covered with no coinsurance, requiring a $75 daily copay for days 1 through 5 and no copay for days 6 through 90 for both acute and psychiatric stays. This partially covered benefit includes unlimited additional acute days with no copay, but excludes upgrades, non-Medicare-covered stays, and additional psychiatric days.
Outpatient Services See details
CareBreeze Platinum (HMO C-SNP) covers outpatient services with no coinsurance, featuring a $0 to $50 copay for outpatient hospital services and a $10 copay for outpatient substance abuse sessions. There is no copay for ambulatory surgical center, observation, and outpatient blood services, though prior authorization and referrals are required.
Partial Hospitalization See details
CareBreeze Platinum (HMO C-SNP) covers partial hospitalization services with a $10.00 copay and no coinsurance. Prior authorization and a referral are required to access this benefit.
Ambulance and Transportation Services See details
CareBreeze Platinum (HMO C-SNP) offers ambulance and transportation services, though transportation is only partially covered since trips to any health-related location are not covered. Ground ambulance services require a $0 to $150 copay and no coinsurance, air ambulance services require a 20% coinsurance and no copay, and up to 26 one-way trips to plan-approved locations are covered with no copay or coinsurance.
Emergency Services See details
CareBreeze Platinum (HMO C-SNP) covers emergency services with a $150 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, while worldwide emergency, urgent, and transportation services feature no coinsurance and copays ranging from $10 to $150.
Primary Care See details
CareBreeze Platinum (HMO C-SNP) provides primary care and specialist services with no coinsurance, featuring no copay for primary care physician visits and a $10 copay for most specialist, therapy, and mental health services. Chiropractic services are partially covered with a $10 copay for up to 12 routine visits per year, though other chiropractic services are not covered.
Preventive Services See details
CareBreeze Platinum (HMO C-SNP) covers preventive services, including annual physical exams, kidney disease education, glaucoma screenings, and memory fitness, with no copays and no coinsurance. However, these benefits are only partially covered, and services such as health education, in-home safety assessments, medical nutrition therapy, weight management, and telemonitoring are not covered.
Hearing Services See details
CareBreeze Platinum (HMO C-SNP) covers hearing services, offering medicare-covered exams for a $10 copay and no coinsurance, alongside routine exams, fitting evaluations, and OTC hearing aids with no copay and no coinsurance. Prescription hearing aids are partially covered with no copay and no coinsurance up to $500 per ear annually, though inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Vision services are partially covered by CareBreeze Platinum (HMO C-SNP) with no deductibles, no coinsurance, and copays ranging from $0 to $10, requiring referrals and prior authorizations. Covered options include one annual routine eye exam and up to $200 yearly for contact lenses and eyeglasses with no copay, whereas other eye exams, individual eyeglass lenses, individual frames, and upgrades are not covered.
Dental Services See details
Dental services are partially covered by CareBreeze Platinum (HMO C-SNP), featuring a $10 copay and no coinsurance for Medicare-covered dental, and no copay or coinsurance for other covered preventive and comprehensive services. Fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by CareBreeze Platinum (HMO C-SNP) with no copay, though prior authorization and step therapy may apply. Associated Medicare Part B chemotherapy, radiation, and other drugs require no copay and carry no coinsurance to 20% coinsurance, while covered Part B insulin requires a $35 copay and up to 20% coinsurance.
Dialysis Services See details
CareBreeze Platinum (HMO C-SNP) covers dialysis services with no copay and a 20% coinsurance, though prior authorization and a referral are required.
Medical Equipment See details
CareBreeze Platinum (HMO C-SNP) covers durable medical equipment (DME) with a 20% coinsurance and no copay, subject to prior authorization and preferred vendor limitations. Prosthetics, medical supplies, and diabetic equipment are also covered with no copay and no coinsurance, though prior authorization is required and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by CareBreeze Platinum (HMO C-SNP) with prior authorization and referrals required. Diagnostic services feature no coinsurance, with no copay for lab services and a $0 to $100 copay for tests, while radiological services require no copay for X-rays and diagnostic radiology, and a minimum $10 copay and 20% coinsurance for therapeutic radiology.
Home Health Services See details
Home Health Services are covered under the CareBreeze Platinum (HMO C-SNP) plan with no copay and no coinsurance. Prior authorization and a referral are required to access these services.
Cardiac Rehabilitation Services See details
CareBreeze Platinum (HMO C-SNP) covers cardiac rehabilitation services with no coinsurance, but only some services are covered in practice. Standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered and carry a $10 copay.
Skilled Nursing Facility (SNF) See details
CareBreeze Platinum (HMO C-SNP) provides partially covered Skilled Nursing Facility (SNF) services with no coinsurance, requiring no copay for days 1 through 20 and a $150 daily copay for days 21 through 100. Prior authorization and referrals are required, and additional days beyond the standard 100-day Medicare benefit period are not covered.
Other Services See details
CareBreeze Platinum (HMO C-SNP) covers other services, including acupuncture, over-the-counter (OTC) items, and chronic illness meal benefits, all with no copay and no coinsurance. Prior authorization is required for the meal benefit and acupuncture, which is limited to 25 treatments per year.
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