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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 2025, 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 out of 5 stars in 2025.
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 $166.00. 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 $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 CareBreeze Platinum (HMO C-SNP) plan has a $0 deductible for prescription drugs. In the initial coverage phase, you'll pay varying copays and coinsurance amounts depending on the drug tier and pharmacy type. For example, standard generic drugs have a $5 copay at a standard pharmacy and $16 at a standard mail pharmacy. After your total drug costs reach $2,000, you enter the catastrophic coverage phase, where you pay nothing for covered Part D drugs. However, you may still pay a share of the costs for excluded drugs covered under any enhanced benefit. This plan may also have a reduced premium if you qualify for the low-income subsidy (LIS).
Additional Benefits
The CareBreeze Platinum (HMO C-SNP) plan offers a wide range of benefits with varying costs. You'll find inpatient hospital stays with a $100 copay for the first seven days, and then no copay for the rest of your stay. Outpatient services and emergency services also have copays, ranging from $0 to $140 depending on the service. This plan provides coverage for primary care, preventive services, hearing, vision, and dental services, often with no copay or a low copay. It also includes coverage for ambulance, transportation, home health, and other services. Additionally, this plan offers coverage for prescription hearing aids up to $500 per year and OTC hearing aids up to $125 every three months, along with other valuable benefits.
Inpatient Hospital See details
Inpatient Hospital services, including acute and psychiatric, are covered. For acute inpatient hospital stays, you'll pay a $100 copay for days 1-7, and no copay for days 8-90. For inpatient psychiatric stays, you'll pay a $100 copay for days 1-7, and no copay for days 8-90. Additional days for inpatient hospital acute are covered with no copay. Non-Medicare-covered stays and upgrades for both acute and psychiatric inpatient hospital services are not covered.
Outpatient Services See details
Outpatient Services are covered, including outpatient hospital services with a copay between $0 and $100, 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 with a $10 copay, and requires prior authorization and a doctor referral.
Ambulance and Transportation Services See details
The CareBreeze Platinum (HMO C-SNP) plan covers ambulance and transportation services. Ground ambulance services have a copay of $0-$90, while air ambulance services have a 20% coinsurance; transportation services have no copay, with up to 26 one-way trips per year to plan-approved health-related locations.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the CareBreeze Platinum (HMO C-SNP) plan. Emergency Services and Worldwide Emergency Coverage have a $140 copay, Urgently Needed Services have a $10 copay, and Worldwide Urgent Coverage has a copay between $10 and $140.
Primary Care See details
CareBreeze Platinum (HMO C-SNP) covers primary care physician services with no copay, and chiropractic services with a $10 copay. This plan also covers occupational therapy services with a $10 copay, physician specialist services with a $10 copay, and physical therapy and speech-language pathology services with a $10 copay. The plan also covers mental health specialty services, podiatry services, other health care professional services, psychiatric services, additional telehealth benefits, and opioid treatment program services with copays ranging from $0 to $10, depending on the service.
Preventive Services See details
The CareBreeze Platinum (HMO C-SNP) plan covers preventive services, including an annual physical exam with no copay, and additional preventive services with varying copays. Kidney disease education services, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit are also covered with no copay. However, health education, in-home safety assessments, Personal Emergency Response Systems (PERS), Medical Nutrition Therapy (MNT), and other services are not covered.
Hearing Services See details
CareBreeze Platinum (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 $500 per year, and OTC hearing aids are covered up to $125 every three months. Prescription hearing aids - inner ear, outer ear, and over the ear are not covered.
Vision Services See details
Vision services are covered by the CareBreeze Platinum (HMO C-SNP) plan, with routine eye exams costing between $0 and $10, and eyewear also covered with no copay. Eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
CareBreeze Platinum (HMO C-SNP) covers Medicare Dental Services with a $10 copay, and Oral Exams, Dental X-Rays, Other Diagnostic Dental Services, Prophylaxis (Cleaning), Other Preventive Dental Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable), and Oral and Maxillofacial Surgery with no copay. Fluoride Treatment, Maxillofacial Prosthetics, Implant Services, Prosthodontics (fixed), and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the CareBreeze Platinum (HMO C-SNP) plan, but require prior authorization. Medicare Part B Insulin Drugs have a $35 copay and between 0% and 20% coinsurance, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have between 0% and 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by the CareBreeze Platinum (HMO C-SNP) plan, but require prior authorization and a doctor referral. You will pay 20% coinsurance for these services.
Medical Equipment See details
CareBreeze Platinum (HMO C-SNP) covers medical equipment, including Durable Medical Equipment (DME) with a 20% coinsurance and a $0 copay, and Prosthetics/Medical Supplies with no coinsurance and a copay for Medicare-covered devices and supplies. Diabetic Equipment is covered with a copay for Medicare-covered supplies and shoes/inserts.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests with a copay between $0 and $100, Lab Services with no copay, Diagnostic Radiological Services with a copay up to $100, Therapeutic Radiological Services with a copay up to $50 and a coinsurance of at least 20%, and Outpatient X-Ray Services with no copay. All services require prior authorization and a doctor's referral.
Home Health Services See details
Home Health Services are covered by the CareBreeze Platinum (HMO C-SNP) plan with no copay and no coinsurance. However, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the CareBreeze Platinum (HMO C-SNP) plan. Prior authorization and a doctor referral are required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the CareBreeze Platinum (HMO C-SNP) plan, but require prior authorization and a doctor's referral. There is no copay for days 1-20, and a $150 copay for days 21-100, with no coinsurance. Additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
The CareBreeze Platinum (HMO C-SNP) plan covers acupuncture with no copay, but requires prior authorization and is limited to 25 treatments per year. Over-the-counter (OTC) items are covered, including nicotine replacement therapy and naloxone, with a maximum benefit coverage amount of $125 every three months. The plan also covers a meal benefit for chronic illnesses with no copay, but requires prior authorization.
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