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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 $170.00. 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 CareBreeze Platinum (HMO C-SNP) plan has a $0 deductible for prescription drugs. In the initial coverage phase, you'll pay different copays or coinsurance amounts depending on the drug tier and pharmacy. For example, standard generic drugs have a $47 copay, while preferred brand drugs have 50% coinsurance. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase, where you pay nothing for Part D-covered drugs. This plan may offer a premium reduction if you qualify for the low-income subsidy.
Additional Benefits
The CareBreeze Platinum (HMO C-SNP) plan offers a wide range of benefits with varying costs. This plan includes no copay for primary care, preventive services, home health, and many outpatient services. You can also expect a $10 copay for specialist visits, mental health, and other services. This plan also provides coverage for inpatient hospital stays, emergency services, and transportation, with copays and coinsurance depending on the specific service. Vision, hearing, and dental services are included, with no copays for many services, but with some limitations on specific types of care.
Inpatient Hospital See details
Inpatient Hospital benefits with CareBreeze Platinum (HMO C-SNP) include coverage for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services. For the first 7 days, there is a $50 copay, and days 8-90 have no copay. Additional days for Inpatient Hospital-Acute have no copay. However, non-Medicare-covered stays and upgrades for both Inpatient Hospital-Acute and Inpatient Hospital Psychiatric are not covered, as are additional days for Inpatient Hospital Psychiatric.
Outpatient Services See details
The CareBreeze 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 individual and group sessions; and outpatient blood services with no copay. Prior authorization and a doctor referral are required for these services.
Partial Hospitalization See details
Partial Hospitalization is covered under the CareBreeze Platinum (HMO C-SNP) plan, with a $10 copay. Prior authorization and a doctor referral are required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the CareBreeze Platinum (HMO C-SNP) plan. Ground ambulance services have a copay of $0-$200, while air ambulance services have a 20% coinsurance. Transportation Services to a plan-approved health-related location are covered for up to 26 one-way trips per year with no copay, but transportation to any health-related location is not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the CareBreeze Platinum (HMO C-SNP) plan. Emergency Services have a $120 copay, and Urgently Needed Services have a $10 copay, and Worldwide Emergency Coverage and Worldwide Emergency Transportation have a $120 copay, while Worldwide Urgent Coverage has a copay between $10 and $120.
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, physician specialist services, mental health specialty services, podiatry services, other health care professional services, psychiatric services, physical therapy, speech-language pathology services, additional telehealth benefits, and opioid treatment program services, each with a $10 copay.
Preventive Services See details
The CareBreeze Platinum (HMO C-SNP) plan covers preventive services, including an annual physical exam with no copay. Additional preventive services are covered, but specific services like health education, in-home safety assessment, and others are not covered. Other preventive services, such as glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following Welcome Visit, are covered with no copay.
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 have a maximum benefit of $1500 per year, and OTC hearing aids are covered up to $50 per month. Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, and Prescription Hearing Aids - Over the Ear are not covered.
Vision Services See details
Vision services are covered, including eye exams and eyewear. Eye exams have a copay of $0 - $10, and eyewear has 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
CareBreeze Platinum (HMO C-SNP) covers dental services, including Medicare dental services with a $10 copay. Other dental services include oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), and other preventive dental services with 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 under the CareBreeze Platinum (HMO C-SNP) plan, with a $35 copay for Medicare Part B Insulin Drugs and coinsurance between 0% and 20% for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs. Prior authorization is required for this benefit.
Dialysis Services See details
Dialysis Services are covered by the CareBreeze Platinum (HMO C-SNP) plan, but require prior authorization and a doctor's referral. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME) with 20% coinsurance and Prosthetic Devices with no copay. Medical Supplies have a 20% coinsurance and Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts have no copay. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures/tests with a copay of up to $100, lab services with no copay, and outpatient X-ray services with no copay. Therapeutic Radiological Services have a coinsurance of at least 20% and a copay of at most $50, while diagnostic radiological services have a copay of at most $50.
Home Health Services See details
Home Health Services are covered by the CareBreeze 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 the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization and a doctor's referral are required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the CareBreeze Platinum (HMO C-SNP) plan, requiring prior authorization and a doctor's referral. There is no copay for days 1-20, and a $150 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
CareBreeze Platinum (HMO C-SNP) covers acupuncture with no copay, as well as over-the-counter items with a $50 monthly benefit. The plan also covers a meal benefit with no copay. However, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), and many other services are not covered.
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