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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 $176.00. 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 $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) prescription drug plan features an annual drug deductible of $615. Beneficiaries enjoy no copay for Tier 1 preferred generic and Tier 6 select care drugs at standard pharmacies and through preferred mail order. Tier 2 generic medications are also highly affordable, with standard pharmacy copays starting at $5 for a one-month supply and no copay for a three-month supply via preferred mail order. For Tier 3 preferred brand drugs, you will pay a $47 copay for a one-month supply, though a three-month preferred mail order supply reduces the cost to $94. Tier 4 non-preferred drugs require a 50% coinsurance, while Tier 5 specialty tier drugs carry a 25% coinsurance for a one-month supply.
Additional Benefits
The CareBreeze Platinum (HMO C-SNP) plan offers comprehensive healthcare coverage with predictable out-of-pocket costs, featuring no copay and no coinsurance for primary care visits, preventive services, and home health care. Specialist visits, urgent care, and outpatient services are highly affordable, requiring low copays and no coinsurance. For hospital stays, members pay no coinsurance, with a $50 daily copay for the first seven days of inpatient care and no copay for days eight through ninety. This plan also includes valuable supplemental benefits like routine dental, vision, and hearing care, most of which feature no copay and no coinsurance. Additionally, members benefit from no copay for up to 26 one-way transportation trips per year, alongside no copay or coinsurance for diabetic supplies and over-the-counter items. Durable medical equipment and dialysis services generally require a 20% coinsurance with no copay, ensuring essential medical needs remain highly accessible.
Inpatient Hospital See details
CareBreeze Platinum (HMO C-SNP) partially covers inpatient hospital services with no coinsurance, requiring a $50 daily copay for days 1 through 7 and no copay for days 8 through 90. Unlimited additional acute care days are covered at no copay, but upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
CareBreeze Platinum (HMO C-SNP) covers outpatient services with no coinsurance, requiring prior authorization and referrals for most care. Under this benefit, outpatient hospital services have a copay of $0 to $50, outpatient substance abuse sessions have a $10 copay, and ambulatory surgical, observation, and blood services have no copay.
Partial Hospitalization See details
Partial hospitalization is covered by CareBreeze Platinum (HMO C-SNP) with a $25.00 copay and no coinsurance. Prior authorization and a referral are required to receive these services.
Ambulance and Transportation Services See details
CareBreeze Platinum (HMO C-SNP) covers ambulance services with a $0 to $250 copay and coinsurance for ground transport, and a 20% coinsurance and copay for air transport. Transportation services are partially covered with no copay or coinsurance for up to 26 one-way trips per year to plan-approved locations, while transportation to any health-related location is not covered.
Emergency Services See details
CareBreeze Platinum (HMO C-SNP) covers emergency services with a $150 copay and no coinsurance, which is waived if admitted to the hospital within 24 hours, and urgently needed services with a $10 copay and no coinsurance. These costs do not apply to the plan deductible, and worldwide emergency, urgent, and transportation services are also covered with no coinsurance and copays ranging from $10 to $150.
Primary Care See details
CareBreeze Platinum (HMO C-SNP) covers primary care physician services with no copay and no coinsurance, while specialist visits, physical therapy, and mental health services require a $10 copay and no coinsurance. Chiropractic services are partially covered with a $15 copay and no coinsurance 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, and screenings for glaucoma and diabetes, with no copay and no coinsurance. Additional preventive services are partially covered with no copay and no coinsurance for memory fitness, but do not cover health education, in-home safety assessments, PERS, medical nutrition therapy, medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, remote access, home safety modifications, or counseling.
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 or coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to $1,750 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), offering no copay and no coinsurance for one routine eye exam per year and up to $300 annually for contact lenses and eyeglasses. Other eye exams, separate lenses or frames, and upgrades are not covered, and prior authorization and referrals are required.
Dental Services See details
CareBreeze Platinum (HMO C-SNP) offers partially covered dental services, featuring Medicare-covered dental care for a $10 copay and no coinsurance, and other preventive and comprehensive dental benefits with no copay and no coinsurance. Fluoride treatment, endodontics, maxillofacial prosthetics, implant services, and orthodontics are not covered by this plan.
Home Infusion bundled Services See details
CareBreeze Platinum (HMO C-SNP) covers home infusion bundled services with no copay, although prior authorization and step therapy are required. Covered Medicare Part B drugs, including chemotherapy and other infusion drugs, have no coinsurance to 20% coinsurance, while Medicare Part B insulin drugs require a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under CareBreeze Platinum (HMO C-SNP) with no copay and a 20% coinsurance. Prior authorization and a referral are required to access this benefit.
Medical Equipment See details
CareBreeze Platinum (HMO C-SNP) covers durable medical equipment (DME) with a 20% coinsurance and no copay, and prosthetic devices with no copay. Medical supplies carry a 20% coinsurance, while diabetic supplies have no copay or coinsurance, and diabetic therapeutic shoes or inserts require a $10 copay and no coinsurance.
Diagnostic and Radiological Services See details
CareBreeze Platinum (HMO C-SNP) covers diagnostic services with no coinsurance, offering no copay for lab services and a copay of up to $100 for diagnostic procedures. Radiological services are also covered, featuring no copay for outpatient X-rays, no minimum copay for diagnostic radiological services, and a minimum $10 copay and 20% coinsurance for therapeutic radiological services. Prior authorization and referrals are required for all diagnostic and radiological services.
Home Health Services See details
CareBreeze Platinum (HMO C-SNP) covers Home Health Services with no copay and no coinsurance. Both prior authorization and a referral are required to receive these covered services.
Cardiac Rehabilitation Services See details
CareBreeze Platinum (HMO C-SNP) covers some cardiac rehabilitation services with no coinsurance, but standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) rehabilitation services are not covered and require a $10 copay.
Skilled Nursing Facility (SNF) See details
CareBreeze Platinum (HMO C-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, featuring no copay for days 1 through 20 and a $160 daily copay for days 21 through 100. Prior authorization and referrals are required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
CareBreeze Platinum (HMO C-SNP) provides partial coverage for other services, offering acupuncture, over-the-counter items, and chronic illness meals with no copays and no coinsurance. Prior authorization is required for acupuncture, which is limited to 25 treatments per year, and the meal benefit, while other miscellaneous services are not covered.
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