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CareBreeze (HMO C-SNP)

Benefits Summary and Overview

This page is a benefits summary and overview of key plan information for CareBreeze (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 (HMO C-SNP) in 2026, please refer to our full plan details page.

CareBreeze (HMO C-SNP) is a HMO C-SNP plan offered by Humana Inc. available for enrollment in 2026 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 CareBreeze (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 (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.

Overview IconKey Plan Facts

Below are a few key facts and commonly-asked questions about CareBreeze (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 (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:

Regular visits to your primary care doctor are covered and will have a copay of and coinsurance of 0% (no coinsurance).

Specialist Visits:

Visits to specialists are covered and will have a copay of and coinsurance of 0% (no coinsurance). Specialist visits may require a referral from your primary care doctor or prior authorization.

Emergency Room:

Trips to the Emergency Room are covered, and will have a copay of and coinsurance of 0% (no coinsurance). Coverage may vary for in-network and out-of-network hospitals.

Urgent Care:

Trips to Urgent Care arecovered and will have a copay of and coinsurance of 0% (no coinsurance). Coverage may vary for in-network and out-of-network hospitals.

Sign up for CareBreeze (HMO C-SNP)

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Drug Coverage IconDrug Coverage

The CareBreeze (HMO C-SNP) Medicare prescription drug plan features an annual drug deductible of $615. You can save on healthcare costs with no copay for Tier 1 preferred generics, Tier 2 generics, and Tier 6 select care drugs when utilizing standard pharmacies or preferred mail order options. For standard mail order delivery, Tier 1 drugs cost $2 to $6, while Tier 2 drugs range from $16 to $48. For Tier 3 preferred brand-name drugs, you will pay a $40 copay for a one-month supply at standard pharmacies and through preferred mail order. Higher-tier medications require coinsurance, with Tier 4 non-preferred drugs carrying a 50% coinsurance and Tier 5 specialty drugs requiring a 25% coinsurance. This plan structure provides clear options for managing your prescription costs through preferred and standard pharmacies.

Additional Benefits IconAdditional Benefits

The CareBreeze (HMO C-SNP) plan offers comprehensive medical coverage with highly affordable out-of-pocket costs, featuring no copay for primary care visits, home health services, and standard laboratory or diagnostic radiology tests. For hospital stays, members pay a $50 copay for days 1 through 5 of inpatient care and no copay for days 6 through 90, with no coinsurance required. Outpatient services and specialist visits are also highly accessible, requiring either no copay or a minimal $10 copay for most consultations and therapy sessions. This plan also includes valuable supplemental benefits such as no copay for routine dental, vision, and hearing exams, alongside a $200 annual allowance for eyewear and covered transportation for up to 26 one-way trips. While durable medical equipment and dialysis services require a 10% to 20% coinsurance, members pay no copay or coinsurance for routine diabetic supplies, annual physicals, and select over-the-counter items. Additionally, emergency care is covered with a $140 copay, which is waived if you are admitted to the hospital within 24 hours.

Inpatient Hospital See details

Inpatient hospital benefits under CareBreeze (HMO C-SNP) are partially covered with no coinsurance, requiring a $50 copay for days 1 to 5 and no copay for days 6 to 90 for both acute and psychiatric stays. While unlimited additional acute days are covered with no copay, additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.

Outpatient Services See details

CareBreeze (HMO C-SNP) covers outpatient services with no coinsurance, offering ambulatory surgical center, observation, and blood services with no copay. Outpatient hospital services have a copay of $0 to $50, while outpatient substance abuse sessions require a $10 copay, with prior authorization and referrals generally required.

Partial Hospitalization See details

Partial hospitalization is covered by CareBreeze (HMO C-SNP) with a $25 copay and no coinsurance. Prior authorization and a referral are required to receive these covered services.

Ambulance and Transportation Services See details

CareBreeze (HMO C-SNP) covers ambulance services with prior authorization, requiring 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 (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 require a $10 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no coinsurance and copays ranging from $10 to $140.

Primary Care See details

CareBreeze (HMO C-SNP) offers primary care physician services with no copay and no coinsurance, while specialist, therapy, mental health, psychiatric, and podiatry services 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, but other chiropractic services are not covered. Telehealth and other professional services range from a $0 to $10 copay with no coinsurance.

Preventive Services See details

CareBreeze (HMO C-SNP) preventive services are partially covered with no copay and no coinsurance for annual physical exams, kidney disease education, and memory fitness. However, sub-services including health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, and weight management programs are not covered.

Hearing Services See details

Hearing services covered by CareBreeze (HMO C-SNP) include Medicare-covered exams for a $10 copay and no coinsurance, as well as routine exams, fittings, and OTC hearing aids with no copay and no coinsurance. Prescription hearing aids are partially covered with no copay and no coinsurance up to a $250 annual maximum per ear, though inner ear, outer ear, and over the ear types are not covered.

Vision Services See details

Vision services are partially covered by CareBreeze (HMO C-SNP) with no deductibles and no coinsurance. Covered benefits include one annual routine eye exam with no copay (other eye exams have a $0 to $10 copay) and up to $200 yearly for contact lenses and eyeglasses with no copay, while other eye exam services, eyeglass lenses, eyeglass frames, and upgrades are not covered.

Dental Services See details

Dental services are partially covered by CareBreeze (HMO C-SNP), with Medicare-covered dental requiring a $10.00 copay and no coinsurance, while other covered dental services have no copay and no coinsurance. Fluoride treatment, maxillofacial prosthetics, implant services, fixed prosthodontics, and orthodontics are not covered under this plan.

Home Infusion bundled Services See details

CareBreeze (HMO C-SNP) covers home infusion bundled services with no copay, although prior authorization is required. Covered Medicare Part B drugs, including chemotherapy, radiation, and insulin, carry a coinsurance ranging from no coinsurance up to 20%, with insulin drugs also requiring a $35 copay.

Dialysis Services See details

CareBreeze (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

CareBreeze (HMO C-SNP) covers durable medical equipment (DME) with a 10% to 20% coinsurance and no copay, and prosthetics and medical supplies with a 20% coinsurance and no copay. Diabetic equipment is covered with no coinsurance, featuring no copay for diabetic supplies and a $10 copay for diabetic therapeutic shoes or inserts.

Diagnostic and Radiological Services See details

CareBreeze (HMO C-SNP) covers diagnostic and radiological services, which require prior authorization and referrals. Members pay no coinsurance and a copay of up to $150 for diagnostic procedures, no copay for lab services, diagnostic radiology, and outpatient X-rays, and a $35 copay along with 20% coinsurance for therapeutic radiological services.

Home Health Services See details

Home health services are covered under the CareBreeze (HMO C-SNP) plan with no copay and no coinsurance, though prior authorization and a referral are required.

Cardiac Rehabilitation Services See details

Cardiac Rehabilitation Services are covered by CareBreeze (HMO C-SNP) with no coinsurance, though some services are covered while standard Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and SET for PAD services are not covered and require a $10 copay. Prior authorization and referrals are required for these services.

Skilled Nursing Facility (SNF) See details

Skilled Nursing Facility (SNF) services are covered by CareBreeze (HMO C-SNP) with no coinsurance, featuring no copay for days 1 to 20 and a $150 copay for days 21 to 100. Prior authorization and referrals are required, and additional days beyond the standard Medicare-covered 100 days are not covered.

Other Services See details

Other services are partially covered by CareBreeze (HMO C-SNP) with no copay and no coinsurance for acupuncture (up to 25 treatments per year), chronic illness meal benefits, and select over-the-counter items. Prior authorization is required for acupuncture and meal benefits, while highly integrated dual-eligible services and other unspecified services are not covered.

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