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Florida Complete Care (HMO I-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Florida Complete Care (HMO I-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Florida Complete Care (HMO I-SNP) in 2026, please refer to our full plan details page.
Florida Complete Care (HMO I-SNP) is a HMO I-SNP plan offered by Independent Living Systems, LLC available for enrollment in 2025 to people living in Northern, Central and Southern Florida. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that Florida Complete Care (HMO I-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Florida Complete Care (HMO I-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 Florida Complete Care (HMO I-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 Florida Complete Care (HMO I-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $4.80. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your 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 $3400.00 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 Florida Complete Care (HMO I-SNP) Medicare Advantage plan features an annual prescription drug deductible of $615. This deductible is the amount you must pay out-of-pocket for your covered medications before the plan begins to cover its portion of the costs. Specific drug tier coverage details, including individual copays and coinsurance rates for generic or brand-name medications, are not available for this plan. To determine your exact prescription costs under the Florida Complete Care (HMO I-SNP) plan, it is best to consult the plan's formulary or contact the provider.
Additional Benefits
The Florida Complete Care (HMO I-SNP) plan offers comprehensive coverage for essential medical services, frequently featuring no copay alongside a standard 20% coinsurance. Beneficiaries will pay no copay and no coinsurance for primary care visits, home health services, and skilled nursing facility stays. For inpatient hospital stays, outpatient services, specialist visits, and emergency care, the plan generally charges no copay but requires a 20% coinsurance. When it comes to supplemental benefits, the plan provides robust dental coverage with no copay and no coinsurance up to $912.50 every three months, alongside a $305 quarterly allowance for over-the-counter items. However, routine vision services and hearing aids are not covered, though basic hearing exams are available with no copay or coinsurance. Diagnostic tests, medical equipment, and dialysis services are also covered with no copay and a 20% coinsurance.
Inpatient Hospital See details
Florida Complete Care (HMO I-SNP) covers acute and psychiatric inpatient hospital stays with no copay, though prior authorization is required and Medicare-defined cost sharing applies. This benefit is partially covered, as additional days, non-Medicare-covered stays, and upgrades are not covered.
Outpatient Services See details
Florida Complete Care (HMO I-SNP) covers outpatient services, including outpatient hospital, ambulatory surgical center, substance abuse, and blood services, with no copay and a 20% coinsurance. Prior authorization is required for most of these covered services, and there is no deductible.
Partial Hospitalization See details
Partial hospitalization services are covered under the Florida Complete Care (HMO I-SNP) plan with no copay and a 20% coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Florida Complete Care (HMO I-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, subject to prior authorization. Transportation services are not covered under this plan.
Emergency Services See details
Florida Complete Care (HMO I-SNP) covers emergency services with a 20% coinsurance up to $120 per visit and no copay, and urgently needed services with a 20% coinsurance up to $65 per visit and no copay. Cost sharing is waived if you are admitted to the hospital within three days and does not count toward the plan deductible, but worldwide emergency, urgent, and transportation services are not covered.
Primary Care See details
Florida Complete Care (HMO I-SNP) provides primary care physician services with no copay and no coinsurance, and telehealth benefits with no copay and 0% to 20% coinsurance. Specialist visits, therapy services, mental health sessions, podiatry, and opioid treatment are covered with no copay and 20% coinsurance, while chiropractic services are not covered.
Preventive Services See details
Florida Complete Care (HMO I-SNP) partially covers preventive services, offering Medicare-covered preventive services, kidney disease education, and select screenings with no copay and no coinsurance. However, annual physical exams and all additional preventive services, including fitness benefits, health education, and in-home safety assessments, are not covered.
Hearing Services See details
Florida Complete Care (HMO I-SNP) covers hearing exams with no copay, no coinsurance, and no deductible, though routine hearing exams and fitting evaluations are not covered. For prescription hearing aids, some services are covered, but all types—including inner ear, outer ear, and over-the-ear options—as well as over-the-counter hearing aids, are not covered.
Vision Services See details
Florida Complete Care (HMO I-SNP) does not cover vision services in practice, as routine eye exams, contact lenses, and eyeglasses are all excluded from coverage. Although the plan technically lists no copay and 20% coinsurance with no deductible for these categories, no actual vision benefits are covered.
Dental Services See details
Florida Complete Care (HMO I-SNP) partially covers dental services, offering Medicare-covered dental with no copay and 20% coinsurance, and other preventive and comprehensive dental services with no copay and no coinsurance up to a maximum limit of $912.50 every three months. While exams, cleanings, and orthodontic services are covered, fluoride treatments are not covered.
Home Infusion bundled Services See details
Florida Complete Care (HMO I-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs carry a 0% to 20% coinsurance, while Medicare Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Florida Complete Care (HMO I-SNP) covers dialysis services with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Florida Complete Care (HMO I-SNP) covers medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic equipment, with no copay and a 20% coinsurance. Prior authorization is required for these covered benefits, and durable medical equipment may be subject to preferred vendor limitations.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Florida Complete Care (HMO I-SNP) with prior authorization required. There is no copay for these services, but a 20% coinsurance applies to all diagnostic procedures, lab services, diagnostic and therapeutic radiological services, and outpatient X-rays.
Home Health Services See details
Home Health Services are covered by Florida Complete Care (HMO I-SNP) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Florida Complete Care (HMO I-SNP) covers some cardiac rehabilitation services with no copay, though prior authorization and referrals are required. Standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Florida Complete Care (HMO I-SNP) with no copay and no coinsurance, and a prior three-day inpatient hospital stay is not required for admission. Additional days beyond the standard Medicare-covered days are not covered.
Other Services See details
Other services are partially covered by Florida Complete Care (HMO I-SNP), which offers no copay and no coinsurance for over-the-counter (OTC) items and post-hospitalization meals, though acupuncture is not covered. This benefit includes a $305 quarterly OTC catalogue allowance and post-surgery meals, which require prior authorization.
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