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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 2025, 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 4 out of 5 stars in 2025.
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 $20.30. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.20. 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 $590.00 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) plan has a prescription drug deductible of $590. After you meet the deductible, you will pay the costs for drugs in each tier until your total drug costs reach $2000. If you qualify for the low-income subsidy (LIS), your Part D premium will be $20.30. Once your yearly out-of-pocket drug costs reach $2000, you will pay nothing for your Part D covered drugs.
Additional Benefits
The Florida Complete Care (HMO I-SNP) plan offers a variety of benefits beyond Original Medicare. This plan includes coverage for inpatient and outpatient services, with a 20% coinsurance for many services. Primary care physician visits have no copay, and the plan also covers services such as dental, vision, and hearing, with varying cost-sharing requirements. This plan provides coverage for ambulance, emergency, and home health services, with specific cost-sharing structures. It also offers benefits like home infusion, dialysis, and medical equipment, all with a 20% coinsurance. However, certain services like cardiac rehabilitation and some preventive services are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered, but additional days, non-Medicare-covered stays, and upgrades for both are not covered. The coinsurance for covered services follows Original Medicare guidelines.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services and observation services with a 20% coinsurance, as well as ambulatory surgical center services and outpatient substance abuse services with a 20% coinsurance. Outpatient blood services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization. You will pay 20% coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the Florida Complete Care (HMO I-SNP) plan. Both ground and air ambulance services have a 20% coinsurance, and there is no copay. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, including urgently needed services, are covered by the Florida Complete Care (HMO I-SNP) plan, with a 20% coinsurance and no copay; however, worldwide emergency services, worldwide urgent coverage, and worldwide emergency transportation are not covered. If admitted to the hospital, the coinsurance for emergency services and urgently needed services is waived if the admission occurs within 3 days.
Primary Care See details
Primary Care benefits include coverage for Primary Care Physician Services with no copay and no coinsurance, Chiropractic Services with 20% coinsurance, Occupational Therapy Services with 20% coinsurance, Physician Specialist Services with 20% coinsurance, Mental Health Specialty Services with 20% coinsurance, Podiatry Services with 20% coinsurance, Other Health Care Professional with 20% coinsurance, Psychiatric Services with 20% coinsurance, Physical Therapy and Speech-Language Pathology Services with 20% coinsurance, Additional Telehealth Benefits with 0% - 20% coinsurance, and Opioid Treatment Program Services with 20% coinsurance. Routine Chiropractic Care is not covered.
Preventive Services See details
Preventive Services are covered, though the plan does not cover annual physical exams, health education, in-home safety assessments, Personal Emergency Response Systems (PERS), Medical Nutrition Therapy (MNT), post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, fitness benefit, enhanced disease management, telemonitoring services, remote access technologies, home and bathroom safety devices and modifications, or counseling services. Glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a welcome visit are covered.
Hearing Services See details
Hearing Services are partially covered by the Florida Complete Care (HMO I-SNP) plan. While hearing exams are covered with a coinsurance of at most 20%, routine hearing exams and fitting/evaluation for hearing aids are not covered, and prescription and OTC hearing aids are also not covered.
Vision Services See details
Vision services are covered, but routine eye exams, contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are not covered. Eye exams and eyewear have a 20% coinsurance, with no deductible.
Dental Services See details
The Florida Complete Care (HMO I-SNP) plan covers dental services with a 20% coinsurance for Medicare Dental Services. Other dental services have a maximum benefit of $912.50 every three months, while Oral Exams are limited to one visit every six months, Dental X-Rays are limited to one per year, and Prophylaxis (Cleaning) is limited to one every six months. Fluoride Treatment is not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay, and other Medicare Part B drugs with a coinsurance between 0% and 20%. Prior authorization is required.
Dialysis Services See details
Dialysis Services are covered by the Florida Complete Care (HMO I-SNP) plan. You will pay 20% coinsurance for these services, and prior authorization is required.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment, is covered under the Florida Complete Care (HMO I-SNP) plan. DME has a 20% coinsurance, while Prosthetic Devices and Medical Supplies also have a 20% coinsurance. Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, and may require prior authorization. There is no copay for diagnostic services or radiological services. For diagnostic procedures, tests, and lab services, you pay a coinsurance of at most 20%. For diagnostic and therapeutic radiological services, and outpatient X-ray services, you pay a coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered by the Florida Complete Care (HMO I-SNP) plan with no copay and no coinsurance, but authorization is required. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Florida Complete Care (HMO I-SNP) plan. Prior authorization and a doctor's referral are required for this service.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but additional days beyond Medicare-covered stays and non-Medicare-covered stays are not covered. This plan does not provide SNF services as a supplemental benefit under Part C.
Other Services See details
Other Services includes Over-the-Counter (OTC) Items and Meal Benefit, but acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered. Over-the-counter items are covered with a maximum benefit of $350 every three months. Meal benefits are covered and require prior authorization.
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