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Florida Complete Care- In The Community (HMO-POS I-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Florida Complete Care- In The Community (HMO-POS 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- In The Community (HMO-POS I-SNP) in 2025, please refer to our full plan details page.
Florida Complete Care- In The Community (HMO-POS I-SNP) is a HMO-POS 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- In The Community (HMO-POS 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- In The Community (HMO-POS 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- In The Community (HMO-POS 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- In The Community (HMO-POS 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.
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 $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 combined Maximum Out-Of-Pocket cost of $3400.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $3400.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
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- In The Community (HMO-POS I-SNP) plan has a $590 deductible for prescription drugs. After the deductible is met, 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 pay nothing for covered drugs.
Additional Benefits
The Florida Complete Care- In The Community (HMO-POS I-SNP) plan offers a range of benefits with varying cost-sharing. Many services, including preventive care, home health services, and medical equipment, have no copay, but often come with a 20% coinsurance. The plan covers essential services like inpatient and outpatient care, primary care, and dental, with additional benefits such as over-the-counter items and meal benefits. However, it's important to note that certain services like routine vision and hearing exams, and many alternative therapies are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered, but the coinsurance information is available in the plan details. Additional days and non-Medicare-covered stays for both acute and psychiatric services are not covered.
Outpatient Services See details
Outpatient Services are covered, including outpatient hospital services and observation services, both with a 20% coinsurance; ambulatory surgical center (ASC) services and outpatient substance abuse services are also covered, with a minimum of 20% coinsurance and a maximum of 20% coinsurance. Outpatient blood services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered by the Florida Complete Care- In The Community (HMO-POS I-SNP) plan, 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- In The Community (HMO-POS I-SNP) plan. Ground and Air Ambulance Services have a 20% coinsurance, while Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Florida Complete Care- In The Community (HMO-POS I-SNP) plan. Emergency Services and Urgently Needed Services have a 20% coinsurance, while Worldwide Emergency Services are not covered.
Primary Care See details
The Florida Complete Care- In The Community (HMO-POS I-SNP) plan covers Primary Care Physician Services, Occupational Therapy Services, Physician Specialist Services, Physical Therapy and Speech-Language Pathology Services, and Opioid Treatment Program Services with a 20% coinsurance. Chiropractic Services, Mental Health Specialty Services, Podiatry Services, Psychiatric Services, and Additional Telehealth Benefits are also covered, but have additional coinsurance details. Routine Chiropractic Care is not covered.
Preventive Services See details
The Florida Complete Care- In The Community (HMO-POS I-SNP) plan covers several preventive services with no copay, but does not cover annual physical exams, health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, 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 benefits, enhanced disease management, telemonitoring services, remote access technologies, home and bathroom safety devices and modifications, or counseling services. The plan also covers glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a Welcome Visit with no copay.
Hearing Services See details
Hearing services are partially covered, with hearing exams covered at a coinsurance of at most 20%. Prescription hearing aids and OTC hearing aids are not covered, and the sub-services Routine Hearing Exams and Fitting/Evaluation for Hearing Aid are not covered.
Vision Services See details
Vision services are partially covered, with a 20% coinsurance for eye exams and contact lenses, though routine eye exams and eyewear such as contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are not covered. There is no deductible for these services.
Dental Services See details
Dental Services are covered, with a 20% coinsurance for Medicare Dental Services. Other Dental Services have a maximum plan benefit of $862.50 every three months, and specific services like fluoride treatment and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs are covered with coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Florida Complete Care- In The Community (HMO-POS I-SNP) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits are covered, including Durable Medical Equipment, Prosthetics/Medical Supplies, and Diabetic Equipment. Durable Medical Equipment has a 20% coinsurance and no copay, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Medical Supplies have a 20% coinsurance and no copay. Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance and no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including all diagnostic services, diagnostic procedures/tests, and lab services, as well as all radiological services. For diagnostic procedures/tests, lab services, diagnostic radiological services, therapeutic radiological services, and outpatient X-ray services, you pay at most 20% coinsurance. There is no copay for any of these services.
Home Health Services See details
Home Health Services are covered by the Florida Complete Care- In The Community (HMO-POS I-SNP) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover the sub-services of Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and 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, but additional days beyond Medicare-covered stays and non-Medicare-covered stays are not covered. Prior authorization is required for SNF services.
Other Services See details
The Florida Complete Care- In The Community (HMO-POS I-SNP) plan covers over-the-counter items with a maximum benefit of $40.00 every month, as well as meal benefits following surgery, inpatient hospitalization, or for a chronic illness. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, and several other services are not covered.
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