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Florida Complete Care-Duals VIP (HMO-POS D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Florida Complete Care-Duals VIP (HMO-POS D-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-Duals VIP (HMO-POS D-SNP) in 2026, please refer to our full plan details page.
Florida Complete Care-Duals VIP (HMO-POS D-SNP) is a HMO-POS D-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-Duals VIP (HMO-POS D-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-Duals VIP (HMO-POS D-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-Duals VIP (HMO-POS D-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-Duals VIP (HMO-POS D-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 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-Duals VIP (HMO-POS D-SNP) Medicare 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 share of the costs. Specific drug coverage tier details, including individual copayments and coinsurance rates, are not available for this plan. To determine how your personal prescriptions are covered and to estimate your potential out-of-pocket expenses, it is best to review the plan's comprehensive formulary.
Additional Benefits
The Florida Complete Care-Duals VIP (HMO-POS D-SNP) offers comprehensive medical coverage featuring no copays for inpatient hospital stays, primary care, home health, and skilled nursing facility services. For outpatient care, specialist visits, emergency services, and medical equipment, members will generally pay no copay and a 20% coinsurance. Medicare Part B insulin is available for a $35 copay with no coinsurance, while other Part B drugs require no copay and a 0% to 20% coinsurance. Additional benefits include routine dental care with no copay or coinsurance up to $1,165 every three months, alongside routine vision exams and contact lenses with a 20% coinsurance up to a $400 yearly limit. Members also benefit from unlimited round trips to plan-approved locations and a monthly over-the-counter allowance of up to $100 with no copays. Routine hearing exams, hearing aids, and post-hospitalization meals are also covered to further reduce out-of-pocket costs.
Inpatient Hospital See details
Inpatient hospital services are partially covered by Florida Complete Care-Duals VIP (HMO-POS D-SNP) with no copay or coinsurance for acute and psychiatric stays, though prior authorization is required. Additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered under Florida Complete Care-Duals VIP (HMO-POS D-SNP) with no copay and a 20% coinsurance. This coverage includes outpatient hospital, ambulatory surgical center, outpatient substance abuse, and outpatient blood services, most of which require prior authorization.
Partial Hospitalization See details
Florida Complete Care-Duals VIP (HMO-POS D-SNP) covers partial hospitalization services with no copay and a 20% coinsurance. Prior authorization may be required for these covered services.
Ambulance and Transportation Services See details
Florida Complete Care-Duals VIP (HMO-POS D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay. Transportation services are partially covered, offering unlimited round trips to plan-approved locations with no copay and no coinsurance, while transportation to any health-related location is not covered.
Emergency Services See details
Florida Complete Care-Duals VIP (HMO-POS D-SNP) partially covers emergency services, requiring a 20% coinsurance and no copay for emergency and urgent care, with the cost sharing waived if admitted to the hospital within three days. While worldwide emergency services are technically covered, some services are covered but worldwide emergency coverage, worldwide urgent coverage, and worldwide emergency transportation are not covered.
Primary Care See details
Florida Complete Care-Duals VIP (HMO-POS D-SNP) covers primary care physician services with no copay and no coinsurance, while specialist, therapy, mental health, and podiatry services require no copay and a 20% coinsurance. Additional telehealth benefits are offered with no copay and 0% to 20% coinsurance, though chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by Florida Complete Care-Duals VIP (HMO-POS D-SNP) with no copay and no coinsurance for Medicare-covered zero-dollar preventive services, kidney disease education, and select screenings. However, annual physical exams and additional preventive services, including fitness benefits, health education, and in-home safety assessments, are not covered.
Hearing Services See details
Florida Complete Care-Duals VIP (HMO-POS D-SNP) covers hearing exams with no copay and a 20% coinsurance for routine exams, up to a $1,000 annual maximum. Prescription hearing aids are partially covered with no copay and no coinsurance, though inner ear, outer ear, over the ear, and OTC hearing aids are not covered.
Vision Services See details
Vision services are covered by Florida Complete Care-Duals VIP (HMO-POS D-SNP) with no copays or deductibles, though a 20% coinsurance applies to routine eye exams and contact lenses up to a $400 yearly limit. This benefit is partially covered because other eye exam services and eyewear upgrades are not covered.
Dental Services See details
Dental services are partially covered by Florida Complete Care-Duals VIP (HMO-POS D-SNP), featuring no copay and a 20% coinsurance for Medicare-covered dental, and no copay or coinsurance for other covered services up to a maximum of $1,165 every three months. Fluoride treatments and orthodontics are not covered, and most covered preventive and comprehensive services require prior authorization.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by Florida Complete Care-Duals VIP (HMO-POS D-SNP) with no copay, though prior authorization is required. Under this benefit, Medicare Part B insulin drugs require a $35 copay and no coinsurance, while Medicare Part B chemotherapy, radiation, and other Part B drugs require no copay and a 0% to 20% coinsurance.
Dialysis Services See details
Florida Complete Care-Duals VIP (HMO-POS D-SNP) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization is required to receive these services.
Medical Equipment See details
Florida Complete Care-Duals VIP (HMO-POS D-SNP) covers durable medical equipment, prosthetics, medical supplies, and diabetic equipment with no copay and a 20% coinsurance. Prior authorization is required for these benefits, and durable medical equipment may be limited to preferred vendors.
Diagnostic and Radiological Services See details
Florida Complete Care-Duals VIP (HMO-POS D-SNP) covers diagnostic and radiological services with no copay and a 20% coinsurance for diagnostic procedures, lab services, radiological services, and X-rays. Prior authorization is required for all of these covered services.
Home Health Services See details
Florida Complete Care-Duals VIP (HMO-POS D-SNP) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Florida Complete Care-Duals VIP (HMO-POS D-SNP) with no copay, though some services are covered while standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) services are not covered and require a 20% coinsurance. Prior authorization and referrals are also required for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Florida Complete Care-Duals VIP (HMO-POS D-SNP) with no copay and no coinsurance, though prior authorization is required. The plan allows SNF admission without a prior three-day inpatient hospital stay, but it does not cover additional days beyond the standard Medicare-covered limit.
Other Services See details
Florida Complete Care-Duals VIP (HMO-POS D-SNP) offers partially covered other services, including over-the-counter (OTC) items and a meal benefit with no copay and no coinsurance, while acupuncture is not covered. The OTC benefit provides up to $100 monthly via reimbursement, and the meal benefit is available with prior authorization for chronic illness or post-hospitalization.
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