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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) prescription drug plan features an annual drug deductible of $615. You will need to pay this deductible amount out-of-pocket before the plan begins to cover the costs of your prescription medications. This upfront cost is an important factor to consider when evaluating your overall healthcare budget. Specific drug coverage tier details, including individual copayments and coinsurance percentages, are not available for this plan. To determine your exact costs for specific prescriptions, it is recommended to consult the plan's formulary or contact the provider. Understanding these costs ensures you select the most cost-effective Medicare plan for your needs.
Additional Benefits
The Florida Complete Care-Duals VIP (HMO-POS D-SNP) plan offers comprehensive coverage with no copays for major medical services, including inpatient hospital stays, skilled nursing facility care, home health, and primary care visits. Many outpatient services, specialist visits, emergency care, and diagnostic tests also feature no copay, though they do require a 20% coinsurance. Additionally, members can access unlimited round-trip transportation to plan-approved health locations with no copay and no coinsurance. For supplemental care, the plan provides dental, vision, and hearing benefits with no copays, though some routine services require a 20% coinsurance up to specific limits. Covered insulin is available with a $35 copay and no coinsurance, while Medicare Part B drugs carry a 0% to 20% coinsurance. Members also benefit from no copays or coinsurance on over-the-counter items up to $75 monthly and post-surgery meal benefits.
Inpatient Hospital See details
Florida Complete Care-Duals VIP (HMO-POS D-SNP) covers inpatient acute and psychiatric hospital services with no copay and no coinsurance, although prior authorization is required. This benefit is partially covered as additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Florida Complete Care-Duals VIP (HMO-POS D-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 services, and there is no deductible for outpatient blood services.
Partial Hospitalization See details
Partial hospitalization is covered by Florida Complete Care-Duals VIP (HMO-POS D-SNP) with no copay and a 20% coinsurance. Prior authorization is required to receive these 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, subject to prior authorization. Transportation services are partially covered, offering unlimited round trips to plan-approved health-related locations with no copay and no coinsurance, while transportation to any health-related location is not covered.
Emergency Services See details
Emergency services and urgently needed services are covered by Florida Complete Care-Duals VIP (HMO-POS D-SNP) with a 20% coinsurance and no copay, which is waived if you are admitted to the hospital within three days. For worldwide emergency services, some services are covered, but worldwide emergency coverage, urgent coverage, and emergency transportation are not covered.
Primary Care See details
Florida Complete Care-Duals VIP (HMO-POS D-SNP) provides primary care physician services with no copay and no coinsurance, while specialist, therapy, podiatry, and mental health services feature no copay and 20% coinsurance. While some chiropractic services are covered, routine chiropractic care and other chiropractic services are not covered.
Preventive Services See details
Preventive services are covered by Florida Complete Care-Duals VIP (HMO-POS D-SNP) with no copay and no coinsurance for Medicare-covered zero-dollar services, kidney disease education, and screenings like glaucoma and diabetes self-management training. This benefit is partially covered, as the annual physical exam and additional services—such as 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 and fitting evaluations with no deductible and no copay, though routine exams require a 20% coinsurance up to a $1,000 annual limit. Prescription hearing aids are partially covered with no copay or coinsurance, but inner ear, outer ear, over-the-ear, and OTC hearing aids are not covered.
Vision Services See details
Florida Complete Care-Duals VIP (HMO-POS D-SNP) provides partially covered vision services with no copays, featuring a 20% coinsurance for routine eye exams and contact lenses, and no coinsurance for eyeglasses up to a $400 annual limit. While routine eye exams (one every six months) and eyewear are covered, other eye exam services and eyewear upgrades are not covered.
Dental Services See details
Florida Complete Care-Duals VIP (HMO-POS D-SNP) partially covers dental services, offering Medicare-covered dental care with no copay and 20% coinsurance, and other dental services with no copay, no coinsurance, up to a $1,095 maximum benefit every three months. Under this plan, fluoride treatments and orthodontics are not covered.
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 and no coinsurance, though prior authorization is required. Medicare Part B chemotherapy, radiation, and other Part B drugs carry no copay and a 0% to 20% coinsurance, while covered insulin has a $35 copay and no coinsurance.
Dialysis Services See details
Dialysis services are covered by Florida Complete Care-Duals VIP (HMO-POS D-SNP) with no copay and a 20% coinsurance. Prior authorization is required for this benefit.
Medical Equipment See details
Florida Complete Care-Duals VIP (HMO-POS D-SNP) covers medical equipment, including durable medical equipment, prosthetics, and diabetic supplies, with no copay and 20% coinsurance. Prior authorization is required for these benefits, and durable medical equipment is subject to preferred vendor limitations.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Florida Complete Care-Duals VIP (HMO-POS D-SNP) with no copay and a 20% coinsurance, though prior authorization is required. This benefit includes outpatient diagnostic procedures, lab services, diagnostic and therapeutic radiological services, and X-rays.
Home Health Services See details
Home Health Services are covered by Florida Complete Care-Duals VIP (HMO-POS D-SNP) with no copay and no coinsurance. Prior authorization is required to receive these services.
Cardiac Rehabilitation Services See details
Florida Complete Care-Duals VIP (HMO-POS D-SNP) covers some cardiac rehabilitation services with no copay, though prior authorization and a referral are required. However, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Florida Complete Care-Duals VIP (HMO-POS D-SNP) covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance, although prior authorization is required. This benefit is partially covered because additional days beyond Medicare-covered limits are not covered, though admission is allowed without a prior three-day inpatient hospital stay.
Other Services See details
Florida Complete Care-Duals VIP (HMO-POS D-SNP) provides partially covered other services, offering over-the-counter items (up to $75 monthly) and post-surgery or chronic illness meal benefits with no copay and no coinsurance. Acupuncture, nicotine replacement therapy, and highly integrated services are not covered, and the meal benefit requires prior authorization.
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