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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 2025, 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 4 out of 5 stars in 2025.
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 $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-Duals VIP (HMO-POS D-SNP) plan has a $590 deductible for prescription drugs. After 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, you will pay $20.30 per month for Part D. Once your yearly out-of-pocket drug costs reach $2000, you will pay nothing for covered drugs.
Additional Benefits
The Florida Complete Care-Duals VIP (HMO-POS D-SNP) plan offers a variety of benefits with a focus on outpatient services. Many services such as primary care physician services, emergency services, and home health services have no copay. However, most services like outpatient services, hearing, vision, and dental services have a 20% coinsurance. This plan also includes additional benefits such as coverage for hearing aids, with a maximum plan benefit of $1000 per year, and dental services, with a maximum benefit of $1025 every three months. The plan covers home infusion services, with a $35 copay for Medicare Part B Insulin Drugs and a 20% coinsurance for other Part B drugs. Additionally, the plan covers medical equipment, dialysis services, and diagnostic services.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered. However, additional days, non-Medicare-covered stays, and upgrades for both acute and psychiatric care are not covered.
Outpatient Services See details
Outpatient Services are covered, including outpatient hospital services and observation services with a 20% coinsurance, and outpatient substance abuse services with a 20% coinsurance for individual and group sessions. Ambulatory Surgical Center (ASC) Services have a coinsurance between 20% and 20%, while outpatient blood services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered by the Florida Complete Care-Duals VIP (HMO-POS D-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, with no copay for ambulance services. Ground and air ambulance services have a 20% coinsurance. Transportation Services to a plan-approved health-related location are covered, while transportation to any other health-related location is not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Florida Complete Care-Duals VIP (HMO-POS D-SNP) plan. Emergency Services and Urgently Needed Services have a 20% coinsurance, with no copay; Worldwide Emergency Services, including Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, are not covered.
Primary Care See details
The Florida Complete Care-Duals VIP (HMO-POS D-SNP) plan covers primary care physician services with no copay and no coinsurance, and also covers chiropractic services with 20% coinsurance. This plan also covers occupational therapy services with 20% coinsurance, physician specialist services with 20% coinsurance, and mental health specialty services with 20% coinsurance for individual and group sessions. Additionally, podiatry services, other health care professional services, psychiatric services, physical therapy, speech-language pathology services, opioid treatment program services, and additional telehealth benefits are covered with 20% coinsurance.
Preventive Services See details
Preventive services are covered, but 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, and counseling services are not covered. Other covered services include glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a welcome visit.
Hearing Services See details
Hearing services include routine hearing exams with a coinsurance of at most 20% and a maximum plan benefit of $1000 per year, as well as fitting/evaluation for hearing aids with a limit of 1 visit every six months. Prescription hearing aids (all types) are covered, while inner ear, outer ear, and over-the-ear hearing aids, as well as OTC hearing aids, are not covered.
Vision Services See details
Vision services include routine eye exams and eyewear. Eye exams have a 20% coinsurance, and eyewear, including contact lenses, also has a 20% coinsurance. Upgrades are not covered.
Dental Services See details
Dental services are covered, with a 20% coinsurance for Medicare dental services. Other dental services have a maximum benefit of $1025.00 every three months.
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 have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Florida Complete Care-Duals VIP (HMO-POS D-SNP) plan and require prior authorization. The coinsurance for these services is 20%.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME) with a 20% coinsurance and Prosthetics/Medical Supplies, as well as Diabetic Equipment with 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, with no copay. Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services have a coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered by the Florida Complete Care-Duals VIP (HMO-POS D-SNP) plan with no copay and no coinsurance, but Additional Hours of Care and Personal Care Services are not covered. Prior authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Florida Complete Care-Duals VIP (HMO-POS D-SNP) plan. The plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but additional days beyond Medicare and non-Medicare stays for SNF are not covered. Prior authorization is required.
Other Services See details
The Florida Complete Care-Duals VIP (HMO-POS D-SNP) plan's Other Services benefit covers over-the-counter items with a maximum benefit of $85.00 every month, and a meal benefit that requires prior authorization. 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.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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