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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. This deductible is the amount you must pay out-of-pocket for your medications before the plan's coverage begins to pay. Specific drug coverage tier details, including copays and coinsurance for different tiers, are not available for this plan. You should verify your specific medication list against the plan's formulary to determine your actual out-of-pocket costs under this deductible.
Additional Benefits
The Florida Complete Care-Duals VIP (HMO-POS D-SNP) plan offers comprehensive medical coverage with many essential services featuring no copay. You will pay no copay and no coinsurance for inpatient hospital stays, primary care doctor visits, home health services, and skilled nursing facility care. However, outpatient services, specialist visits, emergency care, and durable medical equipment generally require a 20% coinsurance with no copay. This plan also provides valuable supplemental benefits to support your daily health and wellness. You can access dental coverage up to $1,025 every three months with no copay, alongside vision and hearing benefits that feature no copay and a 20% coinsurance for routine services. Additionally, members can take advantage of a monthly $75 over-the-counter allowance and unlimited transportation to plan-approved health locations with no copay or coinsurance.
Inpatient Hospital See details
Inpatient hospital care is partially covered by Florida Complete Care-Duals VIP (HMO-POS D-SNP) with no copay and no coinsurance, although prior authorization is required. While acute and psychiatric stays are covered, additional hospital 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 hospital, ambulatory surgical center, substance abuse, and blood services, with no copay and a 20% coinsurance. Prior authorization is required for most of these covered outpatient services, and there is no deductible for outpatient blood services.
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 depending on the specific services received.
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, while transportation services are partially covered. Covered transportation includes unlimited round trips to plan-approved health-related locations with no copay or coinsurance, but transportation to any health-related location is not covered.
Emergency Services See details
Florida Complete Care-Duals VIP (HMO-POS D-SNP) covers emergency and urgently needed services with a 20% coinsurance and no copay, with the coinsurance waived if you are admitted to the hospital within three days. Worldwide emergency, urgent care, and emergency transportation services 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 telehealth benefits feature no copay and 0% to 20% coinsurance. Specialist visits, mental health, psychiatry, therapies, podiatry, and opioid treatment services are covered with no copay and 20% coinsurance, though chiropractic services are not covered.
Preventive Services See details
Florida Complete Care-Duals VIP (HMO-POS D-SNP) partially covers preventive services, offering Medicare-covered preventive care, kidney disease education, and screenings with no copay and no coinsurance. However, annual physical exams and additional preventive 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 evaluations with 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 and no coinsurance, as inner ear, outer ear, and over-the-ear types are not covered, and over-the-counter (OTC) hearing aids are also excluded.
Vision Services See details
Vision Services are partially covered by Florida Complete Care-Duals VIP (HMO-POS D-SNP) with no copay and a 20% coinsurance for routine exams and contact lenses, up to a $400 yearly limit. Covered benefits include routine eye exams, eyeglasses, and contact lenses, while other eye exam services and eyewear upgrades are not covered.
Dental Services See details
Florida Complete Care-Duals VIP (HMO-POS D-SNP) covers Medicare dental services with no copay and 20% coinsurance, and other dental services with no copay and no coinsurance up to a maximum of $1,025 every three months. Dental services are partially covered under this plan, as fluoride treatments and orthodontics are not covered.
Home Infusion bundled Services See details
Florida Complete Care-Duals VIP (HMO-POS D-SNP) covers Home Infusion bundled Services with no copay, although prior authorization is required. Under this plan, Medicare Part B insulin is covered with a $35 copay and no coinsurance, while Medicare Part B chemotherapy, radiation, and other drugs have a coinsurance ranging from 0% to 20%.
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 this coverage.
Medical Equipment See details
Florida Complete Care-Duals VIP (HMO-POS D-SNP) covers medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic equipment, with no copay and a 20% coinsurance. Prior authorization is required for these benefits, and preferred vendor limitations may apply to durable medical equipment.
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% minimum coinsurance, subject to prior authorization. This coverage includes outpatient diagnostic procedures, lab services, diagnostic and therapeutic radiological services, and outpatient 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, although prior authorization is required.
Cardiac Rehabilitation Services See details
Florida Complete Care-Duals VIP (HMO-POS D-SNP) offers Cardiac Rehabilitation Services with no copay, but only some services are covered in practice. Standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Florida Complete Care-Duals VIP (HMO-POS D-SNP) partially covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance, though prior authorization is required. Admission does not require a prior three-day inpatient hospital stay, but additional days beyond standard Medicare-covered days are not covered.
Other Services See details
Florida Complete Care-Duals VIP (HMO-POS D-SNP) partially covers other services, which include a monthly $75 over-the-counter allowance and post-hospitalization or chronic illness meals with no copay and no coinsurance. Acupuncture and certain other supplemental services are not covered under this plan.
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