CarePlus Health Plans, a division of Humana, offers Medicare Advantage Plans in Florida. All CarePlus plans have high ratings and offer $0 premiums.
What you need to know about CarePlus Medicare Advantage.
CarePlus Medicare Advantage pros
CarePlus offers both advantages and disadvantages.
Pros
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Affordable plans: The majority of CarePlus’ Medicare Advantage plans come with a $0 premium.
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Member satisfaction: CarePlus’ parent company Humana ranks second among nine major providers in J.D. Power’s 2022 Medicare Benefit member satisfaction index.
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Prescription drug coverage: The majority of CarePlus Medicare Advantage plans offer prescription drug coverage.
Cons
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LimitedAvailability: CarePlus provides Medicare Advantage plans in Florida only.
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HMOs Only: CarePlus only offers HMO plans. These plans generally offer the least flexibility for patients seeking care.
Available Medicare Advantage plans
There are several CarePlus Medicare Advantage plans available. They vary in structure, cost and benefits. CarePlus provides Medicare Advantage prescription drug plans (MAPDs), as well as Medicare Advantage plans that do not include drug coverage.
Plans offer the following types of services:
HMOs, which are health maintenance organizations, require that you only use a certain network of hospitals and doctors. To see a specialist you may need to be referred by your primary physician. Out-of-network benefits can often be very limited.
SNPs are special needs plans that restrict membership to those with specific diseases and characteristics. The benefits, network, and drug formularies of CarePlus are tailored to meet the needs of members. CarePlus provides two types of SNPs.
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Chronical Condition SNP: This program is designed to help members with chronic conditions such as diabetes, heart disease, and congestive heart failure.
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Dual Eligible SNP: This is for people who are eligible to Medicare and also have the ability to receive assistance through a state Medicaid program.
Additional Benefits
CarePlus Medicare Advantage plans offer a range of benefits that aren’t available through Original Medicare. These are just a few examples. However, availability can vary by plan.
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Monthly allowance: Members might be eligible for an OTC allowance that they can use to purchase cough medicine, pain relief pills, and other OTC items.
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Card: Some members may be eligible to receive a preloaded card that can be used to pay for additional services such as vision, hearing, or dental care.
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SilverSneakers Members have access to gyms and live, prerecorded classes that are tailored for older adults.
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Meal delivery After an overnight stay at a skilled nursing facility or hospital, members may be eligible to have a set number of meals delivered to them.
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Wigs for chemotherapy: Members might be eligible to receive reimbursement for wig costs related to chemotherapy.
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Part-B premium giveback: Certain plans may include some money towards your Part B monthly premium.
Customer service
How CarePlus members can contact customer support:
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1-800-794-5907 (TTY 711) Call Member Services. Services are available from Oct. 1 through March 31 at 8 a.m. until 8 p.m., and Monday through Friday at 8 a.m. until 8 p.m.
CarePlus Medicare Advantage service area
CarePlus is a Medicare Advantage plan that only Florida residents can access.
Humana, CarePlus’ parent company is the second-largest provider in Medicare Advantage plans.
. CarePlus plans now cover more than 200,000 Medicare Advantage beneficiaries.
Medicare Advantage costs depend on the plan you choose, where you live and what your health needs are. The plan’s premium is an important cost to consider. The majority of CarePlus Medicare Advantage plans have an $0 premium
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All CarePlus Medicare Advantage plans other than those for special needs will have a $0 monthly premium in 2023. About 80% of CarePlus SNPs will have a $0 monthly premium. CarePlus SNPs have a monthly premium of between $14.70 to $18.10.
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You will still have to pay your Medicare Part B premium even if you are a Medicare Advantage user. It is $170.10 per monthly in 2022 ($164.90 annually in 2023), but some plans cover a portion or all of it. This is the standard amount that most people pay. However, if you earn more than this, you will pay more. )
Consider other out-of-pocket expenses:
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The plan will cover any portion of your Medicare Part B premium.
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Plan’s annual deductibles and other deductibles such as a drug or deductible.
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Each visit will have a copayment and/or coinsurance. You might pay a $10 copay to see your primary physician and $45 for specialist visits.
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Plan’s out-of network and in-network out of-pocket maximums.
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Find out if your providers are in-network and out-of-network. Also, find out how often you might need to be out of network.
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Determine if you need additional benefits and whether the plan will charge for them.
Use Medicare’s plan-finding service to get an idea of the costs. To compare plans across multiple insurance carriers, you can choose to view only CarePlus plans. Enter your ZIP code to shop online at CarePlus.
Medicare star ratings
Average star ranking, weighted according to enrollment: 4.0
The Centers for Medicare & Medicaid Services keeps star ratings for Medicare Advantage plans. These ratings are based on a 5-point scale that ranks plans from the best (5 stars) up to the worst (1 star). These ratings are based on the quality of care provided and customer satisfaction. Ratings may change year to year.
CarePlus’ 2023 Medicare Benefit plans receive an average rating of 4.0 stars based on the most recent data and weighted based upon enrollment.
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The average star rating of plans from all providers are 4.15
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Where was CarePlus outperforms?
The CMS rates contracts based on 40 plan elements to determine their overall star rating. The CMS Star Ratings Technical notes provides detailed information on each of these factors. These are the measures that CarePlus plans scored an average score of 4.5 out of 5 and higher:
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Screening for breast cancer.
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Colorectal cancer screening.
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Monitoring of physical activity.
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Review of medication for older adults.
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Pain assessment for older adults.
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Eye exam for diabetes.
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Monitoring of kidney disease and diabetes.
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Diabetes management — Blood sugar control.
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Controlling blood pressure
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Medication reconciliation post-discharge.
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Rating for health plans.
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Review appeals decisions.
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Health Plan: Call center — TTY and foreign language interpreter available.
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Drug plan: Call center — Foreign language interpreter and TTY available.
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Completed medication therapy management program for comprehensive medication review.
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Diabetes patients should not take statins.
Where was CarePlus at its worst?
CarePlus plans scored sub-3.0 in a few categories. These factors are described in the CMS Star Ratings Technical notes. )
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Annual flu vaccine.
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Care coordination.
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Health plan quality improvement.
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Quality improvement in drug plans.
Third-party ratings
We’ve included two companies here that weigh in on company strength or health plans.
AM Best Financial Strength Rating: A- (Excellent)
AM Best is an insurance-focused credit rating agency. AM Best confirmed its Financial Strength Rating A- (Excellent), for most of Humana Inc.’s health and dental insurance subsidiaries, including CarePlus Health Plans, in September 2022.
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A rating of A in this category means that AM Best believes Humana is able to fulfill its ongoing insurance obligations.
J.D. Power Ranking: 2nd Out of 9
It is available in its
2022 U.S. Medicare Advantage Study
J.D. J.D. Power measured satisfaction with Medicare Advantage plans using six factors: provider choice, coverage and benefits, cost, information and communication, billing and payment, and cost. CarePlus’ parent company, Humana scored 824 out of 1000 and was second among the top nine Medicare Advantage providers.
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Compare Medicare Advantage providers
Find out more about the top Medicare Advantage providers. These insurers offer plans across most states. The plans that you can choose will depend on where you live and what county it is.
CarePlus
CarePlus Health Plans was established in 1985 under the name Florida 1st Health Plans. In 2002, CarePlus Health Plans was renamed to CarePlus Health Plans. Its headquarters are located in Miami. Humana purchased CarePlus in 2005.
CarePlus provides Medicare Advantage plans that cover more than 200,000 Florida residents.
Search for the best Medicare Advantage plan
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How much do you know about the costs of the plan? What is the cost of the premium, deductibles, and copays? Are they affordable?
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Are you in-network with your doctor? Make sure that they are included in your plan’s network.
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What are your prescriptions? It’s important to know what the plan covers if you take medication. Which tier do you belong on for prescription drugs? Are there any specific coverage rules?
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Does the plan provide dental coverage? Do you have routine coverage for vision, hearing and dental needs?
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Is there anything extra? Do you have any additional benefits such as meal delivery or transportation benefits?