edited by 
CarePlus, a private health insurance company, specializes in offering Medicare Advantage plans specifically tailored for residents in select areas of Florida. These plans serve as an alternative to Original Medicare (Parts A and B), providing comprehensive coverage through a private insurer.
Notably, CarePlus Medicare Advantage plans extend beyond basic medical benefits to potentially include additional services such as dental, hearing, and vision coverage, depending on the chosen plan.
This article aims to explore the array of Medicare Advantage plans provided by CarePlus. As Medicare Advantage represents a significant departure from Original Medicare by incorporating a suite of extra benefits, understanding the offerings from CarePlus is essential for anyone considering their Medicare options in Florida.
Continue reading to gain insights into the specific Medicare Advantage plans CarePlus offers and how they can cater to your healthcare needs.
What is Medicare Advantage?
Medicare Advantage, also known as Part C, is an alternative to Original Medicare (Parts A and B) offered through private insurance companies approved by Medicare.
These plans provide all the benefits of Original Medicare, covering hospital and medical services, but often include additional benefits not available through the federal program.
Key features of Medicare Advantage plans include:
- Comprehensive Coverage: In addition to the hospital and medical coverage provided under Original Medicare, many Medicare Advantage plans offer extra benefits such as prescription drug coverage (similar to Part D), as well as dental, vision, and hearing services.
- Network-Based Care: These plans typically operate within a specified network of healthcare providers. Depending on the type of Medicare Advantage plan (like HMO or PPO), you may need to see in-network providers for covered services.
- Out-of-Pocket Costs: While Original Medicare has standardized costs set by Medicare, Medicare Advantage plans may have different out-of-pocket expenses, such as premiums, deductibles, copays, and coinsurance, which can vary by plan.
- Annual Enrollment: Beneficiaries can choose or switch Medicare Advantage plans during annual enrollment periods, providing flexibility and the opportunity to select a plan that best meets their current healthcare needs.
What Are the CarePlus Medicare Advantage Plan Options?
HMO (Health Maintenance Organization) Plans
- Key Characteristics: HMO plans require members to receive care from a network of local healthcare providers and hospitals. Except for emergencies, out-of-network services are typically not covered.
- Primary Care Physician (PCP): Enrollees must choose a PCP who coordinates their healthcare, including referrals to specialists.
- Costs and Benefits: HMO plans often feature lower premiums and out-of-pocket costs compared to PPO plans. They emphasize preventive care and wellness services.
PPO (Preferred Provider Organization) Plans
- Key Characteristics: PPO plans offer more flexibility by allowing members to see providers both in and out of the plan’s network, often without a referral.
- Costs vs. Flexibility: While PPO plans generally have higher premiums and out-of-pocket costs than HMO plans, they provide greater freedom in choosing healthcare providers.
- Coverage Area: PPO plans are particularly beneficial for individuals who travel frequently or live in rural areas where in-network providers might be limited.
Part D Plan Options
CarePlus Medicare Advantage plans often include Part D prescription drug coverage, providing a convenient, integrated solution for health and medication needs.
Each plan has a formulary, or a list of covered drugs, which can vary by plan. It’s essential to review the formulary to ensure your medications are covered.
Cost Considerations
Many CarePlus Medicare Advantage plans offer the advantage of having no premiums. While enrollees are still responsible for their monthly Medicare Part B premium payable to Medicare, there is no additional premium for the Medicare Advantage coverage through CarePlus.
It’s crucial to note that to fully benefit from CarePlus Medicare services, enrollees need to choose healthcare providers, medications, and pharmacies that are part of the CarePlus network.
Here is an overview of the varying plans and benefits CarePlus offers across selected cities in Florida:
| Area, plan | Monthly premium | Deductible | In-network out-of-pocket max | Primary physician visit copay | Specialist visit copay |
| Daytona Area, FL: CareOne Plus (HMO) | $0 | $0 | $3,000 | $0 | $10 |
| Jacksonville Coast, FL: CareOne Plus (HMO) | $0 | $0 | $4,500 | $0 | $30 |
| Tampa, FL: Hillsborough, Pinellas, and Pasco Counties, CareNeeds Plus (HMO D-SNP) | $0 | $0 | $2,000 | $0 | $5 |
| South Florida, FL: CareFree (HMO) | $0 | $0 | $3,400 | $0 | $20 |
| Orlando Area, FL: Lake, Marion, and Sumter Counties, CareFree Platinum (HMO) | $0 | $0 | $4,000 | $0 | $25 |
Where Are CarePlus MA Plans Offered?
CarePlus Medicare Advantage (MA) plans are specifically tailored to cater to residents in various parts of Florida, ensuring that beneficiaries can access comprehensive healthcare services within their locality.
Here’s a list of where CarePlus MA plans are offered in 2024:
South Florida
- Broward
- Miami-Dade
- Palm Beach
Tampa Area
- Hernando
- Hillsborough
- Pasco
- Pinellas
- Polk
Orlando Area
- Lake
- Marion
- Orange
- Osceola
- Seminole
- Sumter
Daytona Area
- Flagler
- Volusia
Treasure Coast previously Space Coast
- Brevard
- Indian River
Jacksonville Area previously North Florida
- Clay
- Duval
- St. Johns
What Do CarePlus Medicare Advantage Plans Cover?
CarePlus Medicare Advantage plans are known for their comprehensive coverage, designed to cater to a wide range of healthcare needs for Medicare beneficiaries.
While specific benefits can vary depending on the plan and location, here are general benefits that CarePlus Medicare Advantage plans typically cover:
- Hospital and Medical Coverage: Includes Medicare Part A and Part B services, such as hospital stays, doctor visits, outpatient care, and preventive services.
- Prescription Drug Coverage (Part D): Most CarePlus Medicare Advantage plans include prescription drug coverage, helping to cover the cost of medications.
- Dental, Vision, and Hearing Services: Additional benefits often include routine dental care, eye exams, eyewear allowances, hearing exams, and discounts on hearing aids.
- Wellness Programs: Many plans offer access to fitness programs, such as gym memberships or fitness activities tailored to senior health.
- Over-the-Counter (OTC) Allowances: Some plans provide an allowance for over-the-counter health items, such as vitamins, pain relievers, and first aid supplies.
- Telehealth Services: Coverage for virtual visits with healthcare providers, allowing beneficiaries to access medical consultations from home.
- Transportation Benefits: Certain plans may offer transportation assistance to and from medical appointments.
- Chronic Disease Management: Programs and support for managing chronic conditions, such as diabetes or heart disease, to improve health outcomes.
- Emergency Coverage Abroad: Some plans extend emergency healthcare coverage to travels outside the United States.
Choosing the right Medicare Advantage plan can be a critical decision affecting your health and financial well-being. With the array of benefits provided by CarePlus, understanding your options and making an informed choice becomes paramount.
Don’t let the array of choices overwhelm you. Reach out to CoverRight today for personalized support in selecting the CarePlus Medicare Advantage plan that best serves your needs.
FAQs
Do CarePlus Medicare Advantage plans include prescription drug coverage?
Most CarePlus Medicare Advantage plans come with Part D prescription drug coverage included. This allows beneficiaries to manage both their medical and prescription drug needs under one plan, offering convenience and potentially saving on costs.
Can I switch from my current Medicare Advantage plan to a CarePlus plan outside the Annual Enrollment Period?
Switching Medicare Advantage plans typically requires waiting for the Annual Enrollment Period (AEP) from October 15th to December 7th each year. However, certain circumstances, such as moving out of your plan’s service area or qualifying for a Special Enrollment Period (SEP), may allow you to switch plans outside the AEP.
Are there any special eligibility requirements for enrolling in a CarePlus Medicare Advantage Plan?
Generally, to enroll in a CarePlus Medicare Advantage plan, you must be enrolled in both Medicare Part A and Part B, live in the plan’s service area, and not have end-stage renal disease (ESRD) at the time of enrollment. However, there are some exceptions to the ESRD rule.
