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CarePlus Advantage Plus (HMO) (CarePlus Health Plans) — Florida Medicare Advantage Plan

Mitchell Budwig, Licensed Insurance Agent

By Mitchell Budwig, Licensed Insurance Agent

CarePlus Advantage Plus (HMO) is an HMO Medicare Advantage plan from CarePlus Health Plans with a $42 monthly premium, a CMS rating of 4.0 out of 5 stars, and a $5,500 annual out-of-pocket maximum. Prescription drug coverage is included. Included benefits: dental, vision, hearing, over-the-counter allowance, transportation, fitness membership.

  • Includes Dental
  • Includes Drug Coverage
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At a glance

CarePlus Advantage Plus (HMO) at a glance
DetailValue
Monthly plan premium$42 per month
Annual medical deductible$0
Annual out-of-pocket maximum$5,500
CMS star rating4.0 out of 5 stars
Plan typeHMO
Contract / plan IDH1019-020

What this plan covers

Medical (Part B)

Part B coverage through a south Florida network built around clinic-based primary care with same-day appointments.

Hospital (Part A)

Part A hospital and skilled nursing coverage at south Florida contracted facilities.

Prescription drugs (Part D)

Part D is included, with a generous over-the-counter allowance layered on top.

Extra benefits

  • Dental
  • Vision
  • Hearing
  • Fitness membership
  • Over-the-counter allowance: $85 per month for over-the-counter items
  • Transportation: 36 one-way trips per year

Costs and copays

Typical copays for CarePlus Advantage Plus (HMO)
ServiceYou pay in network
Primary care visit$0
Specialist visit$25
Urgent care$40
Emergency room$120 (waived if admitted)
Inpatient hospital (per stay)$350 per day, days 1–5
Lab work$0
Diagnostic imaging (MRI, CT)$100
Generic drugs (Tier 1)$0
Preferred brand drugs (Tier 3)$42

Typical in-network cost sharing. Amounts shown are standard cost shares for this plan and can change each plan year — always confirm against the plan's Summary of Benefits before enrolling.

Who this plan may fit

  • South Florida residents who want richer extra benefits and will pay a monthly premium for them
  • People who use their over-the-counter allowance and transportation benefit every month
  • Anyone who prefers lower specialist copays

Who it may not suit

If you rarely use extra benefits, a $0-premium plan in the same county will likely cost you less over the year.

How to use this plan

Finding in-network providers
Search the carrier's online provider directory by name, specialty, and ZIP code, or call us and we will check your doctors against the network before you enroll.
Do you need referrals?
Yes — this is an HMO, so you choose a primary care physician who coordinates your care and issues referrals to specialists.
How prior authorization works
Certain services — planned inpatient stays, advanced imaging, some outpatient surgeries, durable medical equipment, and specialty drugs — need approval before the plan pays. Your provider submits the request; ask them to confirm approval before scheduling.
Traveling and coverage away from home
Urgent and emergency care is covered anywhere in the United States. Routine care outside the service area is generally not covered, so schedule check-ups for when you are home.

Where this plan is available (7 counties)

Select your county to see everything available where you live. Eligibility is based on your permanent address.

How to enroll in this plan

You can join this plan when you first become eligible for Medicare, during your seven-month Initial Enrollment Period around your 65th birthday.

After that, the Annual Enrollment Period runs October 15 to December 7 each year, with coverage starting January 1. If you are already in a Medicare Advantage plan, Medicare Advantage Open Enrollment from January 1 to March 31 lets you make one switch.

Outside those windows, a qualifying life event such as a move, a loss of employer coverage, or a change in Medicaid eligibility can open a Special Enrollment Period that lets you enroll right away.

Enroll Into Plan Today

Takes about a minute · A licensed agent completes the application with you

Open enrollment datesSpecial enrollment periods

Answer These Quick Questions to Enroll Into CarePlus Health Plans Today

Enroll into CarePlus Advantage Plus (HMO)

Send your details and a licensed agent will call you to confirm your eligibility, check your doctors and prescriptions against CarePlus Advantage Plus (HMO), and complete the CarePlus Health Plans application with you over the phone. Nothing is submitted to CarePlus Health Plans until you approve it.

The plan you're inquiring about

Plan:
CarePlus Advantage Plus (HMO)
Carrier:
CarePlus Health Plans
Plan type:
HMO
Monthly premium:
$42 per month
CMS rating:
4.0 out of 5 stars
Plan ID:
H1019-020

Looking at a different plan? Compare all Florida plans

No cost, no obligation. Medicare caps what an agent can be paid, and the carrier pays it whether you enroll with us or on your own. Your premium is exactly the same either way. We never sell your information, and you can ask us to stop contacting you at any time.

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Monday – Friday, 8:00 am – 8:00 pm ET · Saturday, 9:00 am – 5:00 pm ET

Check whether this plan covers your doctors and prescriptions

A licensed agent will run your providers and medication list against this plan before you enroll, and show you the comparable plans in your county so you can see the trade-offs.

Monday – Friday, 8:00 am – 8:00 pm ET · Saturday, 9:00 am – 5:00 pm ET

Questions about this plan

How much does CarePlus Advantage Plus (HMO) cost each month?

The plan premium is $42 per month. You also continue to pay your Medicare Part B premium, which goes to Medicare rather than to CarePlus Health Plans. Beyond premiums you pay copays as you use services, up to an annual out-of-pocket maximum of $5,500.

Does CarePlus Advantage Plus (HMO) include prescription drug coverage?

Yes. Part D coverage is built into this plan, so you do not need — and should not buy — a separate prescription drug plan. Tier 1 generics start at $0.

Do I need a referral to see a specialist on CarePlus Advantage Plus (HMO)?

Yes — this is an HMO, so you choose a primary care physician who coordinates your care and issues referrals to specialists.

What is the CMS star rating for CarePlus Advantage Plus (HMO)?

Medicare rates this plan 4.0 out of 5 stars. Star ratings measure things like preventive care, member experience, customer service, and how quickly problems get resolved. Ratings are published each fall and can change from year to year.

Which Florida counties can I enroll in CarePlus Advantage Plus (HMO)?

CMS approved this plan in 7 Florida counties. Medicare Advantage plans are approved county by county, so your eligibility depends on the address where you actually live.

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