Enter your ZIP code to learn about the CarePlus Medicare Advantage plans in your area, or call us at 1-855-605-6171; TTY: 711.
CarePlus offers Medicare Advantage plans in many Florida counties.
Please check the links below to review the Summary of Benefits and/or Evidence of Coverage (EOC) for each specific benefit plan. The Summary of Benefits and Evidence of Coverage (EOC) will provide you with the plan's description of benefits. The Summary of Benefits and Evidence of Coverage were last updated on our website on February 24,2023. Only the current document for each plan will display.
Most CarePlus plans require members to use network providers except plans with a Point of Service (POS) option. Emergency or urgently needed services can always be obtained in or out of the service area from the nearest available provider whenever network providers are not accessible. When in the service area, you should use plan providers for urgent care. In addition, when out of the service area, you can obtain dialysis treatment from any qualified dialysis provider. If you obtain routine care from out-of-network providers, neither Medicare nor CarePlus will be responsible for the costs.
CarePlus members may request a printed Evidence of Coverage be mailed to them. Please fill out and submit this form or call Member Services at 1-800-794-5907 (TTY: 711). From October 1 - March 31, we are open 7 days a week, 8 a.m. to 8 p.m. From April 1 - September 30, we are open Monday - Friday, 8 a.m. to 8 p.m. You may always leave a voicemail after hours, Saturdays, Sundays, and holidays and we will return your call within one business day.
If you are not a CarePlus Member, please fill out this form to request an Evidence of Coverage be mailed to you.
Covered Durable Medical Equipment Items and Brands
Durable Medical Equipment (DME) is certain medical equipment ordered by your doctor for medical reasons. Generally, CarePlus covers any DME that Original Medicare covers. The list below tells you which brands and manufacturers of DME our benefit plans cover.
PDF2023 Covered Durable Medical Equipment Items and Brands (PDF opens in new window)
1CareNeeds Plus (D-SNP): This plan is available to anyone receiving both Medicare and Medicaid: Qualified Medicare Beneficiaries (QMB/QMB+), Specified Low-Income Medicare Beneficiaries (SLMB/SLMB+), Qualifying Individuals (QI), Qualified Disabled and Working Individuals (QDWI) and other Full Benefit Dual Eligibles (FBDE). CareNeeds Plus (HMO D-SNP) is sponsored by CarePlus Health Plans, Inc. and the State of Florida, Agency for Health Care Administration.
2CareComplete (HMO C-SNP): This plan is available to anyone enrolled in Medicare with a diagnosis of diabetes, cardiovascular disorders or chronic heart failure.
3CareBreeze (HMO C-SNP): This plan is available to anyone enrolled in Medicare with a diagnosis of chronic lung disorders.
4(057-CareOne Plus (HMO-POS)): This plan covers certain out-of-network services for members while visiting Puerto Rico. Except in emergency or urgent situations, non-contracted providers may deny care.
5CareOne Platinum (HMO-POS): This plan covers certain services received from out-of-network providers in Brevard and Indian River counties in Florida. Except in emergency or urgent situations, non-contracted providers may deny care. You will pay a higher copay for services received by non-contracted providers.
6CareComplete Platinum (HMO-POS C-SNP) This plan covers certain services received from out-of-network providers located within the plan's service area. Except in emergency or urgent situations, non-contracted providers may deny care. You will pay a higher copay for services received by non-contracted providers.
7CareBreeze Platinum (HMO-POS C-SNP) This plan covers certain services received from out-of-network providers located within the plan's service area. Except in emergency or urgent situations, non-contracted providers may deny care. You will pay a higher copay for services received by non-contracted providers.
8CareSalute (HMO-POS) : This plan covers certain services received from out-of-network providers located within the plan's service area. Except in emergency or urgent situations, non-contracted providers may deny care. You will pay a higher copay for services received by non-contracted providers.
Out-of-network/non-contracted providers are under no obligation to treat CarePlus members, except in emergency situations. Please call our Member Services number or see your Evidence of Coverage for more information, including the cost- sharing that applies to out-of-network services.
