Medicare Advantage Plans

CarePlus Medicare Advantage Plans - Overview

Understanding How These Plans Work

At CarePlus, we have a holistic view of health care. We also believe that prevention really is the best medicine, and health solutions come about when we work closely with our providers and members. We cover all Medicare-covered preventive services and screenings at no cost to you.

When you become a member of CarePlus, you must choose a general practitioner or family doctor from our network of providers to be your Primary Care Physician (PCP). Your PCP is a physician who meets state requirements and is trained to give you basic medical care. You will get your routine or basic care from your PCP. Your PCP can also coordinate the rest of the covered services you need. In most cases, you must see your PCP to get a referral before you see any other health care provider.

CarePlus Medicare Advantage plans include:

  • $0 monthly plan premiums for most members*
  • Inpatient hospitalization coverage
  • Prescription drug coverage
  • Fitness & exercise classes
  • Vision benefits
  • Dental benefits
  • Transportation benefits (to plan approved locations)
  • Access to mail-order pharmacy
  • 24-hour nurse advice line
  • Over-the-counter monthly allowance
  • Wellness Rewards Program

Most CarePlus Medicare Advantage plans also include:

  • Hearing benefits
  • Post-hospitalization meal program

*Premiums may vary based on the level of “Extra Help” you receive. Please contact the plan for further details. The monthly premium for CareExtra in Dade County is $12.50; however, if you receive “Extra Help,” you may pay a lesser premium or no premium at all .

Beneficiaries are eligible to choose a CarePlus Medicare Advantage plan if they are entitled to Medicare Part A and enrolled in Part B. Beneficiaries must be entitled to Medicare Part A and Part B benefits as of the effective date of coverage under the plan.

You must use plan providers, except for emergencies, urgently needed care, or out-of-area dialysis services, and cases in which CarePlus authorizes use of out-of-network providers. You must receive all routine care from plan providers. If you obtain routine care from an out-of-network provider without prior authorization, neither Medicare nor CarePlus will pay for the services.

This information is not a complete description of benefits. In addition, not all benefits listed may be available on all plans or in a single plan benefit package. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or member cost-share may change on January 1 of each year. You must continue to pay your Medicare Part B premium. The Part B premium may be covered through your State Medicaid Program.