CarePlus Medicare Advantage 2023 Review

CarePlus Medicare Advantage plans are available in Florida only, but they come with high ratings.
Kate Ashford, CSA®
By Kate Ashford, CSA® 
Edited by Chris Hutchison

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CarePlus Health Plans, a subsidiary of Humana, offers Medicare Advantage plans in Florida. All CarePlus plans are highly rated and most offer $0 premiums.

Here’s what you should know about CarePlus Medicare Advantage.

CarePlus Medicare Advantage pros and cons

CarePlus’ offerings have advantages and disadvantages.

Pros

  • Low-cost plans: Most of CarePlus’ Medicare Advantage plans have a $0 premium.

  • Member satisfaction: CarePlus’ parent company, Humana, ranks second out of nine major providers in J.D. Power’s 2022 Medicare Advantage member satisfaction index.

  • Drug coverage: Most CarePlus Medicare Advantage plans include prescription drug coverage.

Cons

  • Limited availability: CarePlus offers Medicare Advantage plans in one state only: Florida.

  • Only HMOs: CarePlus offers only HMO plans, which generally provide the least flexibility when seeking medical care.

Available Medicare Advantage plans

There are a few kinds of CarePlus Medicare Advantage plans, and they vary in terms of structure, costs and benefits. CarePlus offers Medicare Advantage prescription drug plans, or MAPDs, as well as Medicare Advantage plans without drug coverage.

Plan offerings include the following types:

A health maintenance organization, or HMO, generally requires that you use a specific network of doctors and hospitals. You may need a referral from your primary doctor in order to see a specialist, and out-of-network benefits are usually very limited.

Special needs plans, or SNPs, restrict membership to people with certain diseases or characteristics. Hence, the benefits, network and drug formularies are tailored to the needs of those members. CarePlus offers two types of SNPs:

  • Chronic Condition SNP: Designed to meet the needs of members living with certain chronic conditions, such as diabetes, congestive heart failure and cardiovascular disease.

  • Dual-Eligible SNP: For people who are entitled to Medicare and who also qualify for assistance from a state Medicaid program.

Additional benefits

CarePlus Medicare Advantage plans include a variety of benefits that aren’t available from Original Medicare. Here are some examples, although availability varies by plan:

  • Over-the-counter allowance: Members may be able to receive a monthly allowance they can use to pay for OTC items such as cough medicine and pain relievers.

  • CareCard: Members may be eligible for a pre-loaded card they can use to pay for dental, hearing or vision services that exceed what the plan pays.

  • SilverSneakers: Members can visit gyms and access live and prerecorded online fitness classes tailored to older adults.

  • Meal delivery: Members may be able to receive a certain number of meals delivered to their homes after an overnight stay in a hospital or skilled nursing facility.

  • Wigs related to chemotherapy: Members may be eligible for reimbursement for wig expenses related to chemotherapy treatment.

  • Part B premium giveback: Some plans may include some amount toward your Part B monthly premium.

Customer service

Here’s how CarePlus members can contact customer service:

  • Call Member Services at 800-794-5907 (TTY: 711). From Oct. 1 to March 31, services are open seven days a week, 8 a.m. to 8 p.m. And from April 1 to Sept. 30, services are open Monday to Friday, 8 a.m. to 8 p.m.

CarePlus Medicare Advantage service area

CarePlus offers Medicare Advantage plans in Florida only.

CarePlus' parent company, Humana, is the second-largest provider of Medicare Advantage plans in the country

. CarePlus plans cover more than 200,000 Medicare Advantage beneficiaries as of October 2022.

Cost

Costs for Medicare Advantage plans depend on your plan, your geographic location and your health needs. One of the costs to consider is the plan’s premium. Most CarePlus Medicare Advantage plans have a $0 premium

Centers for Medicare & Medicaid Services. 2023 MA Landscape Source File (v 10 14 2022) (ZIP). Accessed Dec 1, 2022.
.

In 2023, all CarePlus Medicare Advantage plans that aren’t special needs plans have a $0 premium, and about 80% of CarePlus SNPs have a $0 premium. CarePlus SNPs with a monthly premium cost between $14.70 and $18.10 per month

Centers for Medicare & Medicaid Services. 2023 SNP Landscape Source File (v 10 14 2022) (ZIP). Accessed Dec 1, 2022.
.

Even as a Medicare Advantage user, you’ll still be responsible for paying your Medicare Part B premium, which is $164.90 per month in 2023, although some plans cover part or all of this cost. (Most people pay this standard amount, but if your income is above a certain threshold, you'll pay more.)

Other out-of-pocket costs to consider include:

  • Whether the plan covers any part of your monthly Medicare Part B premium.

  • The plan’s yearly deductibles and any other deductibles, such as a drug deductible.

  • Copayments and/or coinsurance for each visit or service. For instance, there may be a $10 copay for seeing your primary doctor and a $45 copay for seeing a specialist.

  • The plan’s in-network and out-of-network out-of-pocket maximums.

  • Whether your medical providers are in-network or out-of-network, or how often you may go out of network for care.

  • Whether you require extra benefits, and if the plan charges for them.

To get a sense of costs, use Medicare’s plan-finding tool to compare information among available plans in your area. You can select by insurance carrier to see only CarePlus plans or compare across carriers. You can also shop directly from CarePlus’ website by entering your ZIP code.

Medicare star ratings

Average star rating, weighted by enrollment: 4.0

The Centers for Medicare & Medicaid Services maintains star ratings for Medicare Advantage plans on a 5-point scale, ranking plans from best (5 stars) to worst (1 star). The agency bases these ratings on plans’ quality of care and measurements of customer satisfaction, and ratings may change from year to year.

Based on the most recent year of data and weighted by enrollment, CarePlus’ 2023 Medicare Advantage plans get an average rating of 4.0 stars

Centers for Medicare & Medicaid Services. 2023 Star Ratings Data Table (ZIP). Accessed Dec 1, 2022.
.

The average star rating for plans from all providers is 4.15

Centers for Medicare & Medicaid Services. 2023 Medicare Star Ratings Fact Sheet (PDF). Accessed Dec 1, 2022.
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To get an overall star rating, the CMS ranks contracts on 40 plan factors. (You can find definitions for each of these factors in the CMS Star Ratings Technical Notes.) Here are the measures for which CarePlus plans scored an average of 4.5 (out of 5) and above:

  • Breast cancer screening.

  • Colorectal cancer screening.

  • Monitoring physical activity.

  • Care for older adults — medication review.

  • Care for older adults — pain assessment.

  • Diabetes care — eye exam.

  • Diabetes care — kidney disease monitoring.

  • Diabetes care — blood sugar controlled.

  • Controlling blood pressure. 

  • Medication reconciliation post-discharge.

  • Rating of health plan.

  • Reviewing appeals decisions.

  • Health plan: Call center — foreign language interpreter and TTY availability.

  • Drug plan: Call center — foreign language interpreter and TTY availability. 

  • Medication therapy management program completion rate for comprehensive medication review.

  • Statin use in persons with diabetes. 

CarePlus plans averaged sub-3.0 scores in a few measured categories. (You can find definitions for each of these factors in the CMS Star Ratings Technical Notes.)

  • Annual flu vaccine.

  • Care coordination.

  • Health plan quality improvement.

  • Drug plan quality improvement.

You can find a plan’s rating with the Medicare plan finding tool.

Third-party ratings

There are a few companies that weigh in on health plans or on the strength of the company in question, and we’ve included two here:

AM Best Financial Strength Rating: A- (Excellent)

AM Best is a credit rating agency that specializes in the insurance industry. In September 2022, AM Best affirmed its Financial Strength Rating of A- (Excellent) for the majority of health and dental insurance subsidiaries of Humana Inc., including CarePlus Health Plans

.

An A- rating in this category indicates that AM Best believes Humana has an excellent ability to meet its ongoing insurance obligations.

J.D. Power Ranking: 2nd out of 9

In its 2022 U.S. Medicare Advantage Study — the eighth it's done so far — J.D. Power measured member satisfaction with Medicare Advantage plans based on six factors: coverage and benefits, provider choice, cost, customer service, information and communication, and billing and payment. On these measures, CarePlus’ parent company, Humana, scored 824 points out of 1,000 and came in second out of the top nine Medicare Advantage providers

.

Compare Medicare Advantage providers

Get more information below about some of the major Medicare Advantage providers. These insurers offer plans in most states. The plans you can choose from will depend on your ZIP code and county.

About CarePlus

CarePlus Health Plans was incorporated in 1985 as Florida 1st Health Plans. The company changed its name to CarePlus Health Plans in 2002, and its headquarters are in Miami. Humana acquired CarePlus in 2005.

CarePlus offers Medicare Advantage plans and covers more than 200,000 members in Florida.

Find the right Medicare Advantage plan

It’s important to do your research before selecting a Medicare Advantage plan for yourself. Here are some questions to consider asking:

  • What are the plan’s costs? Do you understand what the plan’s premium, deductibles, copays and/or coinsurance will be? Can you afford them?

  • Is your doctor in-network? If you have a preferred medical provider or providers, make sure they participate in the plan’s network.

  • Are your prescriptions covered? If you’re on medication, it’s crucial to understand how the plan covers it. What tier are your prescription drugs on, and are there any coverage rules that apply to them?

  • Is there dental coverage? Does the plan offer routine coverage for vision, dental and hearing needs?

  • Are there extras? Does the plan offer any extra benefits, such as fitness memberships, transportation benefits or meal delivery?

If you have additional questions about Medicare, visit Medicare.gov or call 800-MEDICARE (800-633-4227, TTY 877-486-2048).
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