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CarePlus Medicare Advantage 2024 Review
CarePlus Medicare Advantage plans are available in Florida only, and all plans get 4 stars (out of 5) from CMS.
Kate Ashford, CSA® Lead Writer | Medicare, retirement, personal finance
Kate Ashford is a writer and NerdWallet authority on Medicare. She is a certified senior advisor (CSA)® and has more than 18 years of experience writing about personal finance. Previously, she was a freelance writer for both consumer and business publications, and her work has been published by the BBC, Forbes, Money, AARP, LearnVest and Parents, among others. She has a degree from the University of Virginia and a master’s degree in journalism from Northwestern’s Medill School of Journalism. Kate has appeared as a Medicare expert on the PennyWise podcast by Lee Enterprises, and she's been quoted in national publications including Healthline, Real Simple and SingleCare. She is based in New York.
Holly Carey joined NerdWallet in 2021 as an editor on the team responsible for expanding content to additional topics within personal finance. She currently leads the Medicare team. Previously, Holly wrote and edited content and developed digital media strategies as a public affairs officer for the U.S. Navy. She is based in Virginia Beach, Virginia.
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CMS Star RatingAverage Medicare star rating, weighted by enrollment. Star ratings are determined by the Centers for Medicare & Medicaid Services (CMS).
CarePlus plans come with high ratings and low premiums, but are available in Florida only.
Members in high-rated plansPercentage of members who are in rated contracts with a Medicare star rating of 4 or higher.
High (90% or more)
Member experienceThe average of CMS' star ratings for quality measures in the domain "Member Experience with the Health Plan," weighted by contract enrollment.
3.17 (Average)
Pros
Many plans have a $0 premium.
Most plans include prescription drug coverage.
Cons
Available in Florida only.
CarePlus offers only HMO and HMO-POS plans, which provide less flexibility when seeking medical care.
States available
1 state
Members in high-rated plansPercentage of members who are in rated contracts with a Medicare star rating of 4 or higher.
High (90% or more)
Member experienceThe average of CMS' star ratings for quality measures in the domain "Member Experience with the Health Plan," weighted by contract enrollment.
3.17 (Average)
Pros
Many plans have a $0 premium.
Most plans include prescription drug coverage.
Cons
Available in Florida only.
CarePlus offers only HMO and HMO-POS plans, which provide less flexibility when seeking medical care.
CarePlus Health Plans, a subsidiary of Humana, offers Medicare Advantage plans in Florida. All CarePlus plans are highly rated and many 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: Many of CarePlus’ Medicare Advantage plans have a $0 premium.
Drug coverage: Most CarePlus Medicare Advantage plans include prescription drug coverage
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’ 2024 Medicare Advantage plans get an average rating of 4.0 stars
Costs for Medicare Advantage plans depend on your plan, your geographic location and your health needs.
Premiums
One of the costs to consider is the plan’s premium. In 2024, all CarePlus Medicare Advantage plans that aren’t special needs plans (SNPs) have a $0 premium, and half of CarePlus SNPs have a $0 premium
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 ($174.70 in 2024)
Centers for Medicare & Medicaid Services. Costs. Accessed Oct 24, 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.)
Copays, coinsurance and deductibles
Requirements for copays, coinsurance and deductibles vary depending on your plan, location and the services you use. 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.
Here are examples of CarePlus Medicare Advantage costs for the most popular plans in a mid-range city:
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.
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 (MAPDs), as well as Medicare Advantage plans without drug coverage.
Plan offerings include the following types:
HMO plans
A health maintenance organization (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.
HMO-POS plans
HMO point of service (POS) plans are HMO plans that allow members to get some out-of-network services, but they’ll pay more for those services.
SNPs
Special needs plans (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.
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 2023, AM Best upgraded its Financial Strength Rating to 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
In its 2023 U.S. Medicare Advantage Study — the ninth it's done so far — J.D. Power measured member satisfaction with Medicare Advantage plans based on eight factors ranging from level of trust to how well a provider resolves problems or complaints. The study was fielded in the five biggest Medicare markets, and here’s how CarePlus’s parent company, Humana, ranked out of all major providers:
. CarePlus plans cover more than 200,000 Medicare Advantage beneficiaries.
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.
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.
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.
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).
