CarePlus Announces Medicare Advantage Plan Offerings for 2025

Rhea-AI Summary

CarePlus Health Plans, a Florida-based Medicare Advantage provider, announces enhancements to its 2025 plans, marking 25 years of operation. Key features include:

Expanded Access: CareAccess (HMO) plan available across all service areas, allowing in-network specialist visits without referrals. Financial Benefits: Part B premium giveback on over 65% of plans, $0 premium on all plans, and roll-over CareEssentials Allowance funds. New Offerings: CareComplete (HMO C-SNP) plan for chronic conditions and enhanced support for dual Medicare-Medicaid eligibles.

Most plans also offer robust dental coverage, vision and hearing allowances, $0 copay for various medical services, affordable prescription drugs, and wellness programs. The Annual Enrollment Period runs from Oct. 15 to Dec. 7.

Positive

• Expansion of CareAccess (HMO) plan to all service areas
• Part B premium giveback benefit on over 65% of plans
• $0 premium on all Medicare Advantage plans for 2025
• Introduction of CareComplete (HMO C-SNP) plan for chronic conditions
• Roll-over feature for unused CareEssentials Allowance funds
• $0 copay for Tier 1 drugs on all Medicare Advantage Prescription Drug plans
• $2,000 maximum limit on out-of-pocket costs for covered drugs

Negative

• None.

Insights

Healthcare Policy Analyst

CarePlus's 2025 Medicare Advantage plan enhancements reflect a strategic move to capture market share in Florida's competitive healthcare landscape. The expansion of the CareAccess (HMO) plan and introduction of the CareComplete (HMO C-SNP) plan demonstrate a focus on flexibility and specialized care for chronic conditions. The $0 premium across all plans and increased Part B premium giveback benefit are aggressive pricing strategies aimed at attracting cost-conscious seniors.

The rollover feature for CareEssentials Allowance and enhanced support for dual-eligible beneficiaries show a commitment to addressing social determinants of health. These moves align with industry trends towards more holistic care models. The $0 copays for various services and $2,000 out-of-pocket maximum for prescription drugs position CarePlus competitively in terms of affordability.

While these enhancements may pressure profit margins in the short term, they could lead to increased enrollment and market share gains, potentially benefiting Humana's long-term revenue growth in the lucrative Medicare Advantage space.

Financial Analyst

Humana's strategic expansion of CarePlus offerings in Florida signals a strong push for growth in the Medicare Advantage market. The zero-premium plans and enhanced benefits are likely to drive enrollment, potentially increasing Humana's market share in Florida, a key state for Medicare Advantage plans due to its large senior population.

The introduction of more comprehensive benefits, such as the CareEssentials Allowance with rollover feature and expanded chronic condition coverage, may lead to higher per-member costs in the short term. However, these investments could result in improved health outcomes and reduced long-term medical costs, positively impacting Humana's Medical Loss Ratio (MLR) over time.

The focus on $0 copays for various services and the $2,000 out-of-pocket maximum for prescription drugs may pressure margins initially but could lead to increased member satisfaction and retention, important factors for long-term profitability in the Medicare Advantage space. Investors should monitor enrollment figures and MLR trends in upcoming quarters to gauge the success of these initiatives.

Marking 25 years of operation, CarePlus increases focus on affordable health and financial well-being through robust allowances, $0 copays, and a giveback benefit.

MIAMI--(BUSINESS WIRE)-- CarePlus Health Plans, Inc., a Florida-based provider of Medicare Advantage plans, is proud to announce enhancements to its Medicare Advantage plans for 2025. The plans, benefits, and resources are part of CarePlus’ ongoing commitment to improving health outcomes across the state.

“Our top priority is to provide affordable healthcare solutions that cater to the individual needs of our members,” said Steven Ruiz, President of CarePlus Health Plans. “As we enter our 25th year exclusively serving Florida’s Medicare-eligible population, we are excited about how our health plan options in 2025 will help contribute to our members’ overall well-being.”

New for 2025:

• Expanded Access: The CareAccess (HMO) plan will be available across all service areas, following its initial launch in Orlando and Daytona. This plan allows members to see in-network specialists without needing a referral, enhancing healthcare flexibility.¹
• Easing Financial Burdens: CarePlus’ Part B premium giveback benefit will be included on more than 65% of CarePlus plans for 2025. It reduces the amount members pay for Medicare Part B.²
• $0 Premium on All Plans: CarePlus members will not have to pay an extra premium for their Medicare Advantage plan in 2025.
• Roll-Over Funds: On CarePlus plans that include it, CareEssentials Allowance funds will roll over if unused at the end of each month, providing greater flexibility and spending power for essential purchases like groceries, utilities, and rent.
• New Chronic Condition Plan: The CareComplete (HMO C-SNP) plan³ is for people managing diabetes, cardiovascular disorders, or congestive heart failure. It is available in all CarePlus service areas and includes a $215 monthly CareEssentials Allowance.^*
• Enhanced Support for those who have both Medicare and Medicaid: An over-the-counter allowance will be added to the spending card on the CareNeeds Platinum (HMO D-SNP) plan.⁴ To ensure accessibility, it can be used at participating retailers or through CenterWell Pharmacy™ for mail delivery at no additional cost.

Also Available on Most CarePlus Plans:

• Robust Dental Coverage: $0 copay for services including dentures, extractions, and fillings, with access to over 100,000 dentists nationwide.⁵
• Vision and Hearing: Includes allowances for eyewear and hearing aids.
• Medical Coverage: $0 copay for primary care, podiatry, acupuncture, and chiropractic visits as well as a free meal delivery program after overnight hospital stays.
• Affordable Prescription Drugs: $0 copay for Tier 1 drugs on all Medicare Advantage Prescription Drug plans – and a $2,000 maximum limit on out-of-pocket costs for covered drugs.
• Wellness Programs: Access to SilverSneakers®, free transportation to select locations, and a $50 gift card reward for completing certain healthy activities.

For more information on enrolling in a CarePlus Medicare Advantage plan during Medicare’s Annual Enrollment Period from Oct. 15 to Dec. 7, Florida residents can visit www.CarePlusHealthPlans.com or contact a licensed CarePlus sales agent at 1-855-450-1352 (TTY: 711).

¹Certain services or medications may require preauthorization.

²The Part B Premium Reduction benefit pays part or all your Part B premium and the amount may change based on the amount you pay for Part B.

³This plan is available to anyone enrolled in Medicare with a diagnosis of diabetes, cardiovascular disorders or chronic heart failure.

⁴This 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).

⁵Quantity limits and other restrictions apply.

*Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.

South Florida, West Florida, Central Florida, North Florida, and Atlantic Coast. CarePlus is an HMO plan with a Medicare contract. Enrollment in CarePlus depends on contract renewal. In accordance with the federal requirements of the Centers for Medicare & Medicaid Services (CMS), no amounts on the gift cards shall be redeemable for cash and no amount may be applied toward the purchase of any prescription drug under your plan. Rewards (gift cards) must be earned and redeemed in the same plan year. Rewards not redeemed by 12/31 will be forfeited.

View source version on businesswire.com: https://www.businesswire.com/news/home/20241016793291/en/

Lisa Dimond

Humana Corporate Communications

LDimond@humana.com

Source: Humana Inc.

FAQ

What new Medicare Advantage plans is CarePlus offering for 2025?

CarePlus is introducing the CareComplete (HMO C-SNP) plan for people managing diabetes, cardiovascular disorders, or congestive heart failure, available in all CarePlus service areas.

How is CarePlus expanding access to specialists in their 2025 Medicare Advantage plans?

The CareAccess (HMO) plan, now available across all service areas, allows members to see in-network specialists without needing a referral, enhancing healthcare flexibility.

What financial benefits does CarePlus offer in its 2025 Medicare Advantage plans?

CarePlus offers $0 premiums on all plans, Part B premium giveback on over 65% of plans, and roll-over CareEssentials Allowance funds for essential purchases like groceries, utilities, and rent.

What dental coverage does CarePlus provide in its 2025 Medicare Advantage plans?

Most CarePlus plans offer $0 copay for dental services including dentures, extractions, and fillings, with access to over 100,000 dentists nationwide.