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2014 CarePlus Medicare Advantage Plan Information

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In 2014, CarePlus is offering Medicare Advantage HMO benefit plans in the following service areas throughout Florida: Miami-Dade, Broward, Palm Beach, Hillsborough, Pinellas, Pasco, Orange, Osceola, Seminole, Brevard, Saint Lucie, Okeechobee, Indian River, Martin, Lake, Marion, Sumter, Polk, and Duval counties. Please check the links provided below to review the Summary of Benefits and/or Evidence of Coverage for each specific Medicare benefit plan, which will provide you with the plan's description of benefits.

Individuals must have both Medicare Part A and Part B. You must continue to pay your Medicare Part B premium. The Part B premium may be covered through your State Medicaid Program. Eligible beneficiaries must use network pharmacies to access their prescription drug benefits, except under non-routine circumstances.

You must use plan providers except for emergencies, urgently needed services, 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 providers without authorization, neither Medicare nor CarePlus will pay for the services.

The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan. Limitations, copayments, and restrictions may apply. Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year.

South Florida

Tampa Area:

Orlando Area

+ These benefits plans are available to partial or full benefit dual eligible members. This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, copays, co-insurance, and deductibles may vary based on the level of extra help you receive. CarePlus is a Coordinated Care Plan with a Medicare contract and a contract with the Florida Medicaid Program. Enrollment in CarePlus depends on contract renewal. Please contact the plan for further details.

++These benefit plans are available to QMB and QMB PLUS beneficiaries. Part B premium is covered by the state for full benefit dual eligible members. Premiums, copays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. CarePlus is a Coordinated Care Plan with a Medicare contract and a contract with the Florida Medicaid Program. Enrollment in CarePlus depends on contract renewal. Sponsored by CarePlus and the State of Florida, Agency for Health Care Administration. Please contact the plan for further details.

* This plan is available to anyone with Medicare who has been diagnosed with Diabetes. CarePlus is a Coordinated Care Plan with a Medicare contract. Enrollment in CarePlus depends on contract renewal.

** This plan is available to anyone with Medicare who has been diagnosed with Cardiovascular Disorders or Chronic Heart Failure. CarePlus is a Coordinated Care Plan with a Medicare contract. Enrollment in CarePlus depends on contract renewal.

CareFree (HMO) Plan in Broward county will be combining with one of our other plans, CareOne (HMO). If you are enrolled in this plan you can choose a different Medicare Health Plan or switch to Original Medicare. However, if you don’t choose another plan, we will automatically change your coverage to our CareOne (HMO) Plan on January 1, 2014.

CareFree PLUS (HMO) Plan in Miami-Dade county will be combining with one of our other plans, CareOne PLUS (HMO). If you are enrolled in this plan you can choose a different Medicare Health Plan or switch to Original Medicare. However, if you don’t choose another plan, we will automatically change your coverage to our CareOne (HMO) Plan on January 1, 2014.

If you have any questions or would like further information, please call Member Services at 1-800-794-5907; from 8 a.m. to 8 p.m., 7 days a week. From February 15th to September 30th, we are open Monday – Friday from 8 a.m. to 8 p.m. TTY users should call 711.

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H1019_CPHPEDUMKTG2014REV Approved
Last Updated: 03/06/2014