CareOne Plus (HMO-POS) Medicare Advantage Plan H1019-043 • 2027 • Indian River County, FL
- Monthly Premium
- $0.00Plus Part B premium.
- Medical Deductible
- $0.00
- Maximum Out-of-Pocket
- $4000.00In-network
- Part B Giveback
- Not offered
- Prescription Coverage
- Enhanced, $700.00 deductible
- Additional Benefits
- Dental, Vision, Hearing
- Service Area
- Indian River County, FL
- Local Enrollment
- 270 beneficiaries in Indian River County
CareOne Plus (HMO-POS) Introduction
This Medicare Advantage HMO-POS plan, CareOne Plus, is offered by CarePlus Health Plans, Inc. and uses a Health Maintenance Organization with a Point of Service (HMO-POS) provider network. It comes with prescription drug coverage. For the 2027 plan year, the monthly premium is $0.00, the medical deductible is $0.00, and the in-network maximum out-of-pocket is $4000.00. The plan is identified by CMS Plan ID H1019-043. The 2027 Part D prescription drug deductible is $700.00.
Enrollment in this plan requires residence in Indian River County, Florida. CMS enrollment data reports 270 plan members in Indian River County. New members can call the plan directly at (888)685-8607 (TTY 711) for assistance.
Compare Similar Plans in Indian River County
Compare this plan with the two most-enrolled HMO-POS plans available in Indian River County, Florida. Enrollment is based on CMS local enrollment data.
| Plan Detail | CareOne Plus | AARP Medicare Advantage from UHC FL-0006 | AARP Medicare Advantage from UHC FL-001P |
|---|---|---|---|
| CMS Plan ID | H1019-043-0 |
H1045-028-0 |
H1045-036-0 |
| Local Enrollment | 270 | 1,611 | 843 |
| Monthly Premium | $0.00 | $0.00 | $0.00 |
| Medical Deductible | $0.00 | Coming soon | $0.00 |
| Maximum Out-of-Pocket | $4,000.00 | $3,800.00 | $3,500.00 |
| Part B Giveback | Not offered | Coming soon | Not offered |
| Primary Care | $0 copay | Coming soon | $0 copay |
| Specialist | $15 copay | Coming soon | $0-$30 copay |
| Part D Deductible | $700.00 | $405.00 | $405.00 |
| CMS Star Rating | 4.0 | 4.0 | 4.0 |
| Dental | $0 copay | Coming soon | $0 copay |
| Vision | $0 copay | Coming soon | $0 copay |
| Hearing | $0 copay | Coming soon | $0 copay |
Want to explore more options? Browse all Medicare Advantage plans in Indian River County, or compare Medicare Advantage plans across Florida, including premiums, out-of-pocket costs, CMS ratings, and enrollment.
Plan Benefits
Cost-sharing for CareOne Plus includes out-of-pocket expenses for covered healthcare services. The following tables provide a summary of typical in-network out-of-pocket costs for plan H1019-043.
You can also compare 2027 costs and coverage with last year, side-by-side: Plan H1019-043-0 Cost Compare.
Office Visits
- Primary care
- In-network: $0 copay
- Specialist
- In-network: $15 copay
Out-of-network: $30 copay
Preventive and Wellness Services
- Annual wellness exam
- In-network: $0 copay
- Telehealth benefit
- In-network: $0-$15 copay
- Routine chiropractic
- In-network: $15 copay
- Fitness benefits
- Coming soon
- Health education
- Not covered
- Counseling services
- Not covered
- Over-the-counter drug benefits
- Not covered
- Health transportation (non-emergency)
- Coming soon
Diagnostic, Lab, and Imaging Services
- Diagnostic radiology services
- In-network: $0-$200 copay
Out-of-network: $0-$250 copay - Lab services
- In-network: $0 copay
Out-of-network: $0-$25 copay - Outpatient x-rays
- In-network: $0-$90 copay
Out-of-network: $10-$90 copay - Diagnostic tests and procedures
- In-network: $0-$30 copay
Out-of-network: $0-$30 copay
Emergency and Urgent Care Services
- Emergency room care
- $150 copay
- Worldwide emergency care
- Coming soon
- Urgent care
- $10 copay
- Inpatient hospital care
- In-network:
Tier 1
$225 per day for days 1-7
$0 per day for days 8-90
$0 per stay
Out-of-network:
$250 per day for days 1-7
$0 per day for days 8-90
$0 per stay - Skilled Nursing Facility
- In-network:
Tier 1
$0 per day for days 1-20
$203 per day for days 21-100
Out-of-network:
$0 per day for days 1-20
$203 per day for days 21-100
$0 per stay - Ground ambulance
- In-network: $0-$250 copay
Out-of-network: $0-$250 copay
Mental Health Services
- Outpatient individual therapy
- In-network: $10 copay
Out-of-network: $30 copay - Outpatient group therapy
- In-network: $10 copay
Out-of-network: $30 copay - Inpatient psychiatric hospital care
- In-network:
Tier 1
$225 per day for days 1-7
$0 per day for days 8-90
$0 per stay
Out-of-network:
$250 per day for days 1-7
$0 per day for days 8-90
$0 per stay
Rehabilitation Services
- Physical therapy and speech and language therapy
- In-network: $15 copay
Out-of-network: $30-$45 copay - Occupational therapy
- In-network: $15 copay
Out-of-network: $30-$45 copay
Medical Equipment and Supplies
- Diabetes supplies
- In-network: $0 copay
Out-of-network: $0 copay - Durable medical equipment
- In-network: 20% coinsurance
Out-of-network: 50% coinsurance - Prosthetics
- In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Medicare Part B Drugs
- Chemotherapy
- In-network: 0%-20% coinsurance
Out-of-network: 20% coinsurance - Other Part B drugs (Medicare-covered)
- In-network: 0%-20% coinsurance
Out-of-network: 20% coinsurance
Dental Services
- Oral exam
- In-network: $0 copay
- Dental x-rays
- In-network: $0 copay
- Cleaning
- In-network: $0 copay
- Periodontics
- In-network: $0 copay
- Endodontics
- Not covered
- Restorative services
- In-network: $0 copay
- Implant services
- Not covered
- Orthodontics
- Not covered
- Oral/Maxillofacial surgery
- In-network: $0 copay
Vision Services
- Routine eye exam
- In-network: $0 copay
- Contact lenses
- In-network: $0 copay
- Eyeglass frames only
- Not covered
- Eyeglass lenses only
- Not covered
- Eyeglasses (frames & lenses)
- In-network: $0 copay
- Upgrades
- Not covered
Hearing Services
- Hearing exam
- In-network: $0 copay
- Fitting/evaluation
- In-network: $0 copay
- Prescription hearing aids
- In-network: $575-$750 copay
- OTC hearing aids
- Not covered
Additional and Special Needs Services
- Adult day health services
- Not covered
- Home-based palliative care
- Not covered
- Personal emergency response system
- Coming soon
- Weight management programs
- Not covered
- Wigs for chemotherapy-related hair loss
- Coming soon
- Alternative therapies
- Not covered
- Massage therapy
- Not covered
- Home/bathroom safety devices
- Not covered
Certain preventive services are covered 100% by CareOne Plus as a Part B benefit.
Prescription Drug Coverage
CareOne Plus includes a Medicare Part D prescription drug plan (PDP). Plan type and coverage level are defined by CMS and may vary between basic and enhanced benefit designs.
This plan includes an enhanced benefit Medicare Part D plan (PDP), providing coverage beyond the standard CMS-defined minimum.
Prescription Drug Plan Premium
The Part D prescription drug plan premium is included in the overall Medicare Advantage plan cost. Additional adjustments may apply through the Low-Income Subsidy (LIS) program, also known as Extra Help, administered by Social Security. LIS benefits are separate from Medicare Special Needs Plan coverage.
| Part D Premium Component | Amount |
|---|---|
| Basic Part D Premium: | ($30.60) |
| Supplemental Part D Premium: | $$30.60 |
| Total Part D Premium: | $0.00 |
| Low-Income Premium Subsidy: | $7.28 |
| Low-Income Premium Subsidy Paid by CMS: | $0.00 |
| Low-Income Subsidy Premium: | $0.00 |
For more details, visit the Social Security Extra Help program .
Prescription Drug Plan Deductible
This plan has a $700.00 annual Part D deductible. You'll pay this deductible at the pharmacy before CarePlus Health Plans, Inc. starts contributing towards your prescription costs.
Prescription Drug Plan Out-of-Pocket Costs
Beyond premiums and deductibles, CareOne Plus may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.
| Drug Tier | Retail | Mail Order |
|---|---|---|
| Preferred Generic | $0.00 copay | Coming soon |
| Generic | $0.00 copay | Coming soon |
| Preferred Brand | 17% coinsurance | Coming soon |
| Non-Preferred Drug | 50% coinsurance | Coming soon |
| Specialty Tier | 25% coinsurance | Coming soon |
| *Deductible does not apply. | ||
CMS 5-Star Performance Ratings (Contract ID: H1019)
CMS evaluates Medicare Advantage (Part C) and Part D plans annually using a 5-star rating system. Ratings reflect performance in preventive care, chronic condition management, and member experience.
| CMS Measure | Star Rating |
|---|---|
| 2027 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | |
| Managing Chronic (Long Term) Conditions | |
| Member Experience with Health Plan | |
| Complaints and Changes in Plans Performance | |
| Health Plan Customer Service | |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | |
| Member Experience with the Drug Plan | |
| Drug Safety and Accuracy of Drug Pricing |
Contact Information for CarePlus Health Plans, Inc.
- Website
- CarePlus Health Plans, Inc. Plan Page
- Providers
- CarePlus Health Plans, Inc. Providers Page
- Formulary
- CarePlus Health Plans, Inc. Formulary Page
- Pharmacy
- CarePlus Health Plans, Inc. Pharmacy Page
- New Member Health Plan Help
- (888)685-8607
- New Member Health Plan TTY
- 711
- New Member Part D Help
- (888)685-8607
- New Member Part D TTY Users
- 711
Enrollment status and eligibility information are available through the Social Security Administration. Additional information about Medicare Advantage is available at Medicare.gov.
Medicare Advantage Plan Availability
CareOne Plus is available to eligible Medicare beneficiaries residing in Indian River County, Florida, including communities such as Fellsmere, Sebastian, Vero Beach, and other areas throughout the county. Enrollment eligibility is based on county of residence, not city.
Medicare Plan Data Sources and Methodology
| Data Source | Publisher | Last Accessed |
|---|---|---|
| Landscape Source Files | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Medicare Part C & D Performance | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Plan Benefits Package | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Monthly Enrollment by Contract/Plan/State/County | Centers for Medicare & Medicaid Services | October 5, 2026 |
Data sources and methodology documentation.
| Publisher | Reference | Last Accessed |
|---|---|---|
| CarePlus Health Plans, Inc. (official source) | http://www.careplushealthplans.com | October 4, 2026 |
| CMS.gov | Medicare Advantage Plan Fact Sheet | 25 May, 2025 |
| AARP.org | The Big Choice: Original Medicare vs. Medicare Advantage | 25 May, 2025 |
| Medicare.gov | Your coverage options | 25 May, 2025 |
MedicarePlans.com is an independent informational resource and is not affiliated with or endorsed by the U.S. Government or the federal Medicare program.
Data provenance documentation is maintained in alignment with the U.S. Core Data for Interoperability (USCDI) Provenance standard.
Page content independently curated and maintained by David W. Bynon, Editorial Steward, using a standardized, data-driven methodology for accurate, non-commercial Medicare plan interpretation and resolution.