CareFree Giveback (HMO) Medicare Advantage Plan H1019-149 • 2027
- Monthly Premium
- $0.00Plus Part B premium.
- Medical Deductible
- $0.00
- Maximum Out-of-Pocket
- $3850.00In-network
- Part B Giveback
- −$124.00 reduction
- Prescription Coverage
- Enhanced, $700.00 deductible
- Additional Benefits
- Dental, Vision, Hearing
- Service Area
- See List
- Total Enrollment
- 4,214 beneficiaries
CareFree Giveback (HMO) Introduction
CMS Plan ID H1019-149 identifies CareFree Giveback, a Medicare Advantage HMO plan offered by CarePlus Health Plans. The plan uses a Health Maintenance Organization (HMO) provider network and comes with prescription drug coverage. Its costs for the 2027 plan year include a $0.00 monthly premium, $0.00 medical deductible, and $3850.00 in-network maximum out-of-pocket. The 2027 Part D prescription drug deductible is $700.00.
Plan Benefits
CareFree Giveback includes cost-sharing, which refers to out-of-pocket expenses for covered healthcare services. The tables below outline the most common in-network out-of-pocket costs associated with plan H1019-149.
Compare 2027 plan benefits with 2026.
Office Visits
| Covered Service | 2027 | 2026 |
|---|---|---|
| Primary care | In-network: $0 copay | In-network: $0 copay |
| Specialist | In-network: $15 copay | In-network: $15 copay |
Preventive and Wellness Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Annual wellness exam | In-network: $0 copay | In-network: $0 copay |
| Telehealth benefit | In-network: $0-$65 copay | In-network: $0-$30 copay |
| Routine chiropractic | In-network: $20 copay | In-network: $20 copay |
| Fitness benefits | Coming soon | In-network: $0 copay |
| Health education | Not covered | Not covered |
| Counseling services | Not covered | Not covered |
| Over-the-counter drug benefits | Not covered | Not covered |
| Health transportation (non-emergency) | Coming soon | In-network: $0 copay |
Diagnostic, Lab, and Imaging Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Diagnostic radiology services | In-network: $0-$200 copay | In-network: $0-$200 copay |
| Lab services | In-network: $0 copay | In-network: $0 copay |
| Outpatient x-rays | In-network: $0-$125 copay | In-network: $0-$60 copay |
| Diagnostic tests and procedures | In-network: $0-$225 copay | In-network: $0-$250 copay |
Emergency and Urgent Care Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Emergency room care | $150 copay | $150 copay |
| Worldwide emergency care | Coming soon | $150 copay |
| Urgent care | $65 copay | $15 copay |
| Inpatient hospital care | Tier 1 $175 per day for days 1-5 $0 per day for days 6-90 $0 per stay |
Tier 1 $150 per day for days 1-5 $0 per day for days 6-90 $0 per stay |
| Skilled Nursing Facility | Tier 1 $0 per day for days 1-20 $160 per day for days 21-100 |
Tier 1 $0 per day for days 1-20 $203 per day for days 21-100 |
| Ground ambulance | In-network: $0-$150 copay | In-network: $0-$335 copay |
Mental Health Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Outpatient individual therapy | In-network: $25 copay | In-network: $30 copay |
| Outpatient group therapy | In-network: $25 copay | In-network: $30 copay |
| Inpatient psychiatric hospital care | Tier 1 $175 per day for days 1-5 $0 per day for days 6-90 $0 per stay |
Tier 1 $150 per day for days 1-5 $0 per day for days 6-90 $0 per stay |
Rehabilitation Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Physical therapy and speech and language therapy | In-network: $20 copay | In-network: $15 copay |
| Occupational therapy | In-network: $20 copay | In-network: $15 copay |
Medical Equipment and Supplies
| Covered Service | 2027 | 2026 |
|---|---|---|
| Diabetes supplies | In-network: $0 copay | In-network: $0 copay |
| Durable medical equipment | In-network: 20% coinsurance | In-network: $0 copay, 20% coinsurance |
| Prosthetics | In-network: 20% coinsurance | In-network: 20% coinsurance |
Medicare Part B Drugs
| Covered Service | 2027 | 2026 |
|---|---|---|
| Chemotherapy | In-network: 0%-20% coinsurance | In-network: 0%-20% coinsurance |
| Other Part B drugs (Medicare-covered) | In-network: 0%-20% coinsurance | In-network: 0%-20% coinsurance |
Dental Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Oral exam | In-network: $0 copay | In-network: $0 copay |
| Dental x-rays | In-network: $0 copay | In-network: $0 copay |
| Cleaning | In-network: $0 copay | In-network: $0 copay |
| Periodontics | In-network: 0% coinsurance | In-network: $0 copay |
| Endodontics | In-network: 0% coinsurance | In-network: $0 copay |
| Restorative services | In-network: 0%-30% coinsurance | In-network: $0 copay |
| Implant services | Not covered | Not covered |
| Orthodontics | Not covered | Not covered |
| Oral/Maxillofacial surgery | In-network: 0% coinsurance | In-network: $0 copay |
Vision Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Routine eye exam | In-network: $0 copay | In-network: $0 copay |
| Contact lenses | In-network: $0 copay | In-network: $0 copay |
| Eyeglass frames only | Not covered | Not covered |
| Eyeglass lenses only | Not covered | Not covered |
| Eyeglasses (frames & lenses) | In-network: $0 copay | In-network: $0 copay |
| Upgrades | Not covered | Not covered |
Hearing Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Hearing exam | In-network: $0 copay | In-network: $0 copay |
| Fitting/evaluation | In-network: $0 copay | In-network: $0 copay |
| Prescription hearing aids | In-network: $299-$575 copay | In-network: $0 copay |
| OTC hearing aids | Not covered | Not covered |
Additional and Special Needs Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Adult day health services | Not covered | Not covered |
| Home-based palliative care | Not covered | Not covered |
| Personal emergency response system | Coming soon | Not covered |
| Weight management programs | Not covered | Not covered |
| Wigs for chemotherapy-related hair loss | Coming soon | Not covered |
| Alternative therapies | Not covered | Not covered |
| Massage therapy | Not covered | Not covered |
| Home/bathroom safety devices | Not covered | Not covered |
Certain preventive services are covered 100% by CareFree Giveback as a Part B benefit.
Prescription Drug Coverage
CareFree Giveback 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: | ($23.00) |
| Supplemental Part D Premium: | $$23.00 |
| 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 starts contributing towards your prescription costs.
Prescription Drug Plan Out-of-Pocket Costs
Beyond premiums and deductibles, CareFree Giveback 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
- Website
- CarePlus Health Plans Plan Page
- Providers
- CarePlus Health Plans Providers Page
- Formulary
- CarePlus Health Plans Formulary Page
- Pharmacy
- CarePlus Health Plans 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.
Plan Availability
CareFree Giveback (H1019-149-0) is available in the following locations:
Frequently Asked Questions
Here are some of the most frequently asked questions about this plan (click to open).
Frequently Asked Questions About CareFree Giveback (HMO)
What is the monthly premium for CareFree Giveback (HMO)?
The plan’s monthly premium is $0.00 for 2027. The Part B premium is not included.
What is the in-network MOOP for plan H1019-149?
The annual in-network MOOP is $3850.00 for 2027. After this limit is reached, covered in-network services are fully paid.
What is the CMS star rating for this plan?
CMS rates this plan at ★4.0 out of 5 stars for 2027.
How many beneficiaries are enrolled in this plan?
CMS reports 4,214 beneficiaries enrolled in this plan.
What is the Part D deductible for plan H1019-149?
The Part D deductible is $700.00.
Medicare Plan Data Sources and Methodology
| Data Source | Publisher | CMS Version |
|---|---|---|
| Landscape Source Files | Centers for Medicare & Medicaid Services | CY2027 Landscape (202609.1) |
| Medicare Part C & D Performance | Centers for Medicare & Medicaid Services | 2027 Star Ratings Data Tables |
| Plan Benefits Package | Centers for Medicare & Medicaid Services | PBP Benefits-2027 |
| Monthly Enrollment by Contract/Plan/State/County | Centers for Medicare & Medicaid Services | 2026-09 |
Data sources and methodology documentation.
| Publisher | Reference | Last Accessed |
|---|---|---|
| CarePlus Health Plans (official source) | http://www.careplushealthplans.com | October 4, 2026 |
| Medicare.gov | Understanding Medicare Advantage Plans | 25 May, 2025 |
| AARP.org | The Big Choice: Original Medicare vs. Medicare Advantage | 25 May, 2025 |
| Medicare.gov | Explore your Medicare coverage options | 25 May, 2025 |
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