Networks change. We verify your specific CarePlus Health Plans plan before your first visit; call with your member ID and we will confirm benefits, copay and any referral or authorization requirements.
Also appears on cards as: CarePlus, CarePlus Medicare, CarePlus (Humana), CareOne, CareFree, CareComplete. Offered in Florida.
CarePlus Health Plans is a Florida-only Medicare Advantage HMO owned by Humana and operated as a separate brand, with its largest memberships in Miami-Dade, Broward and Palm Beach counties and a presence along the Treasure Coast, in Brevard County and in Northeast Florida. CarePlus plans are known for low or zero premiums and extra benefits, and all of them are HMO designs that require members to use the CarePlus network. Behavioral health benefits are administered by Carelon Behavioral Health, which maintains the psychiatry network and handles authorizations. Most CarePlus plans cover outpatient psychiatry, medication management and psychotherapy for a fixed mental health copay with no deductible, and most do not require a primary care referral for behavioral health, although some plan designs do.
Telehealth mental health visits from home are typically covered at the same copay as office visits for members located in Florida during the appointment. For Deep TMS, CarePlus must cover what Original Medicare covers and applies Medicare's criteria for severe major depressive disorder after failure of at least two antidepressants and a psychotherapy trial, with prior authorization through Carelon required and a standard course typically approved on documented need. Spravato is covered as a Part B drug with prior authorization, with documentation of treatment-resistant depression, a concurrent oral antidepressant and REMS-certified administration. Many CarePlus members hold plans with low cost sharing, but per-session TMS copays and the Spravato cost share vary by plan, so our staff verify your benefits before treatment begins.
What we check before your visit
- Whether your plan is in network at the office you chose and for telehealth
- Your copay or coinsurance for an evaluation and for follow-ups
- Whether a primary-care referral is required (common with HMO plans)
- Prior-authorization criteria for Deep TMS and Spravato, if those are being considered
Frequently asked questions
Does Stedfast Psychiatry accept CarePlus?
Stedfast Psychiatry accepts CarePlus Medicare Advantage plans at our Florida offices where contracted through Carelon Behavioral Health, which administers mental health for CarePlus. Networks differ among CarePlus plan designs and counties, so confirm your plan by calling the behavioral health number on your card or asking our front desk to verify before scheduling.
Do I need a referral to see a psychiatrist on CarePlus?
Most CarePlus plans allow direct access to in-network behavioral health without a primary care referral, but a few plan designs require one. Your evidence of coverage states the rule for your plan, and we check it when we verify your eligibility. If a referral is needed, your primary care office can usually send it the same day.
What is the copay for a psychiatry visit on CarePlus?
Most CarePlus plans charge a fixed copay for outpatient mental health visits with no deductible, and dual-eligible members typically pay nothing. Telehealth visits usually carry the same copay as office visits. Your evidence of coverage lists the mental health specialty visit amount, and our front desk can confirm it before your appointment.
Will CarePlus cover Deep TMS or Spravato?
Both are covered under Medicare's criteria with prior authorization through Carelon Behavioral Health. TMS requires documented failure of at least two antidepressants and a psychotherapy trial; Spravato requires treatment-resistant depression and a concurrent oral antidepressant. Our Palm Beach Gardens TMS team and Spravato offices submit the request through Carelon's portal and confirm your cost share before scheduling.