Florida Complete Care-Duals VIP (HMO-POS D-SNP)
Available to residents of Volusia County, FL for 2026. Contract H9986, plan 004, segment 1.
- ✉ Email a copy of the plan benefit details
- Plan health benefits
- Benefits in plain text
- Rx cost-sharing for all pharmacies and tiers
- Other plans in Volusia County
- Plan website
- Browse the Florida Complete Care-Duals VIP (HMO-POS D-SNP) formulary
Plan details
| Monthly premium (Part C + D) | $4.80 |
|---|---|
| — medical (Part C) part | $0.00 |
| — drug (Part D) part | $4.80? |
| Drug premium in CMS's quarterly plan file | $0.00The CMS Landscape file above lists $4.80 for the drug part; the two CMS files differ for this plan. |
| Monthly premium with full Extra Help (LIS) | $0.00? |
| Part B premium reduction (giveback) | None |
| In-network out-of-pocket maximum | $3,400.00? |
| In- and out-of-network out-of-pocket maximum | $3,400.00 |
| Drug deductible | $615.00 |
| Drug out-of-pocket threshold | $2,100.00 |
| Plan type | HMO-POS D-SNP? |
| Special needs plan | Dual-eligible SNP |
| Contract / plan | H9986-004-1 |
| Offered by | Florida Complete Care |
| Parent organization | Independent Living Systems, LLC |
| Formulary drugs | 3,425 |
| Pharmacy search | www.fc2healthplan |
| Member services | (833)322-7526TTY 711 |
CMS star ratings
- Overall
- —
- Health plan (Part C)
- 2.5 out of 5 stars for Health plan (Part C)
- Drug plan (Part D)
- 4.5 out of 5 stars for Drug plan (Part D)
Published per contract — every plan under contract H9986 shares this rating.
Plan health benefits
| Service | In-network |
|---|---|
| Doctor visits | |
| Primary care doctor | $0 copay |
| Specialist | 20% coinsurance |
| Other health care professional | 20% coinsurance |
| Additional telehealth services | 0%–20% coinsurance |
| Preventive care | |
| Medicare-covered preventive services | $0 copay |
| Annual physical exam | Not covered |
| Kidney disease education | $0 copay |
| Glaucoma screening | $0 copay |
| Diabetes self-management training | $0 copay |
| Diagnostic tests, labs and imaging | |
| Diagnostic tests and procedures | 20% coinsurance(authorization required) |
| Lab services | 20% coinsurance(authorization required) |
| Diagnostic radiology (e.g. MRI, CT) | 20% coinsurance(authorization required) |
| Therapeutic radiology | 20% coinsurance(authorization required) |
| Outpatient x-rays | 20% coinsurance(authorization required) |
| Emergency and urgent care | |
| Emergency room | 20% coinsurance |
| Urgent care | 20% coinsurance |
| Worldwide emergency coverage | Not covered |
| Worldwide urgent care | Not covered |
| Worldwide emergency transportation | Not covered |
| Hospital care | |
| Inpatient hospital stay | Original Medicare cost-sharing(authorization required) |
| Outpatient hospital services | 20% coinsurance(authorization required) |
| Outpatient observation | 20% coinsurance |
| Ambulatory surgical center | 20% coinsurance(authorization required) |
| Outpatient blood services | 20% coinsurance(authorization required) |
| Skilled nursing and home health | |
| Skilled nursing facility | $0 per stay(authorization required) |
| Home health care | $0 copay(authorization required) |
| Kidney dialysis | 20% coinsurance(authorization required) |
| Rehabilitation | |
| Occupational therapy | 20% coinsurance(authorization required) |
| Physical therapy and speech-language therapy | 20% coinsurance(authorization required) |
| Cardiac rehabilitation | 20% coinsurance(authorization and referral required) |
| Pulmonary rehabilitation | 20% coinsurance(authorization and referral required) |
| Mental health and substance use | |
| Inpatient psychiatric hospital stay | Original Medicare cost-sharing(authorization required) |
| Outpatient mental health, individual session | 20% coinsurance(authorization required) |
| Outpatient mental health, group session | 20% coinsurance(authorization required) |
| Psychiatrist, individual session | 20% coinsurance(authorization required) |
| Psychiatrist, group session | 20% coinsurance(authorization required) |
| Partial hospitalization | 20% coinsurance(authorization required) |
| Intensive outpatient program | 20% coinsurance |
| Outpatient substance use, individual session | 20% coinsurance(authorization required) |
| Outpatient substance use, group session | 20% coinsurance(authorization required) |
| Opioid treatment program | 20% coinsurance(authorization required) |
| Ambulance and transportation | |
| Ground ambulance | 20% coinsurance(authorization required) |
| Air ambulance | 20% coinsurance(authorization required) |
| Transportation to plan-approved locations | $0 copay |
| Medical equipment and supplies | |
| Durable medical equipment (e.g. wheelchairs, oxygen) | 20% coinsurance(authorization required) |
| Prosthetics (e.g. braces, artificial limbs) | 20% coinsurance(authorization required) |
| Medical supplies | 20% coinsurance(authorization required) |
| Diabetes supplies | 20% coinsurance(authorization required) |
| Diabetic therapeutic shoes or inserts | 20% coinsurance(authorization required) |
| Chiropractic, acupuncture and foot care | |
| Chiropractic (Medicare-covered) | 20% coinsurance(authorization required) |
| Routine chiropractic care | Not covered |
| Acupuncture | Not covered |
| Foot exams and treatment (Medicare-covered) | 20% coinsurance(authorization required) |
| Routine foot care | $0 copay(authorization required, limits apply) |
| Dental? | |
| Medicare-covered dental services | 20% coinsurance |
| Preventive dental plan limit | $1,165 plan limit every three months |
| Oral exams | $0 copay(authorization required, limits apply) |
| Cleanings | $0 copay(authorization required, limits apply) |
| Fluoride treatment | Not covered |
| Dental x-rays | $0 copay(authorization required, limits apply) |
| Other diagnostic dental services | $0 copay(authorization required) |
| Other preventive dental services | $0 copay(authorization required) |
| Restorative services (fillings, crowns) | $0 copay(authorization required) |
| Endodontics (root canals) | $0 copay(authorization required) |
| Periodontics (gum disease) | $0 copay(authorization required) |
| Dentures and other removable prosthodontics | $0 copay(authorization required) |
| Maxillofacial prosthetics | $0 copay(authorization required) |
| Implants | $0 copay(authorization required) |
| Bridges and other fixed prosthodontics | $0 copay(authorization required) |
| Oral and maxillofacial surgery | $0 copay(authorization required) |
| Orthodontics | Not covered |
| Adjunctive general services | $0 copay(authorization required) |
| Vision? | |
| Eye exam (Medicare-covered) | 20% coinsurance(limits apply) |
| Routine eye exam | $0 copay(limits apply) |
| Eyewear after cataract surgery (Medicare-covered) | 20% coinsurance(limits apply) |
| Contact lenses | $0 copay(limits apply) |
| Eyeglasses (frames and lenses) | $0 copay(limits apply) |
| Eyeglass lenses | $0 copay(limits apply) |
| Eyeglass frames | $0 copay(limits apply) |
| Eyewear upgrades | Not covered |
| Hearing? | |
| Hearing exam (Medicare-covered) | 20% coinsurance(limits apply) |
| Routine hearing exam | $0 copay(limits apply) |
| Hearing aid fitting and evaluation | $0 copay(limits apply) |
| Hearing aids (all types) | $0 copay(limits apply) |
| Hearing aids, inner ear | Not covered |
| Hearing aids, outer ear | Not covered |
| Hearing aids, over the ear | Not covered |
| Medicare Part B drugs | |
| Part B insulin | $35 copay(authorization required) |
| Chemotherapy and radiation drugs | 0%–20% coinsurance(authorization required) |
| Other Part B drugs | 0%–20% coinsurance(authorization required) |
| Other extra benefits? | |
| Over-the-counter (OTC) allowance | $100 allowance every month |
| Meals after a hospital stay or for a chronic condition | $0 copay(authorization required) |
| Fitness benefit | Not covered |
| Health education | Not covered |
| Nutritional / dietary benefit | Not covered |
| Extra smoking and tobacco cessation counseling | Not covered |
| Enhanced disease management | Not covered |
| Telemonitoring | Not covered |
| Remote access technologies (web/phone, nurse line) | Not covered |
| Home and bathroom safety devices | Not covered |
| Counseling services | Not covered |
| In-home safety assessment | Not covered |
| Personal emergency response system (PERS) | Not covered |
| Medical nutrition therapy | Not covered |
| Post-discharge in-home medication reconciliation | Not covered |
| Re-admission prevention | Not covered |
| Wigs for hair loss from chemotherapy | Not covered |
| Weight management programs | Not covered |
| Alternative therapies | Not covered |
| Therapeutic massage | Not covered |
| Adult day health services | Not covered |
| Home-based palliative care | Not covered |
| In-home support services | Not covered |
| Support for caregivers | Not covered |
In-network cost-sharing as the plan filed it with CMS (CMS plan benefit package (PBP) files, CY2026). A range means the cost depends on the service or setting. Rows the filing does not state are left out rather than guessed. Contact the plan for the full Evidence of Coverage.
Drug tiers — preferred pharmacy, initial coverage
| Tier | Cost-sharing |
|---|---|
| Tier 1 | 25% |
Rx cost-sharing by coverage phase
| Tier | 30-day supply | 90-day supply | ||||
|---|---|---|---|---|---|---|
| Preferred | Standard | Mail Order | Preferred | Standard | Mail Order | |
| Initial coverage phase | ||||||
| Tier 1: Preferred Generic | 25% | 25% | n/a | 25% | 25% | 25% |
| Catastrophic coverage phase | ||||||
| Tier 1: Preferred Generic | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
Also available in 5 other FL counties
Benefits in plain text
Florida Complete Care-Duals VIP (HMO-POS D-SNP) (H9986-004-1) is a 2026 HMO-POS D-SNP Medicare Advantage plan offered by Florida Complete Care, available to residents of Volusia County, FL.
The monthly premium is $4.80 (Part C and Part D together).
With full Extra Help (the Low-Income Subsidy), the total monthly premium is $0.00.
Its in-network out-of-pocket maximum is $3,400.00.
The combined in- and out-of-network out-of-pocket maximum is $3,400.00.
The drug deductible is $615.00.
It is a special needs plan (Dual-eligible SNP).
The plan's formulary lists 3,425 drugs.
At a preferred pharmacy in the initial coverage phase, a 30-day supply costs tier 1: 25%.
Email a copy of the plan benefit details
Plan facts come from the CMS quarterly prescription drug plan public use files; the premium split, Extra Help premium, MOOP and plan type from the CMS Landscape file; the Part B giveback and health benefits from the CMS plan benefit package (PBP) files.