Simply Complete (HMO D-SNP)

Simply Complete (HMO D-SNP) is a HMO D-SNP plan offered by Elevance Health, Inc. available for enrollment in 2025 to people living in Polk. This plan received an overall rating of 4.5 out of 5 stars in 2026.

It's important to know that Simply Complete (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.

Key Plan Facts

Below are a few key facts and commonly-asked questions about Simply Complete (HMO D-SNP).

Plan Costs:

The cost of a Medicare Advantage Plan is made up of four main parts.

• First, the monthly premium — the amount you pay every month.
• Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
• Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
• Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.

You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.

Common Services:

Drug Coverage

The Simply Complete (HMO D-SNP) Medicare plan features an annual drug deductible of $615. Under this plan, you will pay no copay for Tier 1 preferred generic, Tier 2 generic, and Tier 6 supplemental drugs filled at standard retail pharmacies or through standard mail order. This ensures affordable access to a wide range of essential everyday medications. For higher-tier medications, members are responsible for a 25% coinsurance. This 25% coinsurance applies to Tier 3 preferred brand drugs, as well as one-month supplies of Tier 4 non-preferred drugs and Tier 5 specialty drugs. This structure helps you clearly anticipate your out-of-pocket costs at standard pharmacies and mail-order services.

Additional Benefits

The Simply Complete (HMO D-SNP) plan offers comprehensive healthcare coverage with no copays and no coinsurance for the vast majority of its medical and hospital services. Members can access inpatient and outpatient hospital care, primary and specialist visits, emergency services, and skilled nursing facility stays without out-of-pocket costs for copays or coinsurance. Additionally, essential support services like unlimited medical transportation to plan-approved locations, home health care, and medical equipment are covered at no cost, though some services require prior authorization or referrals. This plan also features robust supplemental benefits, including no-copay dental care up to $1,200 annually, vision coverage with a $400 annual eyewear allowance, and hearing aids up to a $2,000 limit. Members also benefit from an $80 monthly allowance for over-the-counter items and covered meal benefits for qualifying chronic conditions. While most care is free of cost-sharing, a 20% coinsurance applies to dialysis and therapeutic radiological services.