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 Orange, Osceola, Seminole, Volusia. 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 prescription drug deductible of $615. Under this plan, you will pay no copay for Tier 1 preferred generic drugs and Tier 6 supplemental drugs filled at standard pharmacies or through standard mail order. This no-copay benefit applies to one-month, two-month, and three-month supplies of these medications. For other drug tiers, you will typically pay a 25% coinsurance at standard pharmacies and standard mail order services. This 25% coinsurance rate applies to Tier 2 generic and Tier 3 preferred brand drugs for all supply lengths, as well as one-month supplies of Tier 4 non-preferred drugs and Tier 5 specialty drugs.

Additional Benefits

The Simply Complete (HMO D-SNP) plan offers comprehensive medical coverage with no copay and no coinsurance for most essential services, including inpatient and outpatient hospital care, primary and specialist visits, preventive care, and emergency services. While most healthcare services cost nothing out of pocket, a 20% coinsurance applies to dialysis and therapeutic radiological services. Additionally, members benefit from covered medical equipment, home health services, and skilled nursing facility stays for up to 100 days at no cost. This plan also features robust supplemental benefits, including dental care up to $1,200 annually, vision exams and eyewear up to a $350 annual limit, and hearing aids up to $1,500 per year, all with no copays or deductibles. Members also receive unlimited one-way rides to plan-approved medical locations, an $80 monthly allowance for over-the-counter items, and chronic illness meal benefits at no extra cost. These additional perks make it easier to manage daily health needs without worrying about unexpected expenses.