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Simply Complete Platinum (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Simply Complete Platinum (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Simply Complete Platinum (HMO D-SNP) in 2025, please refer to our full plan details page.
Simply Complete Platinum (HMO D-SNP) is a HMO D-SNP plan offered by Elevance Health, Inc. available for enrollment in 2025 to people living in Broward, Palm Beach. This plan received an overall rating of 4.5 out of 5 stars in 2025.
It's important to know that Simply Complete Platinum (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Simply Complete Platinum (HMO D-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Simply Complete Platinum (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.
For Simply Complete Platinum (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $590.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $500.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
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:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The Simply Complete Platinum (HMO D-SNP) plan has an "Enhanced Alternative" drug benefit. The plan has a deductible of $590.00. During the initial coverage phase, after you pay your deductible, you will pay a copay or coinsurance depending on the drug tier and pharmacy used. For example, you will pay a $4.00 copay for preferred generic drugs at a standard or mail order pharmacy. Once your total drug costs reach $2000.00, you enter the catastrophic coverage phase, where you pay nothing for Part D covered drugs.
Additional Benefits
The Simply Complete Platinum (HMO D-SNP) plan offers a wide range of benefits with $0 copays for many services. This includes inpatient and outpatient hospital care, primary care, preventive services, hearing and vision exams, dental, home infusion, dialysis, and home health services. The plan also covers ambulance, emergency, and transportation services with no copay. Additional benefits include coverage for medical equipment, diagnostic and radiological services, and skilled nursing facilities. There are also over-the-counter (OTC) items and a meal benefit with no copay. While the plan offers many benefits, services like cardiac rehabilitation, acupuncture, and certain other services are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered with no copay. Additional days, non-Medicare-covered stays, and upgrades for inpatient hospital acute and psychiatric care are not covered.
Outpatient Services See details
Outpatient Services, including outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services, are covered with no copay. Prior authorization and a doctor referral are required for some services.
Partial Hospitalization See details
Partial Hospitalization is covered under the Simply Complete Platinum (HMO D-SNP) plan, with no copay required. Prior authorization and a doctor referral are needed to receive this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Simply Complete Platinum (HMO D-SNP) plan, with no coinsurance for all services. Ground and Air Ambulance Services have no copay, while Transportation Services to a plan-approved health-related location have no copay.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the Simply Complete Platinum (HMO D-SNP) plan. There is no copay or coinsurance for Emergency Services, Urgently Needed Services, Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
The Simply Complete Platinum (HMO D-SNP) plan covers primary care physician services, chiropractic services, occupational therapy services, physician specialist services, mental health specialty services, podiatry services, other health care professional, psychiatric services, physical therapy and speech-language pathology services, additional telehealth benefits, and opioid treatment program services. Primary care physician services, chiropractic services, physician specialist services, individual and group sessions for mental health specialty services, and additional telehealth benefits have no copay. Occupational therapy, podiatry services, other health care professional, psychiatric services, and opioid treatment program services have no copay. Physical therapy and speech-language pathology services have no copay.
Preventive Services See details
Preventive Services are covered, with some services requiring a doctor referral. Medicare-covered preventive services have no copay and additional preventive services are available with no copay for services such as Health Education and Fitness Benefit. Annual physical exams, in-home safety assessments, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, and telemonitoring services are not covered.
Hearing Services See details
The Simply Complete Platinum (HMO D-SNP) plan covers hearing exams and routine hearing exams with no copay, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids are covered, but inner ear, outer ear, and over-the-ear prescription hearing aids are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision services include eye exams and eyewear, with no copay for eye exams, contact lenses, eyeglasses (lenses and frames), and eyeglass lenses. Eyeglass frames are limited to one pair per year, and eyewear has a combined maximum benefit of $400 per year. Upgrades are not covered.
Dental Services See details
Dental services are covered, including oral exams, dental x-rays, prophylaxis (cleaning), restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), oral and maxillofacial surgery, and maxillofacial prosthetics with no copay. Fluoride treatment, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Simply Complete Platinum (HMO D-SNP) plan, including Medicare Part B Insulin Drugs, and Medicare Part B Chemotherapy/Radiation Drugs, with a $0 copay. Other Medicare Part B Drugs are also covered, with a copay between $0 and $0.
Dialysis Services See details
Dialysis Services are covered with no copay and no coinsurance.
Medical Equipment See details
Medical Equipment benefits are covered, with Durable Medical Equipment (DME) covered with no coinsurance and no copay, and Prosthetics/Medical Supplies - Non-Medicare benefits covered with no coinsurance but with a copay. Diabetic Equipment is also covered, with a copay for Medicare-covered Diabetes Supplies and Diabetic Therapeutic Shoes/Inserts.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures and tests, lab services, diagnostic radiological services, therapeutic radiological services, and outpatient X-ray services. Lab services have no copay, and Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the Simply Complete Platinum (HMO D-SNP) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Simply Complete Platinum (HMO D-SNP) plan. Prior authorization and a doctor referral are required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but additional days beyond Medicare-covered SNF stays and non-Medicare-covered SNF stays are not covered. A doctor referral and prior authorization are required.
Other Services See details
The Simply Complete Platinum (HMO D-SNP) plan covers Over-the-Counter (OTC) Items with no copay, and a maximum benefit of $135.00 per month. The plan also covers a Meal Benefit with no copay, but does not cover Acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services.
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