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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 2026, 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 2026.
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 $4.80. 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 $615.00 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) Medicare plan features an annual drug deductible of $615 before coverage begins. Under this plan, you will enjoy no copay for Tier 1 preferred generic drugs and Tier 6 supplemental drugs when using standard pharmacies or standard mail-order services. For Tier 2 generic and Tier 3 preferred brand drugs, the plan requires a 25% coinsurance for one-month, two-month, and three-month supplies. Additionally, Tier 4 non-preferred drugs and Tier 5 specialty drugs are subject to a 25% coinsurance for a one-month supply at standard pharmacies and through standard mail order.
Additional Benefits
The Simply Complete Platinum (HMO D-SNP) offers comprehensive coverage with no copays and no coinsurance for almost all primary medical services. Members can access inpatient and outpatient hospital care, emergency services, primary care, and specialist visits completely free of out-of-pocket costs. Additionally, essential services like diagnostic tests, medical equipment, and skilled nursing facility care for up to 100 days are covered with no copay or coinsurance. This plan also features valuable supplemental benefits, including dental care up to $1,500 annually and eyewear up to $400 per year with no copay or coinsurance. Members also benefit from no-cost routine hearing exams, a hearing aid allowance of up to $2,000, and a $115 monthly allowance for over-the-counter items. Although some services require prior authorization or referrals, this plan provides extensive, affordable coverage for your health and wellness needs.
Inpatient Hospital See details
Simply Complete Platinum (HMO D-SNP) covers inpatient acute and psychiatric hospital stays with no copay and no coinsurance, although prior authorization and referrals are required. Additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by Simply Complete Platinum (HMO D-SNP) with no copays and no coinsurance, including outpatient hospital, ambulatory surgical center, outpatient substance abuse, and blood services. Prior authorization and referrals are required for most of these covered outpatient benefits.
Partial Hospitalization See details
Partial hospitalization services are covered by Simply Complete Platinum (HMO D-SNP) with no copay and no coinsurance. Members will need to obtain a referral and prior authorization before receiving these services.
Ambulance and Transportation Services See details
Simply Complete Platinum (HMO D-SNP) covers ground and air ambulance services with no copay and no coinsurance, though prior authorization is required. Transportation services are partially covered with no copay or coinsurance for unlimited one-way trips to plan-approved locations, but transportation to any health-related location is not covered.
Emergency Services See details
Simply Complete Platinum (HMO D-SNP) covers emergency and urgently needed services with no copay and no coinsurance. Worldwide emergency, urgent, and transportation services are also covered with no copay or coinsurance, up to a maximum benefit limit of $100,000.
Primary Care See details
Simply Complete Platinum (HMO D-SNP) covers primary care, specialist visits, physical therapy, mental health, and telehealth services with no copay and no coinsurance. Although chiropractic services are not covered under this plan, routine podiatry is covered for up to 12 visits per year with no copay and no coinsurance.
Preventive Services See details
Preventive services are partially covered by Simply Complete Platinum (HMO D-SNP) with no copay and no coinsurance for covered benefits like kidney disease education, diabetes training, and fitness benefits. However, several sub-services are not covered, including annual physical exams, medical nutrition therapy, weight management programs, and in-home safety assessments.
Hearing Services See details
Simply Complete Platinum (HMO D-SNP) offers partially covered hearing services with no copay and no coinsurance for Medicare-covered exams, one routine exam, and one fitting evaluation annually. While up to two prescription hearing aids are covered each year with no copay or coinsurance up to a $2,000 maximum, OTC hearing aids as well as inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Vision Services are partially covered by Simply Complete Platinum (HMO D-SNP), featuring no copay, no coinsurance, and no deductible for covered care. The plan includes one routine eye exam and up to $400 per year for eyewear like contacts and eyeglasses, but other eye exam services and upgrades are not covered.
Dental Services See details
Dental services are partially covered by Simply Complete Platinum (HMO D-SNP) with no copay and no coinsurance, up to a maximum annual benefit of $1,500. While preventive care and most comprehensive treatments are covered, implant services and orthodontics are not covered.
Home Infusion bundled Services See details
Simply Complete Platinum (HMO D-SNP) covers home infusion bundled services with no copayments and no coinsurance, though prior authorization and step therapy are required. This coverage includes Medicare Part B chemotherapy, insulin, and other Part B drugs, all of which feature no copays or coinsurance.
Dialysis Services See details
Simply Complete Platinum (HMO D-SNP) covers dialysis services with no copay and no coinsurance.
Medical Equipment See details
Simply Complete Platinum (HMO D-SNP) covers medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic services, with no copay and no coinsurance. Prior authorization is required, and certain benefits may be limited to preferred vendors or specified manufacturers.
Diagnostic and Radiological Services See details
Simply Complete Platinum (HMO D-SNP) covers diagnostic and radiological services, including lab work, X-rays, and therapeutic radiology, with no copay and no coinsurance. Prior authorization and referrals are required for these covered services.
Home Health Services See details
Simply Complete Platinum (HMO D-SNP) covers Home Health Services with no copay and no coinsurance. Prior authorization and a referral are required to access this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Simply Complete Platinum (HMO D-SNP) with no copay and no coinsurance, although only some services are covered while cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered. Prior authorization and a referral are required for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by Simply Complete Platinum (HMO D-SNP) for days 1 through 100 with no copay and no coinsurance, although prior authorization and a referral are required. While the plan does not require a three-day prior inpatient hospital stay for admission, additional days beyond the standard 100 days are not covered.
Other Services See details
Simply Complete Platinum (HMO D-SNP) partially covers other services, offering a $115 monthly over-the-counter items allowance and meals for chronic illnesses with no copay and no coinsurance. Acupuncture, naloxone coverage, and other additional services are not covered under this plan.
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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
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