Simply Integrated (HMO D-SNP)

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

It's important to know that Simply Integrated (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 Integrated (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 Integrated (HMO D-SNP) Medicare plan features an annual prescription drug deductible of $615. Under this plan, members enjoy no copay for Tier 1 preferred generic drugs and Tier 6 supplemental drugs when filled at standard pharmacies or through standard mail order. This ensures that many common and supplemental medications are available at no cost to you. For other medication categories, you will typically pay a 25% coinsurance at standard pharmacies and standard mail order locations. This 25% coinsurance applies to Tier 2 generic and Tier 3 preferred brand drugs for up to a three-month supply, as well as one-month supplies of Tier 4 non-preferred and Tier 5 specialty drugs.

Additional Benefits

The Simply Integrated (HMO D-SNP) plan offers comprehensive medical coverage with no copays and no coinsurance for nearly all of its covered services. Members can access inpatient and outpatient hospital care, emergency services, primary and specialist care, and diagnostic testing at zero out-of-pocket cost. Essential services like home health care, medical equipment, and local transportation to approved locations are also covered with no copay. This plan also features valuable supplemental benefits, including dental care up to a $1,500 annual limit, vision care with a $400 eyewear allowance, and hearing aids up to a $2,000 limit, all with no copay. Members also receive monthly allowances for over-the-counter items and chronic illness meals, though cardiac rehabilitation and acupuncture are not covered under this plan. Please note that several services, including hospital stays, home health, and specialized equipment, require prior authorization or referrals.