Simply Integrated (HMO D-SNP)

Simply Integrated (HMO D-SNP) is a HMO D-SNP plan offered by Simply Healthcare Plans, Inc. available for the 2026 plan year to people living in Clay, Duval, St Johns. 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) plan features an annual drug deductible of $615. Beneficiaries enjoy no copay for Tier 1 preferred generic drugs and Tier 6 supplemental drugs filled through standard pharmacies or standard mail order. This cost-free coverage applies to one-month, two-month, and three-month supply options. For Tier 2 generic and Tier 3 preferred brand medications, the plan requires a 25% coinsurance for all supply durations. Tier 4 non-preferred drugs and Tier 5 specialty drugs also carry a 25% coinsurance, which is limited to a one-month supply. These coinsurance rates apply at both standard retail pharmacies and standard mail-order services.

Additional Benefits

The Simply Integrated (HMO D-SNP) plan offers comprehensive healthcare coverage featuring no copays, no deductibles, and no coinsurance for almost all of its covered services. This includes full coverage for inpatient and outpatient hospital care, emergency and worldwide urgent services, and routine primary or specialist doctor visits. While essential medical services like home health and skilled nursing are covered at no cost, beneficiaries should note that many of these benefits require prior authorization and referrals. Beyond standard medical care, members enjoy robust supplemental benefits at no cost, including a $1,500 annual dental limit, a $400 eyewear allowance, and up to $2,000 yearly for prescription hearing aids. The plan also features a $107 monthly allowance for over-the-counter items and unlimited one-way transportation to plan-approved locations. However, certain services such as cardiac rehabilitation and acupuncture are not covered under this plan.

Plan Providers

Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpring^SM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.