Simply Integrated Platinum (HMO D-SNP)

Simply Integrated Platinum (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 Miami-Dade. This plan received an overall rating of 4.5 out of 5 stars in 2026.

It's important to know that Simply Integrated 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.

Key Plan Facts

Below are a few key facts and commonly-asked questions about Simply Integrated 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.

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 Platinum (HMO D-SNP) prescription drug plan features an annual drug deductible of $615. Members enjoy no copay for Tier 1 preferred generic drugs and Tier 6 supplemental drugs when using standard pharmacies or standard mail order. This ensures that many common and supplemental medications are available at no cost to you. For Tier 2 generic, Tier 3 preferred brand, Tier 4 non-preferred, and Tier 5 specialty drugs, the plan requires a 25% coinsurance. This 25% cost-sharing rate applies to standard pharmacy and standard mail-order services during the initial coverage phase. Understanding these straightforward cost-sharing tiers helps you plan your healthcare budget effectively.

Additional Benefits

The Simply Integrated Platinum (HMO D-SNP) plan offers comprehensive healthcare coverage with no copays and no coinsurance for most essential services. Members can access inpatient hospital stays, outpatient care, primary and specialist visits, and emergency services with zero out-of-pocket costs for copayments or coinsurance. Additionally, the plan covers critical needs like medical equipment, home health, and skilled nursing facility care at no cost to the member, though prior authorization or referrals may be required. This plan also includes valuable supplemental benefits such as dental, vision, and hearing coverage with no copays or coinsurance, subject to specific annual limits. Members benefit from a $2,000 yearly allowance for prescription hearing aids, a $400 annual limit for eyewear, and up to $1,500 annually for comprehensive dental services. Furthermore, eligible members receive up to $132 monthly for over-the-counter items and unlimited one-way transportation to plan-approved health locations at no additional cost.

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.