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Simply Integrated Platinum (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Simply Integrated 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 Integrated Platinum (HMO D-SNP) in 2026, please refer to our full plan details page.
Simply Integrated Platinum (HMO D-SNP) is a HMO D-SNP plan offered by Elevance Health, Inc. available for enrollment in 2026 to people living in Select counties in Tampa Area. 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.
Important:
Simply Integrated 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 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.
For Simply Integrated 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 $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 Integrated Platinum (HMO D-SNP) Medicare plan features an annual drug deductible of $615. Beneficiaries enjoy no copay for Tier 1 preferred generic drugs and Tier 6 supplemental drugs when using standard pharmacies or standard mail order services. This zero-dollar cost sharing is available for one-month, two-month, and three-month supply options. 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% coinsurance rate applies to standard pharmacies and standard mail order services for covered prescriptions. These clear cost-sharing structures help you budget for your medication costs throughout the plan year.
Additional Benefits
The Simply Integrated Platinum (HMO D-SNP) offers comprehensive healthcare coverage with no copays, no coinsurance, and no deductibles for nearly all covered services. This includes essential care such as inpatient and outpatient hospital stays, emergency services, primary and specialist doctor visits, and home health care. Additionally, the plan covers routine transportation to plan-approved locations and ambulance services at no cost to you. Members also benefit from robust supplemental care, including dental coverage up to a $1,500 yearly maximum and vision services with a $400 annual allowance, both with no copays. Hearing aids are covered up to $2,000 annually, and the plan provides a $125 monthly allowance for over-the-counter items alongside covered meal benefits. Please note that prior authorizations or referrals are required for many services, and certain treatments like cardiac rehabilitation are not covered.
Inpatient Hospital See details
Inpatient hospital services are covered by Simply Integrated Platinum (HMO D-SNP) with no copay and no coinsurance for Medicare-covered acute and psychiatric stays. This benefit is partially covered, as prior authorization and referrals are required, and additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by Simply Integrated Platinum (HMO D-SNP) with no copay and no coinsurance for outpatient hospital, ambulatory surgical center, substance abuse, and blood services. Prior authorization and referrals are required for most of these services, and there is no deductible for outpatient blood services.
Partial Hospitalization See details
Simply Integrated Platinum (HMO D-SNP) covers partial hospitalization services with no copay and no coinsurance. Prior authorization and a referral are required to access this covered benefit.
Ambulance and Transportation Services See details
Simply Integrated Platinum (HMO D-SNP) covers ground and air ambulance services with no copay and no coinsurance under prior authorization. Transportation services are also partially covered with no copay or coinsurance for unlimited one-way rides to plan-approved locations, though trips to any health-related location are not covered.
Emergency Services See details
Simply Integrated 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 and no coinsurance, up to a maximum plan benefit of $100,000.
Primary Care See details
Simply Integrated Platinum (HMO D-SNP) covers primary care, specialist visits, telehealth, and therapy services with no copay and no coinsurance. While routine foot care is covered for up to 12 visits per year, chiropractic services are not covered under this plan.
Preventive Services See details
Simply Integrated Platinum (HMO D-SNP) provides partially covered preventive services with no copays and no coinsurance for covered benefits like glaucoma screenings and fitness programs. However, annual physical exams, in-home safety assessments, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, extra smoking cessation, disease management, telemonitoring, and counseling are not covered.
Hearing Services See details
Simply Integrated Platinum (HMO D-SNP) partially covers hearing services with no copays, no coinsurance, and no deductibles for routine exams, fitting evaluations, and up to two prescription hearing aids per year up to a $2,000 maximum limit. However, over-the-counter (OTC) hearing aids, along with inner ear, outer ear, and over-the-ear prescription hearing aid types, are not covered.
Vision Services See details
Simply Integrated Platinum (HMO D-SNP) offers partially covered vision services with no copay, no coinsurance, and no deductible for covered services. Routine eye exams (one per year) and eyewear (including lenses, frames, and contact lenses) are covered up to a combined maximum of $400 per year, though upgrades and other eye exam services are not covered.
Dental Services See details
Dental services are partially covered by Simply Integrated Platinum (HMO D-SNP) with no copay and no coinsurance for covered services, up to a $1,500 yearly maximum. While most preventive and comprehensive dental care are covered, implant services and orthodontics are not covered.
Home Infusion bundled Services See details
Simply Integrated Platinum (HMO D-SNP) covers home infusion bundled services and related Medicare Part B drugs, including chemotherapy and insulin, with no copay and no coinsurance. Prior authorization and step therapy are required for these benefits.
Dialysis Services See details
Dialysis services are covered under the Simply Integrated Platinum (HMO D-SNP) plan with no copay and no coinsurance.
Medical Equipment See details
Simply Integrated Platinum (HMO D-SNP) covers durable medical equipment, prosthetics, medical supplies, and diabetic equipment with no copay and no coinsurance. Prior authorization is required for these benefits, and certain equipment and supplies must be obtained from preferred vendors or specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Simply Integrated Platinum (HMO D-SNP) with no copay and no coinsurance for diagnostic procedures, lab tests, therapeutic radiology, and outpatient X-rays. Prior authorization and referrals are required for these covered services.
Home Health Services See details
Simply Integrated Platinum (HMO D-SNP) covers home health services with no copay and no coinsurance, though prior authorization and a referral are required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Simply Integrated Platinum (HMO D-SNP) plan, including intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Simply Integrated Platinum (HMO D-SNP) for days 1 through 100 with no copay and no coinsurance, and do not require a prior three-day inpatient hospital stay. Prior authorization and referrals are required for these services, and additional days beyond the standard 100 days are not covered.
Other Services See details
Simply Integrated Platinum (HMO D-SNP) offers partially covered other services, including over-the-counter (OTC) items and a meal benefit with no copay and no coinsurance. The OTC benefit provides up to $125 monthly, while acupuncture and highly integrated dual-eligible services are not covered.
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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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