Simply Complete Platinum (HMO D-SNP)

Simply Complete Platinum (HMO D-SNP) is a HMO D-SNP plan offered by Elevance Health, Inc. available for enrollment in 2026 to people living in Lake, Marion, Sumter. 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.

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.

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 Complete Platinum (HMO D-SNP) prescription drug plan features an annual drug deductible of $490. Under this plan, you will pay no copay for Tier 1 preferred generic drugs and Tier 6 supplemental drugs. This no-copay benefit applies to one-month, two-month, and three-month supplies filled through standard pharmacies or standard mail order. For other medication tiers, your costs are based on a percentage of the drug cost. Tier 2 generic drugs, Tier 3 preferred brand drugs, and Tier 4 non-preferred drugs require a 25% coinsurance at standard pharmacies and mail order. Specialty medications in Tier 5 carry a 27% coinsurance for a one-month supply.

Additional Benefits

The Simply Complete Platinum (HMO D-SNP) offers comprehensive healthcare coverage with no copay and no coinsurance for the vast majority of its medical and hospital benefits. This includes full coverage for inpatient and outpatient hospital stays, primary and specialist doctor visits, emergency services, and durable medical equipment. For specialized treatments like dialysis and therapeutic radiological services, members are responsible for a twenty percent coinsurance. Additionally, the plan provides robust supplemental benefits with no copay, including a fifteen hundred dollar annual allowance for dental care and another fifteen hundred dollars for prescription hearing aids. Members also receive a four hundred dollar annual limit for eyewear, a one hundred twenty-five dollar monthly over-the-counter item allowance, and unlimited one-way trips to plan-approved locations. Note that many services, including home health and skilled nursing, require prior authorizations or referrals.