Simply Complete Platinum (HMO D-SNP)

SIMPLY HEALTHCARE PLANS, INC. · 2027 plan year

Plan ID H5471-118-000

HMO★ 4 CMS StarsDual-Eligible SNP
MOOP (in-network)
$500
MOOP (combined)
—
Monthly premium
$0/mo
Part C $0 + Part D $0
Prescription drugs
Included

This plan in 2026

+5 more plans in FL

Plan information

Contract / Plan / Segment
H5471-118-000
Medical deductible
$0 — no deductible
Part D premium
$0/mo (part of the monthly premium above)
Part D deductible
$105/yr
Also owed
Your Medicare Part B premium, paid separately

More SIMPLY HEALTHCARE PLANS, INC. plans in FL

Benefits & cost sharing

Hospital

BenefitIn-network
Worldwide Urgent Care CoverageNo charge
Inpatient Hospital — AcuteNo charge
Inpatient Hospital — PsychiatricNo charge

Pharmacy

BenefitIn-network
Part B DrugsSee plan details
Chemotherapy & Radiation Drugs (Part B)No charge
Other Part B DrugsNo charge

Mental Health

BenefitIn-network
Mental Health — Group SessionsNo charge
Mental Health Specialty ServicesSee plan details
Mental Health — Individual SessionsNo charge
Supplemental Health BenefitsSee plan details

Other

BenefitIn-network
Worldwide Emergency TransportationNo charge
Podiatry ServicesNo charge
Outpatient Hospital ServicesNo charge
Dialysis Services20% coinsurance
Diabetes Self-Management TrainingNo charge
Digital Rectal ExamsNo charge
Welcome to Medicare EKGNo charge
Insulin (Part B)No charge
Dental — Medicare-Covered ServicesNo charge
Vision — Eyeglasses (Lenses & Frames)No charge
Vision — Eyeglass LensesNo charge
Vision — Eyeglass FramesNo charge
Hearing — ExamsNo charge
Hearing — ExamsSee plan details
Hearing — Routine ExamsNo charge
Hearing — Fitting & Evaluation for Hearing AidNo charge
Hearing — Prescription Hearing AidsSee plan details
Hearing — Hearing Aids (All Types)No charge
Dental — Maxillofacial ProstheticsNo charge
Dental — Fixed Prosthodontics (Bridges)No charge
Dental — Oral & Maxillofacial SurgeryNo charge
Intensive Outpatient Program (IOP)No charge
Home Health ServicesNo charge
Dental — Adjunctive General ServicesNo charge
Primary Care Physician ServicesNo charge
Chiropractic ServicesNo charge
Occupational Therapy ServicesNo charge
Physician Specialist ServicesNo charge
Diabetic Therapeutic Shoes & InsertsNo charge
Vision — EyewearSee plan details
Vision — Contact LensesNo charge
Diabetic Supplies & ServicesSee plan details
Diabetic MonitorsNo charge
Dental — Removable Prosthodontics (Dentures)No charge
Partial Hospitalization ProgramNo charge
Diabetic SuppliesNo charge
Skilled Nursing Facility (SNF)No charge
Cardiac & Pulmonary RehabilitationSee plan details
Cardiac Rehabilitation — Additional SessionsNo charge
Intensive Cardiac Rehabilitation — Additional SessionsNo charge
Pulmonary Rehabilitation — Additional SessionsNo charge
Supervised Exercise Therapy (SET)No charge
Emergency ServicesNo charge
Urgently Needed ServicesNo charge
Worldwide Emergency & Urgent CoverageSee plan details
Worldwide Emergency CoverageNo charge
Podiatry ServicesNo charge
Other Health Care Professional ServicesNo charge
Psychiatric ServicesSee plan details
Psychiatric Services — Individual SessionsNo charge
Psychiatric Services — Group SessionsNo charge
Physical Therapy & Speech-Language PathologyNo charge
Additional Telehealth Services (Part B)No charge
Opioid Treatment Program ServicesNo charge
Diagnostic Tests & Lab ServicesSee plan details
Diagnostic Procedures & TestsNo charge
Laboratory ServicesNo charge
Radiological ServicesSee plan details
Diagnostic RadiologyNo charge
Therapeutic Radiology20% coinsurance
X-Ray ServicesNo charge
Hospital Observation ServicesNo charge
Ambulatory Surgical Center (ASC)No charge
Outpatient Substance Abuse ServicesSee plan details
Substance Abuse — Individual SessionsNo charge
Substance Abuse — Group SessionsNo charge
Outpatient Blood ServicesNo charge
Ambulance ServicesSee plan details
Ground AmbulanceNo charge
Air AmbulanceNo charge
Non-Emergency Transportation — Health FacilityNo charge
Durable Medical Equipment (DME)No charge
Prosthetics & OrthoticsSee plan details
Prosthetic DevicesNo charge
Medical SuppliesNo charge
Over-the-Counter (OTC) ItemsNo charge
Meal BenefitNo charge
Medicare-Covered Preventive ServicesSee plan details
Health EducationNo charge
Fitness BenefitNo charge
Remote Access TechnologiesNo charge
Home & Bathroom Safety DevicesNo charge
Personal Emergency Response System (PERS)No charge
Kidney Disease Education ServicesNo charge
Glaucoma ScreeningNo charge
Dental — PreventiveSee plan details
Dental — Oral ExamsNo charge
Dental — X-RaysNo charge
Dental — Diagnostic ServicesNo charge
Dental — Prophylaxis (Cleaning)No charge
Dental — Fluoride TreatmentNo charge
Dental — Other Preventive ServicesNo charge
Dental — ComprehensiveSee plan details
Dental — Restorative ServicesNo charge
Dental — Endodontics (Root Canal)No charge
Dental — Periodontics (Gum Care)No charge
Vision — Eye ExamsNo charge
Vision — Eye ExamsSee plan details
Vision — Routine Eye ExamsNo charge
Vision — EyewearNo charge

Service area

  • FL: 24 counties

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