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Simply Healthcare Medicare Plans: Florida Coverage, Benefits & How to Compare

Simply Healthcare Plans offers Medicare Advantage coverage designed specifically around Florida healthcare markets.

The plan available to you can change according to your county, your doctors, your hospital system, Medicaid eligibility, chronic-condition eligibility and the exact Simply Medicare plan offered in your ZIP code.

The better question is: “What does the Simply plan available where I live cover — and does it fit the healthcare I actually use?”

THE FLORIDA MEDICARE FIT MAP

YOUR COUNTY

NETWORK

PCP • Hospital • Specialists • Referral rules

ELIGIBILITY

Regular MA • D-SNP • C-SNP • Medicaid

BENEFITS

Dental • Vision • Hearing • OTC • Transport

→ YOUR ACTUAL SIMPLY PLAN

Florida First. County Specific. Mostly HMO.

Florida

Market

Medicare Advantage

Coverage Type

HMO

Common Structure

D-SNP + C-SNP

Special Needs Plans

2026 Plan Year

Current plan year: 2026. Last reviewed August 24, 2026.

Part D

Included with applicable MAPD and SNP plans.

Current Plan Names

Examples include Simply More, Simply Integrated, Simply Complete and Simply Level.

Star Ratings

Check the current CMS rating of the exact contract and plan you’re considering.

Put the Network Before the Extras

A plan can have a $0 premium, strong dental, OTC and transportation and still be a poor fit if your cardiologist or preferred hospital doesn’t participate.

Don't ask only “Does my doctor take Simply?”

Ask: “Does my doctor participate with this exact Simply Medicare Advantage plan?”

Local Partners Help Define the Member Experience

DENTAL

LIBERTY Dental

HEARING

Hearing Care Solutions

VISION

iCare

PHARMACY

CarelonRx

TRANSPORT

Ride2MD

LABS

Labcorp

POST-DISCHARGE

GA Foods

BEHAVIORAL

Carelon Behavioral Health

South Florida relationships matter too.

Simply currently identifies Evolent for applicable cardiology and The Oncology Institute for applicable oncology services in Miami-Dade, Broward and Palm Beach. Exact plan rules still control.

Simply + CarelonRx: Check Every Medication

Mutual of Omaha’s current online quoting examples advertise an additional 12% household discount when applicable. Eligibility and percentages vary by state, policy and household circumstances.

Medication

Is it covered?

Drug Tier

What will you pay?

Prior Authorization

Does approval apply?

Step Therapy

Must another drug be tried first?

Quantity Limit

Is dispensing restricted?

Pharmacy

Does participation affect cost?

Understand the Benefit — Then Verify the Plan Rules

The left side is why you choose Plan G. The right side may help you choose Mutual of Omaha.

Dental

Applicable plans can include preventive and comprehensive dental. Verify dentist network, annual benefit and major services.

Vision

Certain plans include routine exams and plan-specific lens or eyewear benefits.

Hearing

Check hearing exam, hearing-aid benefit, approved devices, providers, copay and replacement schedule.

OTC

Applicable plans may provide monthly or quarterly OTC allowances. Funding and rollover rules vary.

Transportation

Certain plans include nonemergency transportation. Trips, destinations and scheduling rules are plan-specific.

Post-Discharge Meals

Certain plans can include home-delivered meals after qualifying facility discharge.

Eligibility Rules Come Before the Extra Benefits

Simply D-SNP

Designed for qualifying people with Medicare + Medicaid. Exact benefits depend on the plan and Medicaid eligibility.

Simply C-SNP

Designed for qualifying chronic conditions such as diabetes, heart disease, chronic kidney disease/ESRD and certain lung conditions. Provider verification can be required.

SEEING THE BENEFIT ≠ QUALIFYING FOR THE BENEFIT

01

Does my plan include it?

02

Do I meet eligibility rules?

03

What amount applies?

04

What expenses are allowed?

Medical Risk Before Giveback and Extras

Your plan premium is not your total healthcare cost.

Maximum Out-of-Pocket

Serious-illness exposure

Hospital

Inpatient cost

Specialist

Important for chronic care

Outpatient Surgery

Potentially significant

Imaging

MRI / CT / PET

Prescriptions

Formulary + pharmacy

Plan Premium

$0 doesn’t mean $0 healthcare

Part B Giveback

Subtract applicable reduction

Supplemental Benefits

Dental / OTC / transport

Don't compare Simply plans by Giveback alone.

Compare Giveback + hospital + specialist + prescriptions + MOOP + network.

Seeing Another Name Doesn't Mean Your Insurance Changed

Simply Healthcare

The Florida health-plan brand.

Elevance Health

The larger parent organization.

Carelon

Affiliated or contracted businesses can handle pharmacy, behavioral health and certain medical-benefit-management functions.

The Answer Is Local

Simply May Deserve a Closer Look If

Compare Other Options Carefully If

HMO vs PPO Medicare Advantage

Compare Simply’s HMO structure with broader PPO flexibility.

Medicare Advantage vs Medicare Supplement

Compare Simply MA against Original Medicare + Medigap.

What's New With Simply Medicare?

HMO

Florida MA focus

D-SNP

Your actual monthly premium

C-SNP

Qualifying chronic-condition plans

4.5 Stars*

Multiple current H5471 offerings

Before enrolling

Verify county • exact plan • PCP • specialists • hospital • prescriptions • pharmacy • prior authorization • referral rules • hospital copays • specialist copays • MOOP • dental • OTC • Giveback • D-SNP/C-SNP eligibility • food/utility eligibility.

*Star Ratings apply to specific CMS contracts and can change annually.

Build Your Comparison Around Your County and Healthcare

Use your actual ZIP code, plan letter, premium, household eligibility and enrollment situation to compare Mutual of Omaha against other Medigap carriers.

Frequently Asked Questions About Simply Medicare

Is Simply Healthcare Medicare only available in Florida?

Simply Healthcare Plans is a Florida managed-care organization serving Medicare and Medicaid populations in the state.

Yes. Simply offers Medicare Advantage plans in Florida, including traditional MAPD coverage and Special Needs Plans.

Simply’s current individual Florida Medicare portfolio is primarily HMO-based rather than a broad PPO offering.

Yes. Simply offers HMO D-SNP coverage for qualifying people who have both Medicare and Medicaid.

Yes. Simply offers HMO C-SNP coverage in qualifying markets for people with applicable chronic conditions.

Simply’s Medicare Advantage prescription drug and SNP offerings include Part D coverage on applicable plans.

Certain Simply Medicare plans include dental benefits. Exact benefits vary by plan.

Many applicable Simply plans include monthly or quarterly OTC allowances. Amounts and rollover rules depend on the plan.

Certain Simply plans can include a Part B premium reduction. The amount and availability depend on the plan and county.

Yes. Simply Healthcare Plans is an affiliated health plan within the Elevance Health organization.

Simply can be a good fit when the specific Florida plan includes your doctors and hospitals, covers your prescriptions competitively, and offers medical costs and benefits that fit your needs.

Simply's Medicare Story Is Florida + County + Network + Eligibility

Simply can be a strong Medicare Advantage option for certain Florida beneficiaries, but the correct comparison is local: same ZIP + same doctors + same prescriptions + same expected healthcare.

Medicare Plan Assistance

Helping make Medicare easier to understand.

Independent Medicare Guidance
Medicare Plan Assistance is an independent insurance agency and is not Medicare, Simply Healthcare Plans, Elevance Health, Carelon or a government agency.

Plan availability, premiums, benefits, provider networks, formularies, OTC allowances, Giveback amounts, Special Needs Plan eligibility and Star Ratings vary by county, plan and year.

Before enrolling, review the exact plan’s Summary of Benefits, Evidence of Coverage, Provider Directory, Drug List and current CMS Star Rating.V

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