Simply Healthcare Plans Inc.
Reviewed by Misty Berryman – Fact checked by Mike Montes
All You Need to Know About Simply Healthcare Plans
Simply Healthcare Plans Inc. is a Florida-based health maintenance organization committed to helping members find plans that meet their unique health needs.
Part of the Wellpoint family, Simply Healthcare began as a minority-owned HMO, and nowoffers a range of Medicare Advantage and Special Needs plans.
For members who qualify for more advanced support, Simply Healthcare even administers Long-Term Care benefits through Florida’s Statewide Medicaid Managed Care Long-Term Care program.
Simply Healthcare Plans Features & Benefits
Most people don’t choose a health plan based on everything it might cover, but on how it works once they’re actually using it, and that’s where Simply Healthcare Plans Inc. puts its focus.
Preventive Care
Routine care is included in most Simply healthcare plans.
That usually means regular checkups and screenings with in-network doctors, giving members a way to stay connected to care instead of waiting until something feels wrong.
Prescription Coverage
Prescriptions are part of both Simply’s Medicare and Medicaid plans.
Members fill medications through a set pharmacy network, using a plan drug list that lays out what’s covered and how costs are handled.
Dental, Vision, and Hearing Extras
Some Simply Healthcare Medicare Advantage plans include dental, vision, and hearing coverage.
These are the kinds of services people tend to use year after year, like eye exams or dental visits, and they’re not covered by Original Medicare on its own.
Telehealth When It Makes Sense
Many doctors in Simply’s network offer telehealth appointments for certain visits.
For some members, that means a follow-up or quick question handled from home instead of another trip across town.
Easy to Access Support
Simply Healthcare Plans Inc. separates its support by program.
Medicaid, Long-Term Care, and Florida Healthy Kids members each have their own Member Services contact, so questions don’t bounce between departments.
Membership Options
Simply Healthcare is known for its Medicare Advantage plans. These plans combine hospital and medical coverage, and include HMO options along with Special Needs Plans for people who also have Medicaid or who have certain long-term health conditions.
How to Enroll in Simply Healthcare Medicare Advantage Plans
Signing up for coverage through Simply Healthcare Plans Inc. isn’t hard, but it’s easier when you know what the flow looks like ahead of time.
Here’s the general rundown, so you’re not guessing as you go.
- Choose your state first. That step makes sure you’re only seeing plans that are offered where you live.
- Request a quote. You’ll fill in a short form with basics like your ZIP code, age, and who needs coverage.
- Look over the plans that show up. Take your time here and read through the options to see which one feels like a match.
- Select Apply Now. When you’ve landed on a plan, click Apply Now next to it.
- Move into enrollment. On the next page, choose Enroll Today to start the application.
- Follow the steps as they appear. Each screen walks you through what’s needed next, so you’re not guessing or backtracking.
If you’d rather talk it through, or something doesn’t quite add up, MediGap Advisors can walk you through the options and help you sort out what actually fits your situation.
Simply Healthcare Plans Pros and Cons
If you’re looking at Simply Healthcare Plans Inc., it’s worth stepping back and seeing where it tends to work well and where it can feel a bit limiting.
Pros
- Special Needs Plans exist for a reason: If you have Medicare and Medicaid, or you’re dealing with certain long-term conditions, D-SNP or C-SNP plans may be part of what’s available.
- Some Medicare plans go beyond medical basics: Certain Medicare Advantage plans include dental, vision, hearing, and prescription coverage that Original Medicare doesn’t include on its own.
- Support isn’t one-size-fits-all: Simply Healthcare lists different Member Services contacts depending on the program, so you’re not starting every call from square one.
- Kids coverage isn’t limited to certain areas: Florida Healthy Kids plans through Simply Healthcare are offered statewide, which helps if your family moves around Florida.
Cons
- What’s offered can change: Plans depend on the county and yearly renewal, so what’s available this year might not look the same next year.
- Networks matter more than people expect: Most plans follow managed care rules, which means staying in network unless it’s an emergency.
- Extras aren’t automatic: OTC amounts, dental, vision. Those depend on the specific plan, not just the Simply Healthcare Plans name.
We’ve helped people find health insurance or a health sharing plan.
Each customer gets the same amazing service.
Robert N. (CO)
“I look forward to having MediGap Advisors help me sail the uncharted waters I will be experiencing during the next year or so with regard to Medicare coverage.
I especially would like to thank Misty for her help the last several years. She deserves many accolades, in my book.”
Janice B. (VA)
“Mike always answers all my concerns thoroughly. That’s why I stay with him for all of our Medicare needs.”
Simply Healthcare Plans Frequently Asked Questions
What is Simply Healthcare?
Simply Healthcare Plans Inc. is a Florida-based Health Maintenance Organization (HMO).
Instead of selling private insurance, it manages coverage for people who qualify for Medicare Advantage, Medicaid, long-term care, or Florida Healthy Kids.
Do the Medicare plans include prescription coverage?
Yes. Prescription coverage is part of Simply’s Medicare Advantage plans, but what’s covered and what you pay depends on the plan and the medication.
Do these plans require staying in network?
Most Simply Healthcare plans follow managed care rules.
That means using in-network providers is important, and care outside the network is usually limited to emergencies.
Is Simply Healthcare the same thing as Medicare?
No, it’s different from Original Medicare.
Simply offers Medicare Advantage plans, which are run by private companies under contract with Medicare and must follow Medicare’s coverage rules.
Are things like dental and vision really included?
Some Simply Medicare Advantage plans include dental, vision, and hearing benefits.
These aren’t part of Original Medicare and they’re only included on certain plans.
How can someone tell if their doctor is covered?
Simply Healthcare offers provider search tools tied to each plan and program.
Checking the network before enrolling is the best way to see whether a specific doctor or hospital is included.
What kind of Medicare plans does Simply Healthcare actually offer?
Simply’s Medicare plans follow an HMO setup.
Some are standard Medicare Advantage plans, while others are Special Needs Plans for people who also have Medicaid or who meet certain chronic condition guidelines.
Can Simply Healthcare members use telehealth instead of going in person?
Many doctors in Simply’s network offer telehealth for certain visits.
Whether that works depends on the provider and the reason for the appointment, so it’s best to ask directly.
Who should members reach out to when something isn’t clear?
Simply Healthcare lists separate Member Services phone numbers depending on the program.