About Simply Healthcare Plans
Formed in December 2009, Simply Healthcare is a Florida licensed health maintenance organization established to meet the needs of Floridians enrolled in government-sponsored healthcare programs.
Simply Healthcare is led by an experienced management team with a proven record of success. The company’s mission is to simplify the healthcare experience for its members and providers. The plan is anchored by its core values: service and respect.
Headquartered in Miami with regional offices in Orlando, Tampa, and Sunrise our employees are Floridians familiar with the community, physicians, hospitals and plan benefits. Being close to our members and providers affords them the highest level of service and respect. Phone calls are answered live at our offices by courteous, knowledgeable representatives.
Every day the employees of Simply Healthcare are fully engaged in delivering the best possible experience for members and providers.
Simply Healthcare offers Medicare Advantage plans in the following counties:
Simply Healthcare Medicare Advantage Plans are available to Medicare beneficiaries entitled to Medicare Part A and enrolled in Medicare Part B who live in the following counties. They have $0 deductibles and many have $0 monthly premiums too:
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- Broward County
- Hernando County
- Hillsborough County
- Miami-Dade County
- Orange County
- Osceola County
- Palm Beach County
- Pasco County
- Pinellas County
- Polk County
- Seminole County
Best Available Evidence (BAE)
The Centers for Medicare & Medicaid Services (CMS) makes it easy to get the latest information about Best Available Practice (BAE) policy. These policies address cost-sharing for low-income beneficiaries. To learn more, click here.
Potential for Contract Termination Notice
Simply Healthcare is required to notify beneficiaries that it is authorized by law to refuse to renew its contract with the Centers for Medicare & Medicaid Services (CMS), that CMS also may refuse to renew the contract, and that termination or non-renewal may result in termination of your enrollment. In addition, the plan may reduce its service area and no longer offer services in the area where you reside. In the event this happens, you will receive advance notice.
For information on Out-of-Network Coverage, click here.
To report suspected fraud, waste or abuse, call our Confidential Compliance and Fraud, Waste & Abuse Hotline at 1-866-847-8247 or send us an email at firstname.lastname@example.org. (You may remain anonymous).
Download the SHP SIU Facsimile Submission Form
Getting Care during a Disaster
In the event of a Presidential or Gubernatorial emergency or major disaster declaration or an announcement of a public health emergency by the Secretary of Health and Human Services, your plan will make the following exceptions to assure adequate care during the emergency:
Approve services to be furnished at specified non-contracted facilities which are considered Medicare-certified facilities;
Temporarily reduce cost sharing for plan-approved out-of-network services to the in-network cost-sharing amounts; and
Waive in full the requirements for a primary physician referral where applicable.
Typically, the source that declared the disaster will clarify when the disaster or emergency is over. If, however, the disaster or emergency time frame has not been closed within 30 days from the initial declaration, and, if CMS has not indicated an end to the disaster or emergency, your plan will resume normal operations 30 days from the initial declaration.
When a disaster or emergency is declared, it is specific to a geographic location (i.e., county). Your plan will apply the above exceptions only if you reside in the geographic location indicated.
It's important we treat you fairly.
Y0114_20_113303_U CMS Accepted 06/19/2020