Simply healthcare otc 2021

Simply healthcare otc 2021 DEFAULT

High Star Rating a result of Simply’s commitment to ensuring members receive high-quality healthcare services and enhanced healthcare experience

MIAMI, October 13, 2021--(BUSINESS WIRE)--Simply Healthcare Plans announced today that the Centers for Medicare & Medicaid Services awarded the company’s 2022 Medicare Advantage plans a 4.5-Star rating, with five stars being the best rating. The 4.5-Star rating is an improvement compared to last year and a result of Simply’s commitment of giving members access to high-quality healthcare services and plan benefits that meet members’ unique needs and help them improve their health and wellbeing.

"We have been committed to ensuring our members have access to high-quality, affordable healthcare services that meet their unique health needs, and that commitment is recognized with this rating," said Doug Johnson, President of Simply’s Medicare business. "I also attribute this high Star Ratings to the collaborative relationships we have had with the care providers in our network. We know that much of our members’ healthcare experience happen in the interactions our members have with them and greatly appreciate everything providers do to help our members lead healthier lives."

Medicare Star Ratings are issued by the Centers for Medicare & Medicaid Services (CMS), and rate health plans on a scale of 1-5 Stars (5 Stars = Excellent). Star Ratings are derived as a composite of dozens of measures that gauge areas such as health plan members’ rating of service and care, how well provider partners detect illness and keep members healthy, and how well plans help members use recommended and safe prescription medications.

The following Medicare Advantage plans are rated 4.5 stars for 2022:

  • Simply More (HMO) (H5471-065) (H5471-071) (H5471-074) (H5471-077) (H5471-078) (H5471-083)

  • Simply Extra (HMO) (H5471-103) (H5471-104) (H5471-105) (H5471-106) (H5471-107) (H5471-108)

  • Simply Level (HMO C-SNP) (H5471-069) (H5471-070) (H5471-073) (H5471-075) (H5471-080) (H5471-085)

  • Simply Complete (HMO D-SNP) (H5471-064) (H5471-066) (H5471-072) (H5471-076) (H5471-084) (H5471-082)

The CMS’ Medicare Star Rating system rates the quality and performance of Medicare Advantage plans to help consumers and their families compare plans. Medicare Advantage plans are rated on their ability to:

  • Help members stay healthy

  • Assist members in managing chronic conditions

  • Ensure positive member experiences with their health plan

  • Achieve member satisfaction

  • Provide effective customer service

Star Ratings are calculated each year using a scale of one to five stars, and may change from year to year. The annual Medicare Star Ratings are posted online at

To learn more about which benefits will be available with each 2022 Medicare Advantage and which plans will be offered in a specific area, consumers can call (888) 820-8906, which is available 8 a.m. to 8 p.m. Monday through Friday, April 1 to Sept. 30; and 8 a.m. to 8 p.m. seven days a week, Oct. 1 to March 31. Consumers can also visit the company’s online store at

Unless members choose to opt out of the cash and monetary rebates benefit, the benefit amounts may have tax implications and may be subject to income tax. To opt out of the cash or monetary rebates program or further questions, individuals can contact member service number at 1-877-577-0115 (TTY:711).

The Star Ratings referenced above apply to contract H5471. Simply Healthcare Plans, Inc. is a Medicare-contracted coordinated care plan that has a Medicaid contract with the State of Florida Agency for Health Care Administration to provide benefits or arrange for benefits to be provided to enrollees. Enrollment in Simply Healthcare Plans, Inc. depends on contract renewal. This information is not a complete description of benefits. Contact the plan for more information. We do not discriminate, exclude people, or treat them differently on the basis of race, color, national origin, sex, age or disability in our health programs and activities. ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-888-230-7338 (TTY: 711).ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. Rele 1-888-230-7338 (TTY: 711). This plan is available to anyone who has both Medical Assistance from the State and Medicare. Other providers are available in our network. The provider network may change at any time. You will receive notice when necessary.

About Simply Healthcare Plans

Simply Healthcare Plans, Inc. ("Simply"), is a Florida managed health care plan that serves Medicare Advantage and Medicaid members in the state of Florida. In addition, Simply, through a line of business called Clear Health Alliance, also serves Florida Medicaid members who are living with HIV/AIDS. Our goal is to provide healthcare and related services that are comprehensive, integrated and patient-centered. Each and every day, members of our team can be found in Florida communities, listening to our members, interacting with our health care providers and partnering with community-based organizations. Our goal is to ensure members and entire communities are empowered to become active participants in their health care and sustain healthy lifestyles. To learn more about Simply, visit

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The Florida Medicaid Preferred Drug List is subject to revision following consideration and recommendations by the Pharmaceutical and Therapeutics (P&T) Committee and the Agency for Health Care Administration.

The Changes Summary Report lists only changes made to the Preferred Drug List as a result of the P&T Committee meeting on June 18, 2021.  It does not include changes made between meeting dates.  Always refer to the Preferred Drug List document for the most current list of preferred drugs.

Changes Summary Report [134KB PDF] Updated 07/15/2021

The Preferred Drug List attached was updated from the June 18, 2021 P&T Committee meeting.  Open the attached list and use the Adobe Acrobat search tool to locate specific drugs by name or HIC3 therapeutic class.  Please read the first page for important additional information.

Preferred Drug List [1.13MB PDF]  Updated 07/15/2021

Important information regarding quantity and/or age limits for various drugs may be found at the following link:

Summary of Drug Limitations, 09/30/2021 [730KB PDF]

The Quick Reference Guide for Physician Administered Preferred Drugs below includes physician administered drug billing codes and quantities for preferred products from the June 18, 2021, P&T Committee meeting; effective July 1, 2021.

Quick Reference Guide [178KB PDF]

Visit the Fee Schedule Website for the complete list of covered Prescribed Drugs Physician Administered Billing Codes (including non-preferred products).

The fee-for-service Fee Schedule Look-Up Tool, located on the Fiscal Agent's website is available to view provider reimbursement rates for HCPCS codes.

Fee Schedule Look-Up Tool 



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Over-the-Counter drug benefits

Save money with the over-the-counter Drug Catalog Program from Simply Healthcare Plans

Simply Healthcare Plans is pleased to provide its members with an Over-the-Counter (OTC) Drug Catalog Program. The supplemental benefit of Over-the-Counter medications and supplies can help you save money on over 100 items like pain relievers, cold medications, dental care and first aid supplies. To see a complete list of covered OTC items, view the:

Simply Healthcare Plans makes it easier for you to obtain your Over-the-Counter medications by working directly with OTC Health Solutions. There are several different ways you can access your OTC benefit:

  • Call OTC Health Solutions at 1-866-298-0578.
  • Place an order online throgh the OTC Health Solutions Member website.
  • Pick up your OTC items at any participating OTC Health Solutions location. Click here to see a list of participating locations.

If you have additional questions regarding your Over-the-Counter supplemental benefit, please call Member Services at 1-877-577-0115 (TTY 711).

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