Popular Articles

  1. How do I request a coverage determination or medical exception for a drug?

    You, your authorized representative, or your prescribing doctor can ask for a coverage determination. Mail us a Coverage Determination Request Form to: Simplete 3310 Fields South Drive Champaign, IL 61822 Call us at (800) 851-3379 , option...
  2. What Is the Part D Late Enrollment Penalty?

    The Part D late enrollment penalty is a an amount added to your Part D monthly premium because you didn't sign up for drug coverage when it was available to you. If you go without a Part D plan or a Medicare Advantage plan with drug coverage for 63 ...
  3. Turning 65

    Getting Ready for Your 65th Birthday A Year Before Start thinking about your move to Medicare. Make sure you understand the difference between Medicare plan options. Start looking into what options are available in your area. Make s...
  4. What Is the Coverage Gap?

    Medicare prescription drug coverage has 3 different phases of coverage — initial coverage, the coverage gap, and catastrophic coverage. Initial Coverage During initial coverage, your prescription drug coverage works like normal health insurance. O...
  5. What are the ratings for our plans?

  6. What Is a POS?

    A POS (Point of Service) plan gives you personal care and the freedom to go in- and out-of-network. You'll get: The comfort of having an in-network PCP to oversee all your care. Flexibility to see out-of-network providers. Savings by seeing doct...
  7. What is Medicare Part A?

    Medicare Part A is also called hospital insurance, and it covers: Inpatient hospital stays. Skilled nursing facility stays. Hospice care. Nursing home care. Home health care.
  8. What is Medicare Part B?

    Medicare Part B is also called medical insurance, and it covers certain care from doctors, outpatient care, medical supplies, and preventive care which includes: Services like flu shots. Clinical research. Ambulances. Durable medical equipment....
  9. What are my rights and responsibilities upon disenrollment?

    If you decide to disenroll from your Simplete Medicare Advantage plan, you are ending your membership. Disenrollment can be voluntary (your choice) or involuntary (not your choice). For more information on enrollment or disenrollment, see your Evide...
  10. What is Medicare Part D?

    Medicare Part D adds prescription drug coverage. You can buy Part D from insurance companies to go with your Original Medicare coverage or your Medicare Supplement coverage, or you can choose a Medicare Advantage plan that includes Part D prescripti...