This directory preamble is current as of May 1, 2025.

This directory provides a list of Simpra Advantage’s current network providers for the state of Alabama.

To request a hard copy of Simpra Advantage’s provider directory, please call our Member Services Department at 1-844-637-4770, 8 a.m. to 8 p.m. local time, seven days a week from October 1 to March 31, and Monday to Friday from April 1 to September 30. Member Services is closed Memorial Day, Independence Day, Labor Day, Thanksgiving, and Christmas. TTY/TDD users should call 1-833-312-0044. Simpra Advantage will mail a hard copy of the provider directory to you within three (3) business days of your request.  Simpra Advantage may ask whether your request for a hard copy is a one-time request or if you are requesting to receive the provider directory in hard copy permanently. If you request it, your request for hard copies of the provider directory remains until you leave Simpra Advantage or request that hard copies be discontinued.

You can get this information for free in other formats, such as large print, braille, or audio. Call our Member Services toll-free number at 1-844-637-4770 (TTY/TDD 1-833-312-0044). Your request for the provider directory in an accessible format or language will be applied on a standing basis unless you request otherwise.

Simpra Advantage is a PPO I-SNP and PPO D-SNP with a Medicare contract. Enrollment in Simpra Advantage depends on contract renewal. Simpra Advantage complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. For questions, please call Member Services at 1-844-637-4770 (TTY/TDD 1-833-312-0044) or visit Simpra.com.

Introduction

This directory provides a list of Simpra Advantage’s network providers.

The network providers listed in this directory have agreed to provide you with your health care services. You may go to any of our network providers listed in this directory.

Out-of-network providers are under no obligation to treat Simpra Advantage enrollees, except in emergencies. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our Member Services Department at 1-844-637-4770, 8 a.m. to 8 p.m. local time, seven days a week from October 1 to March 31, and Monday to Friday from April 1 to September 30. Member Services is closed Memorial Day, Independence Day, Labor Day, Thanksgiving, and Christmas. TTY/TDD users should call 1-833-312-0044. You may also visit Simpra.com (https://simpra.com/for-members/plan-documents/) to refer to your Evidence of Coverage (EOC) for more information, including the cost sharing that applies to out-of-network services.

Please note: If you receive a bill from an out-of-network provider, you should not pay the bill, unless you have received an Explanation of Benefits (EOB) from Simpra Advantage that details what the plan will pay for your service, and any remaining balance you need to pay.

If you have already paid for the covered services, Simpra Advantage will reimburse you for our share of the cost, if prior approval is obtained. If you have any questions, visit Simpra.com or call Member Services at 1-844-637-4770. TTY/TDD users should call 1-833-312-0044. See available days and hours above.

Payment for services is contingent upon:

1. The services you received are included in Simpra Advantage benefits as outlined in your Evidence of Coverage (EOC).
2. The provider or medical facility you received services from is eligible for payment from Simpra Advantage.
3. The service(s) meets the requirement for medical necessity and authorization is obtained where necessary.

You may obtain emergency services from the closest available provider, and urgently needed services from any qualified provider when out of the plan’s service area or when network providers are unavailable. You may download guidelines for finding providers and pharmacies in an emergency situation on Simpra.com (https://simpra.com/for-members/out-of-network-coverage-rules/. Please be aware that with the exception of emergencies, it may cost more to get care from out-of-network providers.

What is the service area for Simpra Advantage?

Simpra Advantage plans are available in all counties of Alabama. The counties are listed below.

• Marion
• Marshall
• Mobile
• Monroe
• Montgomery
• Morgan
• Perry
• Pickens
• Pike
• Randolph
• Russell
• Shelby
• St. Clair
• Sumter
• Talladega
• Tallapoosa
• Tuscaloosa
• Walker
• Washington
• Wilcox
• Winston

Last modified: May 16, 2025