Disclaimers
Simpra Advantage is a PPO I-SNP and PPO D-SNP with a Medicare contract. Enrollment in Simpra Advantage plans depends on CMS Medicare contract renewal. Every year, Medicare evaluates plans based on a 5-star rating system. 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. Pharmacy providers other than CVS are available in the provider network. Only CVS locations support the 2024 Over-the-Counter Product Catalog benefit. Brain HQ is the provider that supports the Memory Fitness benefit.
Eligibility rules apply to some supplemental benefits. Not all members qualify. Please see the specific requirements for Special Supplemental Benefits for the Chronically Ill (SSBCI).
- 2025 Simpra Advantage Nursing Home Plan (PPO I-SNP): To be eligible for SSBCI benefits, the member must have one or more of the following chronic conditions: Dementia or Chronic and disabling mental health conditions. If you qualify for one of the chronic conditions, your coverage also depends on being a “chronically ill” enrollee as defined by CMS regulations and on this Plan’s coverage criteria for SSBCI.
- 2025 Simpra Advantage Dual Care (PPO D-SNP): To be eligible SSBCI benefits, the member must have one or more of the following chronic conditions: Cardiovascular disorders, Chronic heart failure, Stroke, Dementia, Diabetes, or certain other eligible conditions not listed here. All conditions may not apply to all benefits. If you qualify for one of the chronic conditions, you must also qualify as a “chronically ill” enrollee as defined by CMS regulations and on this Plan’s coverage criteria for SSBCI.
- 2025 Simpra Advantage Assist (PPO I-SNP): To be eligible for SSBCI benefits, the member must have one or more of the following chronic conditions: Cardiovascular disorders, Dementia, Diabetes, Chronic lung disorders, Stroke, or certain other eligible conditions not listed here. If you qualify for one of the chronic conditions, you must also qualify as a “chronically ill” enrollee as defined by CMS regulations and on this Plan’s coverage criteria for SSBCI.
The Benefits Mastercard® Prepaid Card is issued by The Bancorp Bank N.A., Member FDIC, pursuant to license by Mastercard International Incorporated and card can be used for eligible expenses wherever Mastercard is accepted. Valid only in the U.S.No cash access. This is not a gift card or gift certificate. Prepaid cards are distributed as a gratuity without the payment of any monetary value or consideration. This card cannot be used to pay for prescription drugs or products that are not eligible. Product exclusions include alcohol, tobacco, firearms and gift cards. If you would like to buy items that are not eligible, you will need to use another form of payment.