Long-Term Care benefits
The Statewide Medicaid Managed Care Long-Term Care (SMMC LTC) program provides services and supports to people who qualify for Medicaid nursing home placement. It includes long-term care services to help you live at home or in setting that you choose. You may be eligible to enroll in the plan if you:
- Are age 18 or older
- Are eligible for Medicaid
- Have had a review by Comprehensive Assessment and Review for Long-Term Care Services (CARES) to decide your eligibility
- Live in our service area
What you get with Simply
We help you get the services and supports you need for everyday living. You will get a personal case manager who will work with you, your loved ones and your providers to make a plan of care.
Plan of care
Care coordination
Caregiver support
Covered long-term care services
If you live in an assisted living facility, adult family care home or nursing home, there may be a room and board or patient responsibility cost. There are no costs for other covered services.
- Adult companion care
- Adult day health care
- Assistive care services
- Assisted living services
- Attendant care services
- Behavioral management
- Care coordination/case management
- Caregiver training
- Home accessibility adaptation
- Home-delivered meals
- Homemaker services
- Hospice services
- Intermittent and skilled nursing
- Medical equipment and supplies
- Medication administration
- Medication management
- Nursing facility services
- Nutritional assessment/risk reduction services
- Occupational, physical, respiratory and speech therapy services
- Personal care services
- Personal Emergency Response System (PERS)
- Respite care
- Nonemergency transportation services
If you need transportation to your medical appointments, you or your provider can schedule a ride for you 8 a.m. to 5 p.m. Monday through Friday at no cost. At least three business days before your appointment, call:
- 844-671-6662 in Broward, Miami-Dade, and Monroe counties.
- 877-931-4753 in all other counties.
Please call back if anything changes.
These services require prior authorization (approval) before you can get them. Your plan of care will have all the services you and your case manager decide on. Your case manager will get approval for your services.
You’ll keep getting your primary care services from your Medicare or Medicaid plan.
We offer extra benefits just for our Simply members free of charge.
Bed-hold payments
For up to 30 days for members in assisted living facilities or adult family care homes
Extra minutes
An extra 200 minutes at enrollment and 100 minutes for their birthday for members enrolled in the federal SafeLink program, which provides a free cellphone with free monthly minutes and text messaging.
Nursing home transition fund
Up to $5,000 toward costs for moving to a home or community setting. Funds can help pay for:
- Security and utility deposits
- Household furnishings
- Moving costs
Items for a healthy lifestyle
Two* free items to help start healthy living habits from this list:
- Digital scale
- Home blood pressure cuff
- Peak flow meter
- Reach and grab tool
- Lumbar cushion
- Clip-on lamp
- Personal fan
*You cannot order two of the same item.
Limitations and restrictions apply. Benefits may change.
You can redeem some benefits online through your secure account. View the extra benefits you’re eligible for on the Benefit Reward Hub. You can also call Member Services at 877-440-3738 (TTY 711) Monday through Friday from 8 a.m. to 7 p.m. Eastern time.
For a full list of extra benefits, review the member handbook.
Log in to get started today!
Log inUnderstanding case management
Your case manager
You’ll have your own case manager who will talk to you, your caregivers and your providers about the services you need. Your case manager will help coordinate all of your services.
Your plan of care
You’ll get a plan of care designed just for you. You and your case manager will work together to figure out the care and services you need to help you meet your health care goals. Your case manager will look at your:
- Health needs
- Home setting
- Support from family and friends
When your needs change, your case manager will look at what has changed and make changes to your plan of care.
Your case management team
Your case manager is part of a team who can help with:
- Finding personal care aides and homemakers
- Coordinating with home health agencies
- Finding assisted living facilities and nursing homes
- Getting rides to your appointments
- Making a back-up plan for possible gaps in service
Need to speak with your case management team?
Call 1-877-440-3738 (TTY 711) and ask for your case management team. Your team is available Monday through Friday from 8:30 a.m. to 5 p.m.
Your Care Plan is a tool for Simply Case Management members to help you:
- Stay connected with your care coordinator
- Get your care coordinator’s phone number and email address
- Send secure messages about diagnoses, goals, medicines, services and more
- View your goals and objectives
- Check due dates and statuses of goals and objectives
Member resources
We want you to understand your benefits and receive the best possible care. Here are some resources to help.
Member handbook
Complete benefit information can be found in your member handbook.
- July 2024 Member handbook update - English
- July 2024 Member handbook update - Spanish
- Member handbook – English
- Member handbook – Spanish
- Transition of Care Insert
- Transition of Care Insert - Spanish
- LTC handbook – English
- LTC handbook – Spanish
- Authorized representative form - English
- Authorized representative form - Spanish
Member Services
If you have any questions, call Member Services at 1-877-440-3738 (TTY 711). Our team is available Monday through Friday from 8 a.m. to 7 p.m. You can also log in to your account to send us a message at any time.
24-hour Nurse HelpLine
Whether it’s 3 a.m. or a Sunday afternoon, health issues come up. That’s why you can always call our 24-hour Nurse HelpLine and speak directly to a nurse. Call 1-877-440-3738 (TTY 711) anytime, day or night.
Not yet a member? Choose Simply.
You have a choice in your health care. Choose Simply for dedicated case managers to coordinate your care and extra benefits to help you live a healthier life.
How to enrollAttention Enrollees or Parents/Guardian(s) of Enrollees receiving Private Duty Nursing in the home.
You can report missed shifts or nursing visits 24 hours a day/7 days a week by phone or email.
Phone: 1-844-215-4264
Email: PDNhours@simplyhealthcareplans.com
Broward, Hardee, Highlands, Hillsborough, Manatee, Miami-Dade, Monroe, Orange, Osceola, Pasco, Pinellas, Polk and Seminole Counties.
The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the Managed Care Plan. Limitations, copayments, and/or restrictions may apply. Benefits, formulary, pharmacy network, premium and/or co-payments/co- insurance may change.