SummaCare’s health plans and services rank among the best in the nation and throughout our history, we’ve been honored for outstanding service and clinical quality.
Star ratings are important because they represent SummaCare’s vision to promote health and wellness by providing quality preventive care and service to its members.
The quality ratings also help consumers determine how well a health plan is performing in areas such as:
- How satisfied members are with the health plan
- How effective the health plan assists its providers in prevention and detection of illnesses
- How well the health plan maintains the overall well‐being of its members
- How quickly the health plan responds to the members’ needs in regard to receiving care and addressing members’ concerns, including appeals
Medicare
- SummaCare's Medicare plans earned a 5-Star (out of 5) overall rating for 2023 from the Centers for Medicare and Medicaid Services (CMS). Plan performance quality Star Ratings are assessed each year and may change from one year to the next. SummaCare is an HMO and HMO-POS plan with a Medicare contract. Enrollment in SummaCare depends on contract renewal. Every year Medicare evaluates plans based on a 5-star rating system.
- SummaCare has been recognized by U.S. News & World Report as a Best Insurance Company for 2023 Medicare Advantage Plans. This achievement is based on the recently released Centers for Medicare and Medicaid Services (CMS) Star Ratings.
- SummaCare’s Medicare Advantage Plan was recently recognized with a 5-Star (out of 5) overall rating for 2023 by CMS. Learn more about the official CMS rating for SummaCare Medicare Advantage Plans in this pdf file.
Commercial
- SummaCare's Commercial PPO plans earned the accreditation status of “Accredited" by NCQA for 2019-2022. NCQA has awarded the status of "Accredited" for service and clinical quality that meet the basic requirements of NCQA's rigorous standards for consumer protection and quality improvement.
- SummaCare's Commercial plans received a 3.5 rating (out of 5) by NCQA’s Private Health Insurance Plan Ratings for 2019-2022, based on clinical quality, member satisfaction and NCQA Accreditation Survey results.
Marketplace
- SummaCare's Individual & Family Marketplace plans earned the accreditation status of “Accredited" by NCQA for 2019-2022. NCQA has awarded the status of "Accredited" for service and clinical quality that meet the basic requirements of NCQA's rigorous standards for consumer protection and quality improvement.
*National Committee for Quality Assurance (NCQA) is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations and recognizes clinicians in key clinical areas. NCQA's HEDIS® is the most widely used performance measurement tool in health care. NCQA's website contains information to help consumers, employers and others make more informed health care choices.
