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Individual & Family plan

Posted November 19, 2020 by Anne Armao VP, Medicare & Individual Products and Sales

Anne Armao

No employer health coverage? No problem.

If you don’t have health insurance coverage through an employer, Medicare, Medicaid or the Children’s Health Insurance Program (CHIP), you can still protect yourself with an Individual & Family plan.

What should you look for in an Individual & Family plan?

Access to care is crucial. Be sure the plan you choose includes your doctors and preferred hospitals in their network and that the drugs you take are in their formulary. Compare total out-of-pocket costs, too, as well as value-added benefits like telehealth and gym discounts.

Explore the benefits of a SummaCare plan.

As a local plan based in Akron, SummaCare has a vested interest in the health of this community. We give our members the personal attention you’d expect from your friends and neighbors. Your calls are answered right here by friendly experts who understand your needs and can help you find a plan to meet them.

SummaCare offers eight different HMO Individual & Family plans with benefits like these:

• All essential benefits are covered, including pre-existing conditions, with no lifetime dollar limits. Our nationwide pharmacy network includes all national pharmacies and most local independent pharmacies. Your premium, deductible and copays will vary by plan.

• You’ll have access to a network of the area’s finest physicians, facilities and hospitals, including Summa Health System, Mercy Medical Center and Akron Children’s Hospital. You don’t need a referral to see a specialist.

• Get more for your money with value-added benefits like:

  • free preventive screenings
  • Global Fit gym discounts
  • 3 free PCP and mental health outpatient visits per year for everyone on your plan (most plans)
  • $0 preventive generic Tier 1 drugs
  • preventive health reminders
  • pediatric vision care

• SummaCare plans include health and wellness programs like one-on-one health coaching to help prevent problems like high blood pressure, diabetes, high cholesterol and heart disease.

• Get access to WebMD’s Health Manager online tool to help you set wellness goals, monitor your progress, track your results and set personal reminders.

• Get the right care at the right time and place with SummaCare’s 24-Hour Nurse Line. RNs are available 24/7 to answer your medical questions, offer health advice and provide guidance on where to seek treatment.

• Get access to telehealth visits through Teladoc® or any in-network provider who offers telehealth, for general medical, dermatology and behavioral health visits.

• New for 2021, we’re adding Assist America® for global emergency travel assistance. If you’re more than 100 miles from home or in a foreign country, you can access a vast network of resources to help coordinate your care. All it takes is a single phone call to their 24/7 operations center. Assist America is exclusive to SummaCare and isn’t offered by any other plans in Ohio.

Federal subsidies are available to lower your monthly premium.

You may qualify for a premium tax credit if your estimated household income falls between 100% and 400% of the federal poverty level for your household size. If your household income is up to 250% of the poverty line, you may also qualify for a cost sharing reduction discount to reduce your out-of-pocket costs (when enrolled in one of our Silver plans).

The Open Enrollment Period for Individual & Family plans runs through December 15th for 2021 health insurance. Beyond that, you can enroll if you have a life event that qualifies you for a Special Enrollment Period.

Questions? Call a SummaCare advisor at888-539-5560. They’re available to take your call from 8:30 a.m. to 5 p.m., Monday through Friday. To learn more or compare plans, visit