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New Special Enrollment Period (SEP) for qualifying Individuals and Families starts February 15

Posted February 24, 2021 by Anne Armao Vice President of Member Experience and Product Development


Anne Armao

As part of the pandemic’s toll, millions of Americans have lost their jobs and their employer-sponsored health coverage. The window to sign up for your own individual or family plan closed on December 15.

Good news! Starting February 15, consumers seeking health insurance may be able to take advantage of this Special Election Period.  Find out if you are eligible by visiting summacare.com/individual or by calling us.  The SEP is being offered from February 15 through May 15.

That means you’ll have a new 90-day window to apply for coverage, like a SummaCare Individual or Family plan. You can rest easy knowing you can still access the medical care you need. That includes plans in the HealthCare.gov marketplace offered through the Affordable Care Act (“Obamacare”).  This does not apply to Medicare.

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

Access to care is crucial. Be sure the plan you choose includes your doctors and preferred hospitals in- network and that the drugs you take are covered. 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 and 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 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:

  • 3 FREE office visits on most plans to your SummaCare Primary Care Physician (PCP)* and outpatient mental health services for each person on your policy
  • FREE preventive health services, including immunizations, flu shots and mammograms
  • Global Fit gym discounts
  • $0 preventive generic Tier 1 drugs
  • Preventive health reminders
  • Pediatric vision care
  • SummaCare plans include health and wellness programs including 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 added 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 plan in Ohio.

    If money’s tight, subsidies are available to lower your monthly premium.

    You can 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 new Special Enrollment Period (SEP) for Individual and Family plans runs from February 15 to May 15. Beyond that, you can enroll if you have a life event that qualifies you for a Special Enrollment Period.

    Questions? Call a SummaCare advisor at 888-251-7957. They are available to take your call from 8:30 a.m. to 5 p.m., Monday through Friday. To learn more or compare plans, visit summacare.com/individual.

     

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