It's Time to Review your Medicare Coverage

Posted October 01, 2021 by Sue Titterington Vice President, Sales & Market Development

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It’s that time of year again when the leaves change color, temperatures turn cooler and the annual Medicare Annual Enrollment Period (AEP) begins. From October 15 through December 7, 2021 is when most Medicare eligibles can select their Medicare coverage for 2022.

Whether you’re just turning 65 and newly eligible for Medicare or you’re simply looking to enhance your current Medicare coverage, there are key things to consider when weighing your options.

SummaCare Medicare Advantage plans offer everything that original Medicare covers but adds extra benefits and services. Those extras could include coverage for dental, vision, hearing aids, over-the-counter items, gym memberships, rides to your doctor and much more. With premiums starting as low as $0 per month, SummaCare Medicare Advantage plans truly help consumers make the most of their Medicare dollar.

And, if you’re a U.S. military veteran, you pair your VA benefits with a SummaCare Medicare Advantage plan and enjoy all of these extra benefits plus have access to a provider network that includes over 22,000 providers and 75 hospitals.

Explore the benefits of SummaCare’s Medicare Advantage plans and get tips on how to choose the plan that’s right for you.

SummaCare’s Medicare Advantage plan benefits

While most health plans simply want you to join, at SummaCare, we make sure you’ll want to stay. Every year we're pleased to add more extra benefits and enhancements to our plans. Find out what’s new for 2022 including:

 

BrainHQ: BrainHQ is your online headquarters for working out your brain. Just as our bodies require care and exercise over the course of life, so do our brains — especially as we age. New for 2022, BrainHQ provides the exercise your brain needs to be at its sharpest. Think of it as a personal gym, where you exercise your memory, attention, brain speed, people skills, intelligence and navigation, instead of your abs, delts and quads.

 

More comprehensive dental coverage: Through our partnership with Delta Dental of Ohio, you now have coverage for fillings, in addition to what’s already covered, including two cleanings and exams, an X-ray, plus visits for dental pain. Further comprehensive coverage is included with the Garnet plan. Additional supplemental dental coverage can be purchased for an additional monthly premium.

 

PERS (Personal Emergency Response System: The new PERS benefit is designed to enable individuals to safely age in place. Offered through ConnectAmerica, PERS provides 24/7 emergency assistance and care, increasing safety, independence and extending your quality of life. This benefit is only offered with the Emerald plan.

 

New additions to provider network: Cleveland Clinic, including Cleveland Clinic Akron General, is now included in our Medicare Advantage provider network. This new relationship provides an additional 12 hospitals and 6,000 doctors.

 

SummaCare is one of the only plans in Ohio to offer Family On-Demand with Papa and Assist America®:

 

Family On-Demand with Papa: This program pairs older adults and families with Papa Pals for companionship and assistance with everyday tasks, including help around the house, a ride to the doctor’s, pharmacy or anywhere around town, assist with errands or simply someone to talk to. Not only does it provide support to SummaCare MA members, but it can also provide relief and respite to caregivers.

Assist America: This program provides global emergency travel assistance when you’re more than 100 miles from home or in a foreign country. It gives you peace of mind while traveling, knowing that a single phone call gives you access to a vast network of resources to help coordinate care on your behalf during any medical travel emergency.

 

All of our Medicare Advantage plans have a $0 copay for routine and supplemental vision exams, supplemental hearing exams, transportation, home safety devices and diabetes test strips. Most also include free vaccines and $0 copays for preferred generic drugs — even through the coverage gap.

 

All of our plans offer Medicare-covered acupuncture for lower back pain. Most also offer therapeutic massages, general acupuncture and a quarterly allowance for OTC items.

 

We contract with Teladoc® to offer their services from the comfort of home, available 24/7/365 with $0 copay. Telehealth visits with in-network physicians are $0 for PCP, dermatology, behavioral health and substance abuse, and $20 for all other specialties.

 

All of our 2022 plans include a visitor/travel benefit for snowbirds. If you travel to Florida, you’ll receive in-network coverage for medical benefits received by any Medicare-approved provider. All our plans also include worldwide emergency, urgent care and ambulance services, plus Assist America®.

 

We offer nutritious, home-delivered meals to members who are recovering from a hospital stay or who have diabetes with a high A1C level.

 

How to choose the plan that’s right for you

With dozens of plans out there, how do you choose? SummaCare helps you narrow down your search to find the right coverage for you:

1. Talk to a SummaCare Medicare Advisor. A SummaCare Medicare Advisor can answer your questions and help you figure out what’s most important to you as you weigh different plan costs, provider networks, prescription drug coverage and more. For instance:

 

Are your preferred doctors and hospitals network providers?

What are the monthly premiums, maximum out-of-pocket costs and copays?

Are your prescription drugs covered?

Are extra benefits like dental, vision, hearing aids, OTC medications and gym memberships offered?

What is their reputation for quality and customer service?

 

SummaCare Medicare Advisors can be reached by calling 330-996-8440 or (toll free) 888-464-8440 (TTY 800-750-0750).

2. Compare plans side-by-side on Medicare.gov or an insurer’s website. Medicare provides an annual Star Rating for each Medicare Advantage plan based on more than 40 rigorous quality measures. A total of 5 stars are possible, with 5 being the highest and 1 being the lowest. Medicare uses a formula that accounts for quality metrics from the following areas to provide a Star Rating for each plan:

 

Staying healthy: screenings, tests and vaccines

Managing chronic (long-term) conditions: monitoring and controlling problems like diabetes and kidney disease

Plan responsiveness and care: how quickly you can get appointments and health care

Member complaints, problems getting services and choosing to leave the plan

Health plan customer service: for example, making sure that appeals are handled in a timely manner

Reviewing Medicare’s star ratings can help you choose a high-quality plan. For instance, SummaCare has consistently been one of the highest-ranking Medicare Advantage plans in Ohio. Our 2021 Star Rating is 4.0.

3.Read the fine print. Once you’ve prioritized the features you want from a plan, do a little digging to be sure you’re getting everything you need for a price you can afford. And don’t forget to check your out-of-pocket maximum cost, which varies from plan to plan.

4. Pick integrated care over big name providers. When doctors, hospitals and insurance companies don’t work together to coordinate and integrate the care, patients are often left to suffer during their most vulnerable times. Coordinated and integrated care seems so simple, but it is not easily achieved if doctors, hospitals and insurance companies spend time dueling with each other.

SummaCare is part of Summa Health, a high-quality integrated delivery system in Northern Ohio. We work with our doctor and hospital partners to design the best integrated care for our members. This is one of the main reasons we consistently outrank our competition in quality scores and Medicare Star Ratings.

The Annual Enrollment Period for Medicare Advantage plans runs from October 15th to December 7th. If you have questions about Medicare, call a SummaCare Medicare Advisor at 330-996-8440 or (toll-free) 888-464-8440 (TTY 800-750-0750). They’re available to take your call from 8 a.m. to 8 p.m., seven days a week. We also offer free informational seminars to learn about SummaCare’s Medicare Advantage plans.

For more information, compare plans or enroll, visit www.summacare.com/medicare.

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. Other providers are available in our network.

 

 

 

 

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