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Medical Benefits

As a SummaCare Individual & Family member, your plan includes comprehensive benefits that will cover you when you do not have employer group insurance and are not yet eligible for Medicare.

Individual & Family Plan Documents

2023 plans:

SummaCare Value with SCConnect Network and 3 Free PCP Visits + Travel Assistance + Adult Vision Exam
SummaCare Bronze 8000 with SCConnect Network and Travel Assistance + Adult Vision Exam
SummaCare Bronze 8000-100 with SCConnect Network and Travel Assistance + Adult Vision Exam
SummaCare Bronze 8000-Limited with SCConnect Network and Travel Assistance + Adult Vision Exam
SummaCare Bronze 8000 with SCConnect Network
SummaCare Bronze 8000-100 with SCConnect Network
SummaCare Bronze 8000-Limited with SCConnect Network
SummaCare Bronze 9100 with SCConnect Network and 3 Free PCP Visits + Travel Assistance + Adult Vision Exam
SummaCare Bronze 9100-100 with SCConnect Network and 3 Free PCP Visits + Travel Assistance + Adult Vision Exam
SummaCare Bronze 9100-Limited with SCConnect Network and 3 Free PCP Visits + Travel Assistance + Adult Vision Exam
SummaCare Bronze 9100 with SCConnect Network and 3 Free PCP Visits
SummaCare Bronze 9100-100 with SCConnect Network and 3 Free PCP Visits
SummaCare Bronze 9100-Limited with SCConnect Network and 3 Free PCP Visits
SummaCare Bronze 7000 HSA with SCConnect Network and Travel Assistance + Adult Vision Exam
SummaCare Bronze 7000-100 with SCConnect Network and Travel Assistance + Adult Vision Exam
SummaCare Bronze 7000-Limited with SCConnect Network and Travel Assistance + Adult Vision Exam
SummaCare Bronze 7000 HSA with SCConnect Network
SummaCare Bronze 7000-100 with SCConnect Network
SummaCare Bronze 7000-Limited with SCConnect Network
SummaCare Silver 3500 with SCConnect Network and 3 Free PCP Visits + Travel Assistance + Adult Vision Exam
SummaCare Silver 3500-73 with SCConnect Network and 3 Free PCP Visits + Travel Assistance + Adult Vision Exam
SummaCare Silver 3500-87 with SCConnect Network and 3 Free PCP Visits + Travel Assistance + Adult Vision Exam
SummaCare Silver 3500-94 with SCConnect Network and 3 Free PCP Visits + Travel Assistance + Adult Vision Exam
SummaCare Silver 3500-100 with SCConnect Network and 3 Free PCP Visits + Travel Assistance + Adult Vision Exam
SummaCare Silver 3500-Limited with SCConnect Network and 3 Free PCP Visits + Travel Assistance + Adult Vision Exam 
SummaCare Silver 3500 with SCConnect Network and 3 Free PCP Visits
SummaCare Silver 3500-73 with SCConnect Network and 3 Free PCP Visits
SummaCare Silver 3500-87 with SCConnect Network and 3 Free PCP Visits
SummaCare Silver 3500-94 with SCConnect Network and 3 Free PCP Visits 
SummaCare Silver 3500-100 with SCConnect Network and 3 Free PCP Visits
SummaCare Silver 3500-Limited with SCConnect Network and 3 Free PCP Visits
SummaCare Silver 5000 with SCConnect Network and 3 Free PCP Visits + Travel Assistance + Adult Vision Exam
SummaCare Silver 5000-73 with SCConnect Network and 3 Free PCP Visits + Travel Assistance + Adult Vision Exam
SummaCare Silver 5000-87 with SCConnect Network and 3 Free PCP Visits + Travel Assistance + Adult Vision Exam
SummaCare Silver 5000-94 with SCConnect Network and 3 Free PCP Visits + Travel Assistance + Adult Vision Exam
SummaCare Silver 5000-100 with SCConnect Network and 3 Free PCP Visits + Travel Assistance + Adult Vision Exam
SummaCare Silver 5000-Limited with SCConnect Network and 3 Free PCP Visits + Travel Assistance + Adult Vision Exam
SummaCare Silver 5000 with SCConnect Network and 3 Free PCP Visits
SummaCare Silver 5000-73 with SCConnect Network and 3 Free PCP Visits
SummaCare Silver 5000-87 with SCConnect Network and 3 Free PCP Visits
SummaCare Silver 5000-94 with SCConnect Network and 3 Free PCP Visits
SummaCare Silver 5000-100 with SCConnect Network and 3 Free PCP Visits
SummaCare Silver 5000-Limited with SCConnect Network and 3 Free PCP Visits
SummaCare Silver 5000 40 with SCConnect Network and Travel Assistance + Adult Vision Exam
SummaCare Silver 5000-73 40 with SCConnect Network and Travel Assistance + Adult Vision Exam
SummaCare Silver 5000-87 40 with SCConnect Network and Travel Assistance + Adult Vision Exam
SummaCare Silver 5000-94 40 with SCConnect Network and Travel Assistance + Adult Vision Exam
SummaCare Silver 5000-100 40 with SCConnect Network and Travel Assistance + Adult Vision Exam
SummaCare Silver 5000-Limited 40 with SCConnect Network and Travel Assistance + Adult Vision Exam
SummaCare Silver 5000 40 with SCConnect Network
SummaCare Silver 5000-73 40 with SCConnect Network
SummaCare Silver 5000-87 40 with SCConnect Network
SummaCare Silver 5000-94 40 with SCConnect Network
SummaCare Silver 5000-100 40 with SCConnect Network
SummaCare Silver 5000-Limited 40 with SCConnect Network
SummaCare Silver 6000 with SCConnect Network and Travel Assistance + Adult Vision Exam
SummaCare Silver 6000-73 with SCConnect Network and Travel Assistance + Adult Vision Exam
SummaCare Silver 6000-87 with SCConnect Network and Travel Assistance + Adult Vision Exam
SummaCare Silver 6000-94 with SCConnect Network and Travel Assistance + Adult Vision Exam
SummaCare Silver 6000-100 with SCConnect Network and Travel Assistance + Adult Vision Exam
SummaCare Silver 6000-Limited with SCConnect Network and Travel Assistance + Adult Vision Exam
SummaCare Silver 6000 with SCConnect Network
SummaCare Silver 6000-73 with SCConnect Network
SummaCare Silver 6000-87 with SCConnect Network
SummaCare Silver 6000-94 with SCConnect Network
SummaCare Silver 6000-100 with SCConnect Network
SummaCare Silver 6000-Limited with SCConnect Network
SummaCare Gold 2000 with SCConnect Network and 3 Free PCP Visits + Travel Assistance + Adult Vision Exam 
SummaCare Gold 2000-Limited with SCConnect Network and 3 Free PCP Visits + Travel Assistance + Adult Vision Exam 
SummaCare Gold 2000-100 with SCConnect Network and 3 Free PCP Visits + Travel Assistance + Adult Vision Exam 
SummaCare Gold 2000 with SCConnect Network and 3 Free PCP Visits
SummaCare Gold 2000-100 with SCConnect Network and 3 Free PCP Visits
SummaCare Gold 2000-Limited with SCConnect Network and 3 Free PCP Visits
SummaCare Standard Silver
SummaCare Standard Silver-73
SummaCare Standard Silver-87
SummaCare Standard Silver-94
SummaCare Standard Gold 

Plan Extras

SummaCare Individual and Family Plans include medical and pharmacy coverage, health and wellness services and programs, and essential health benefits including pediatric dental and maternity are included in all plans. Learn more about what’s included.

Financial Assistance

You may qualify for financial assistance in the form of an advanced premium tax credit and/or cost-sharing subsidy if applicable to your household. To be eligible for savings on your monthly premium, you must be under age 65 and not eligible for coverage through your employer, Medicare or Medicaid. Savings is based upon income, household size and plan options available in your area. Get an estimate of potential cost savings available to you by using the Premium Subsidy Calculator.

Important Determination, Appeals & Grievances Information

If we make a medical coverage decision that you are not satisfied with, you can appeal this decision. An appeal is a formal way of asking us to review and change a coverage decision we have made. Learn more about our appeals and grievances process in your Evidence of Coverage document, as well as how to appeal a decision.

Questions?  We are here to help.

By Phone

Member Services:
330-996-8700

Toll-Free:
800-996-8701

Hours

Monday - Friday
8:30 a.m. - 5:30 p.m. 

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