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Member Resources

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Member Resources

As a trusted partner in your healthcare, we want to be sure you have all the information necessary to make informed decisions about your health. If you have any questions about the information provided, please contact Member Services at 330.996.8671 (TTY 711) or 833.443.0818 (TTY 711). Our Member Services team can help you select a Primary Care Provider (PCP), learn about deductibles and copays and more.

Account Services

Change My Address

Moving or recently changed your address? Use SummaCare’s online address change form to help ensure you continue receiving important plan information, member materials and communications without interruption. Members should report address changes within 30 days to keep account information up to date.

Change Your Address

Change My Primary Care Provider

When you choose SummaCare, we recommend you select a Primary Care Provider (PCP). Your PCP is your guide to better health. You can change your PCP at any time.

Change My PCP

Electronic Funds Transfer

Simplify your monthly premium payments with Electronic Funds Transfer (EFT). Members can securely set up automatic payments from a checking, savings or credit account to help avoid missed payments and manage premiums more conveniently. Learn more about EFT enrollment, payment options and your electronic banking rights.

Learn More

EPTC Tax Credit

Marketplace Enhanced Premium Tax Credit Expiration – What You Need to Know in 2026

If you’re feeling confused about the expiration of Enhanced Premium Tax Credits (EPTCs), and the increased cost of your 2026 Marketplace plan premium—you’re not alone. We’re here to help. Use the subsidy calculator below to estimate your monthly premium cost or read through our list of commonly asked questions to better understand how subsidy changes impact you. 

 

The Basics

Most Marketplace members receive a Premium Tax Credit (PTC) (also called a subsidy) to help cover the cost of their monthly health plan premium. These PTCs are determined based on income and family size. With PTCs, you share the cost of your monthly premium payment with the government, each paying a portion of your monthly premium. 

 

Make a Payment

Paying Your Individual & Family Plan Premium

Thank you for choosing SummaCare. We provide you with multiple payment options to meet your needs.

New Members

Online

Make your Pre-Enrollment Invoice payment here 

Phone

Call 833.443.0818 or 330.996.8671 from 8:30 a.m. to 5:30 p.m. Monday through Friday to make a payment by credit card or Electronic Funds Transfer.

Mail

Make all checks payable to SummaCare and mail to:

SummaCare
PO Box 7411080
Chicago, IL 60674-1080

Please include member's first and last name, address and phone number. 

Current SummaCare Members

Online 

Log in to your SummaCare Plan Central member account to pay your ongoing monthly premium here by credit card. You can also sign up for paperless invoices when logged into your member account. 

Phone

Call 833.443.0818 or 330.996.8671 from 8:30 a.m. to 5:30 p.m. Monday through Friday to make a payment by credit card or Electronic Funds Transfer.

Mail

Make all checks payable to SummaCare and mail to:

SummaCare
P.O. Box 7411080
Chicago, IL 60674-1080

Please include member's first and last name, address and phone number. 

Pay Your Monthly Premium Electronically

Pay your monthly premium electronically through your SummaCare member account using fast, secure payment options.

Go

Request a New Member ID Card

Always carry your member ID card with you. You will need this card whenever you seek medical services, such as visiting your doctor or going to the emergency room.

Get a New Card

Request Benefit Materials

Request printed copies of your plan’s benefit materials and important documents. We’ll send them to you so you have the information you need, when you need it.

Get My Materials

Additional Resources

Formulary

Your policy includes a prescription drug benefit. You can see the list of drugs by viewing the formulary for your policy.

Learn More

Fraud Waste and Abuse

Help protect yourself and your health coverage by learning how to identify and report healthcare fraud and abuse. SummaCare provides resources to help members recognize suspicious activity, understand their rights and report concerns related to billing, services or misuse of health benefits. Reporting fraud and abuse helps maintain the integrity of the healthcare system for everyone.

Learn More

Individual & Family Policies

Your Evidence of Coverage (EOC) is a comprehensive document that details the benefits, services, and rights you have as a SummaCare member. It outlines covered medical and pharmacy services, exclusions, cost-sharing details, and important policies regarding your plan. The EOC also explains how to access care, file claims, and what to do if you need to appeal a coverage decision. Reviewing your EOC helps you understand your health plan and make informed healthcare decisions.

2026 EOCS:
HMO Individual OFF
HMO Individual ON

Schedules of Benefits

Our Vendors

As a member of SummaCare you may or may not be called by one of our vendors to offer you a service or information on behalf of SummaCare.

Learn More

Urgent and Emergency Care

Primary Care Provider

Your (PCP) is the best person to start with when you’re sick or hurt. Contact his or her office first to see if a visit to an urgent care facility is necessary. If your condition isn’t life-threatening, but needs to be taken care of right away, then urgent care may be the right choice for you. Urgent care centers are usually open after normal business hours, including evenings and weekends. Many offer on-site diagnostic tests.

Check here to see if there is an urgent care facility near you.

Emergency Care

A “medical emergency” is when you, or any other prudent layperson with an average knowledge of health and medicine, believe that you have medical symptoms that require immediate medical attention to prevent loss of life, loss of a limb or loss of function of a limb. The medical symptoms may be an illness, injury, severe pain or a medical condition that is quickly getting worse. 

If you have a medical emergency, get help as quickly as possible, Call 911 for help or go to the nearest emergency room or hospital.  

Click here to see which hospitals are in your SCConnect network.

Women's Health and Cancer Rights Act

The Women's Health and Cancer Rights Act was signed into law on October 21, 1998. This law provides mandatory coverage for women with respect to medical and surgical benefits after having a mastectomy, providing that the health plan covers mastectomies. Group health plans, as well as health insurance issuers that offer coverage for mastectomies, are required to provide the coverage to participants of group health plans, as well as to those participants enrolled in an individual plan. Benefits under the Act include:

  1. All stages of reconstruction of the breast on which the mastectomy has been performed
  2. Surgery and reconstruction of the other breast to produce a symmetrical appearance
  3. Prosthesis
  4. Medical complications at all stages of the mastectomy, including lymphedemas
Copays, coinsurance and deductibles apply as long as they are consistent with other benefits under the plan. Additionally, persons moving from one plan to another may be required to comply with the new plan's pre-existing condition limitations, subject to HIPAA (Health Insurance Portability and Accountability Act) restrictions.

Your Network

As of your effective date, SummaCare in-network healthcare services will be provided by the SCConnect network of doctors and hospitals. SCConnect is an exclusive network of providers and is available to residents and businesses located in Medina, Stark, Summit and Portage counties. We are able to offer efficient care at lower costs by providing access to this exclusive network of providers.  

SCConnect Network Providers

Your network includes the area’s finest hospitals, including Summa Health, Akron Children’s Hospital and Cleveland Clinic Mercy Hospital.

In addition, you have access to hundreds of local healthcare professionals and outpatient facilities – including doctors, nurse practitioners, therapists and other providers who work together to coordinate your care. To lower your out-of-pocket costs for emergency care outside of the service area and/or network, use First Health providers.

You can search the SCConnect network here.

It’s a good idea to review the network listing before you access services to be certain the provider is participating in the SCConnect network.

Your Primary Care Provider (PCP)

Having a primary care provider (PCP) can keep you healthier as you age. Your PCP will coordinate your care and work directly with other providers in the network to assure you’re receiving the care that’s most appropriate. If you require care from a specialist, your PCP can serve as your navigator to ensure you receive care from the providers best suited for your medical conditions.

SummaCare generally requires the designation of a PCP. You have the right to designate any primary care provider who participates in our network and who is available to accept you or your family members. Until you make this designation, SummaCare designates one for you. For children, you may designate a pediatrician as the PCP.

If you need help selecting a PCP or have questions about the SCConnect network, call SummaCare Member Services at 330.996.8671 or 833.443.0818 (TTY 711).

Questions?  We are here to help.

Phone

330.996.8671 (TTY 711) Member Services

833.443.0818 (TTY 711) Toll-Free

Email

info@summacare.com existing members

info@summacare.com all other inquiries

Hours

Days Times
Mon – Fri 8:30 a.m. – 5:30 p.m.

Outside these hours, you may leave us a message and a representative will return your call the next business day.

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