SummaCare is dedicated to providing you with easy-to-understand materials and information so you are more informed about your coverage and how it works.

Individual

Coordination of Benefits 

Drug Exceptions Timeframes and Enrollee Responsibilities

Enrollee Claim Submission

Enrollee Recoupment of Overpayments

Grace Period

Information on Explanations of Benefits (EOBs)

Medical Necessity and Prior Authorization

Out-of-Network Liability and Balance Billing

Retroactive Denials

Group

Coordination of Benefits

Drug Exceptions Timeframes and Enrollee Responsibilities

Enrollee Claim Submission

Grace Period

Information on Explanations of Benefits (EOBs)

Medical Necessity and Prior Authorization 

Out-of-Network Liability and Balance Billing

Retroactive Denials

Last Updated: June 13, 2022