AEP Member Referral

Someone you know loves SummaCare—they think you will too!

If you’re new to Medicare or thinking about retiring, request more information about our 5-Star Medicare Advantage plans, and your friend or family member who referred you will receive a $15 Bob Evans gift card!

With more than 22,000 providers and 70 hospitals there are even more reasons why SummaCare may be the only Medicare plan you'll ever have to choose.

Learn why 97% of our Medicare Advantage members stay with SummaCare by requesting your free information now.

Medicare Referral Form

First Name

Last Name

Phone Number

County

Address

City

State

ZIP Code

Referred by First Name

Referred by Last Name

Are you currently a SummaCare Medicare member?

When do you expect to need Medicare coverage?

Date of Birth

Our plans include supplemental benefits
that make a difference for members.

Our portfolio of Medicare Advantage plans feature benefits such as monthly premiums as low as $0, dental, vision and hearing aid coverage, an over-the-counter (OTC) allowance, Papa Pals, free gym memberships through SilverSneakers®, travel coverage and BrainHQ, the online memory fitness program. Plus much more!

Dental Coverage Through Delta Dental

Over-the-Counter (OTC) Allowance

Travel Coverage

New for 2023—Build Your Own Plan! Introducing Jade (HMO) with Bene-Flex™

Start with included core benefits such as dental, vision and hearing—then choose 5 supplemental benefits that best fit your current health needs from more than 15 valuable options (at no additional cost).

Someone you know loves SummaCare—they think you will too!

Medicare Referral Form

Our plans include supplemental benefits that make a difference for members.

New for 2023—Build Your Own Plan! Introducing Jade (HMO) with Bene-Flex™

Our plans include supplemental benefits
that make a difference for members.