Explore the extra benefits available to SummaCare Medicare Advantage plan members. To learn more about the benefits included with the Jade (HMO) plan featuring Bene-Flex™, click here.
(not included with the Amber (HMO) plan)
Most plans conveniently include Part D Prescription Drug Coverage, including $0 copays for Tier 1 drugs, Tier 6 drugs and vaccines. Some plans also offer $0 copay for Tier 2 drugs.
You're covered for a wide variety of services including cleanings and exams as well as simple extractions, root canals, bridges, crowns and dentures on all plans. And, we've increased our annual maximum on our Garnet and Ruby plans. Supplemental dental coverage can be purchased for an additional monthly premium.
Use your SummaCare Visa card to spend your Benefits Bucks quarterly allowance on non-prescription OTC health-related items at more than 68,000 retailers — or have them shipped right to your door. You’ll receive a quarterly amount to spend on non-prescription OTC health-related items like vitamins, pain relievers, cough and cold medicines and first aid supplies. Topaz (HMO) plan members (with a qualifying health condition*) may choose to use their OTC allowance for healthy grocery items.
*This benefit is part of a special supplemental program for the chronically ill; members must have a diagnosis of diabetes mellitus type 1 or type 2, congestive heart failure, chronic kidney disease, COPD, coronary artery disease, chronic non-alcoholic fatty liver disease, autoimmune disease, chronic and disabling mental health conditions, or neurologic disorders to choose/utilize it.
For most benefits, receive in-network coverage in the states of Arizona, Florida and Texas when you visit a Medicare-participating provider through our visitor/travel benefit. Whether you're a snowbird or regularly travel, go with confidence knowing you're covered. Topaz, Jade and Garnet plans also provide in-network coverage in the states of North Carolina and South Carolina when you visit a Medicare-participating provider through our visitor/travel benefit.
Our plans also have built-in worldwide emergency, urgent care coverage and ambulance services too, so you can travel close to home or around the world, worry-free.
Note: SummaCare network providers must be used for Part D prescription drugs and certain supplemental benefits.
If you have chronic low back pain, you’re covered for acupuncture on all plans. Supplemental acupuncture services are available on Amber, Topaz, Garnet and Emerald plans. Visits must be scheduled through HOMELINK.
You’re covered for therapeutic massage services on Amber, Topaz, Garnet and Emerald plans. Visits must be scheduled through HOMELINK. Medicare requires a provider’s order for this and HOMELINK will work with the provider to get one.
Health Coaching is a one-on-one telephonic service to help you identify at-risk behaviors and provide suggestions to improve your wellness.
Condition Management includes a registered nurse helping you learn how to better manage your chronic condition and how to maintain and improve your quality of life.
Once you're a member, you’ll get exclusive access to WebMD’s Health Manager online tool. Set personal goals, monitor your health progress, track results, set personal health and wellness reminders.
Do you sometimes forget to schedule regular check-ups? Once you're a member, we’ll send you reminders for preventive services and other recommended care for common conditions.
And, receive Rewards on your SummaCare Visa card for using key preventive care services, including:
SummaCare can offer support to smokers who are ready to kick the habit. Quitting specialists will enroll members in the no-cost QuitCare counseling program. Members may choose to receive a limited supply of nicotine replacement therapy at no cost.
Hang Out and Help Out. Papa pairs older adults and families with Papa Pals for companionship and assistance with everyday tasks. Get help around the house, including light housework, a ride to the doctor’s office, pharmacy (or anywhere around town), help with errands or simply someone to talk to. Providing support to SummaCare Medicare Advantage members also offers relief and respite to caregivers.
You’re covered for telehealth visits with primary care providers, specialists and/or behavioral health and substance abuse providers. Visits can be scheduled through in-network providers or through Teladoc®. Most Teladoc visits can be scheduled 24 hours a day, 365 days a year.
You may qualify for coverage for home safety devices, such as grab bars, shower stools and more. There is no diagnosis requirement for Emerald and Jade members.
SummaCare is excited to offer BrainHQ — your online headquarters for working out your brain. 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. Just as our bodies require care and exercise over the course of life, so do our brains—especially as we age. BrainHQ provides the exercise your brain needs to be at its sharpest. BrainHQ is not covered on the Topaz plan.
Offered with the Emerald (HMO-POS) plan and can be selected with the Jade (HMO) plan, the PERS (Personal Emergency Response System) benefit, offered through ConnectAmerica, provides 24/7 emergency assistance and care, increasing safety, independence and extending quality of life while enabling individuals to safely age in place (GPS enabled to work outside the home).
Amber (HMO), Topaz (HMO), Garnet (HMO), Ruby (HMO), Sapphire (HMO-POS) and Emerald (HMO-POS) plans include a meal delivery benefit (the number of which varies by plan) for post-discharge after a hospital stay or for diabetics with a high A1C level (over 8).
Jade (HMO-POS) plan members have the option to use one of their five Bene-Flex™ choices for a meal benefit such as Post-Discharge Meal Delivery (28 meals) or Chronic Care Meal Delivery (84 meals) if they have a qualifying health condition**.
**This benefit is part of a special supplemental program for the chronically ill; members must have a diagnosis of diabetes mellitus type 1 or type 2, congestive heart failure, chronic kidney disease, COPD, coronary artery disease, chronic non-alcoholic fatty liver disease, autoimmune disease, chronic and disabling mental health conditions, or neurologic disorders to choose/utilize it.
If you are living with a serious or chronic health condition, SummaCare offers members additional programs and services designed to help you stay independent and feel your best. If you qualify, our Care Management team will reach out to you once you are a member.
*Benefit must be elected as a Bene-Flex™ option to be utilized on the Jade (HMO) plan.