At SummaCare, it’s personal. Your needs come first. Our seven Medicare Advantage plans are packed with extra benefit options to explore.
You’re covered for a wide variety of services including cleanings, fluoride treatments, X-rays, exams, fillings, simple extractions and root canals. Coverage for bridges, crowns and dentures is also available on all plans. Optional Supplemental Dental coverage can be purchased for an additional monthly premium.
Receive supplies to monitor your blood glucose including test strips, lancet devices, lancets and glucose-control solutions for no cost when using Abbott and/or Ascensia Contour products. Both Abbott and Ascensia Contour products are available through in-network pharmacies and/or HOMELINK.
You’re covered for one hearing aid per ear every year; choose from a wide variety of hearing aids and only pay a $395 or $695 copay per hearing aid, depending on model selected. Amplifon does have additional hearing-aid models available for purchase at a discounted rate. Includes a 60-day risk-free trial, 1 year follow-up care, 2-year battery supply or charging station and a 3-year warranty.
You may qualify for coverage for home safety devices, such as grab bars, shower stools and more. To qualify you must have had, within the last 12 months, any of the following: hip replacement, knee replacement or femur fractures; or a diagnosis of falls, as documented by a provider. Home safety devices are not covered on the Quartz (HMO) plan.
A provider’s order is required for this and HOMELINK will work with the provider to get one. There is no diagnosis requirement for Emerald (HMO-POS).
Every member will receive a SummaCare &more card** with which to spend your various Benefit Bucks, including Over-the-Counter (OTC) Allowances and Preventive Care Rewards. You'll receive a quarterly allowance on all plans to spend on non-prescription OTC health-related items like vitamins, pain relievers, cough and cold medicine and first-aid supplies at 70,000+ retailers nationwide.
Six of the seven SummaCare Medicare Advantage plans have $0 copays for Tier 1, 2 and 6 drugs* at preferred pharmacies (Prescription Part D coverage not available on Amber (HMO) plan).
* Benefits may vary based on plan selected and county availability.
Offered with the Emerald (HMO-POS) 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).
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. Papa Pals is not covered on Topaz (HMO) or Quartz (HMO) plans.
All SummaCare Medicare Advantage plans include a SilverSneakers® membership at no added cost. SilverSneakers is more than a traditional fitness program. It’s a way to improve your health and live the life you want. Whether you enjoy group fitness classes, sports, using strength and cardio equipment or prefer staying active at home, SilverSneakers gives you the opportunity to improve your health, gain confidence and connect with your community.
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're covered for therapeutic massage services performed by in-network providers. Medicare requires a provider’s order for these services. HOMELINK will work with your provider to get one. Therapeutic massage services are not covered on Topaz (HMO), Quartz (HMO), Ruby (HMO) and Sapphire (HMO-POS) plans.
You’re covered for a defined number of trips to medical appointments. Most trips can be scheduled in as little as 30 minutes, and you can see providers throughout SummaCare’s 33-county service area. HOMELINK coordinates most transportation trips using local ride-share vendors such as Uber and Lyft. Please schedule stretcher, wheelchair or electric wheelchair transport at least 72 hours in advance; ambulatory sedan trips should be scheduled 48 hours in advance. Transportation is not available on the Topaz (HMO) plan.
Through our visitor/travel benefit, members receive in-network coverage levels (for most benefits) when visiting a Medicare-participating provider in Arizona, Florida and Texas. Garnet (HMO), Ruby (HMO), Quartz (HMO) and Topaz (HMO) plan members also have travel coverage for North and South Carolina. Whether you’re a snowbird or regularly travel, go with confidence knowing you’re covered. Note: You still must use SummaCare network providers for Part D prescription drugs (Part D prescription coverage not included on Amber (HMO) plan) and certain supplemental benefits for in-network coverage to apply. 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.
You’ll receive an annual reimbursement amount to use toward the purchase of frames/lenses or contact lenses with the freedom to purchase ANYWHERE you choose. Coverage also includes in-network diagnostic and routine vision exams for a $0 copay at network providers.
If you have chronic low back pain, you’re covered for acupuncture on all plans. Supplemental acupuncture services are not available on Topaz (HMO), Quartz (HMO), Ruby (HMO) and Sapphire (HMO-POS) plans. Visits must be scheduled through HOMELINK.
You are covered for nutritious, fully prepared meals created by chefs and registered dietitians that fuel healthy living! Following a hospital stay, or if you are diabetic with an A1C over 8, you can receive home-delivered, nutritious meals to help you focus on rest and recovery. Meal delivery is not available on Garnet (HMO), Topaz (HMO) or Quartz (HMO) plans.
You’ll have access to a registered nurse 24 hours a day, seven days a week who can answer your non-emergent health concerns.
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. It’s like having a personal health coach working with you 24/7.
Do you sometimes forget to schedule regular checkups? Once you're a member, we’ll send you reminders for preventive services and other recommended care for common conditions.
SummaCare can offer support to smokers who are ready to kick the habit. Quitting specialists will enroll members in the FREE QuitCare counseling program. Members may also choose to receive FREE nicotine replacement therapy.
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.