If we make a medical coverage decision that you are not satisfied with, you can appeal this decision. An appeal is a formal way of asking us to review and change a coverage decision we have made. If you would like to file an appeal with SummaCare about a medical coverage decision or submit a complaint, please click on the link below to review our Appeals & Grievances processes. If you are looking for Appeals & Grievances information for Part D, click here.
For a complete description of our Appeals and Grievance Processes, you can request a copy of the Evidence of Coverage by calling SummaCare Medicare Customer Service at 330.996.8885 or toll free at 800.996.6250. TTY users may call 800.750.0750. From October 1 through March 31, a representative will be available to take your call from 8:00 am until 8:00 pm, seven days a week. From April 1 through September 30, a representative will be available to take your call from 8:00 am until 8:00 pm, Monday through Friday. Outside these hours, you may leave us a message and a representative will return your call the next business day.
Appeals must be submitted in writing by fax, mail, email or in person. Expedited Appeals – this appeal is for urgent situations where a delay could seriously harm your health or your ability to function – can be requested orally or in writing.
Fax: 330.996.8545
Write: ATTN: Appeals & Grievances, SummaCare, PO Box 1107, Akron, OH 44309-1107
Email: appeals@summacare.com
Grievances may be filed orally, in writing by fax, mail or in person:
Phone: SummaCare Medicare Customer Service at 330.996.8885 or toll free at 800.996.6250. TTY users may call 800.750.0750. From October 1 through March 31, a representative will be available to take your call from 8:00 am until 8:00 pm, seven days a week. From April 1 through September 30, a representative will be available to take your call from 8:00 am until 8:00 pm, Monday through Friday. Outside these hours, you may leave us a message and a representative will return your call the next business day.
Fax: 330.996.8545
Write: ATTN: Appeals & Grievances, SummaCare, PO Box 1107, Akron, OH 44309-1107
If you need additional information:
If you would like information on how you may request SummaCare appeals, grievance or exception data or if you have questions about the appeals or grievance process or to check on the status of your appeal or grievance, please call our SummaCare Medicare Customer Service at the telephone number listed above.
To view our Appeals & Grievances Processes, please click on the links below:
SummaCare Appeals Process
SummaCare Grievances Process
For complete information, please refer to your plan’s Evidence of Coverage document. Learn how to contact a Medicare Beneficiary Ombudsman who can assist you with a Medicare complaint.
For more information and help in handling a problem, you can also contact Medicare. Here are two ways to get information directly from Medicare:
You can call 1.800.MEDICARE (1.800.633.4227), 24 hours a day, 7 days a week. TTY users should call 877.486.2048.
You can also visit medicare.gov to go directly to their complaint website to submit a complaint instead of calling.