We want to make it easy for you to get the care and services you need as a member. In this section, you’ll find information you can use to help you make the most of your SummaCare Medicare Advantage plan.
Change your address by completing the online form.
Are you moving? To ensure you receive important plan information, please complete and submit a Change of Address Form within 30 days of moving.
Interested in switching your current SummaCare Medicare Advantage plan to a different one? Use this link to explore plan options and choose one of the four ways to update your plan.
Change your Primary Care Provider by completing the online form.
Your relationship with your Primary Care Provider (PCP) is very important. SummaCare members may change their PCP at any time by either completing the online form or by calling Member Services at 800.996.6250 (TTY 711).
In the simplest of terms, BrainHQ is 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. 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. Get started at summacare.brainhq.com
BrainHQ is not available on Topaz (HMO)
Health coaching is a one-on-one, telephonic service offered to help you with lifestyle behavior modifications to manage and/or prevent future diagnosis of chronic conditions, such as high blood pressure, diabetes, high cholesterol and heart disease. Your health coach will help you identify at-risk behaviors and provide suggestions to improve your health and wellness. Learn more about Health Coaching.
One of the best ways to avoid the flu is to get an annual flu vaccine. SummaCare members can receive the flu vaccination at no cost (no co-pay) from any in-network pharmacy. Click here to begin entering your search criteria. Remember to call the pharmacy in advance to make sure they offer vaccinations, have the vaccine available, and the best time of day to get a vaccination. Simply present your SummaCare ID card and no co-pay will be required.
If you don’t want to go to an in-network pharmacy, check with your SummaCare provider to see if they have vaccines available. You may be asked for a co-pay if you receive additional services during your office visit. Please note: A visit to an urgent care center for your flu vaccine will result in an urgent care co-pay.
Do you sometimes forget to schedule regular check-ups? We’ll send you reminders for preventive services and other recommended care for common conditions and preventive screenings. Learn more.
You are covered for a fitness benefit through SilverSneakers at participating locations1 , where you can take classes2 and use exercise equipment and other amenities, at no additional cost to you. Enroll in as many locations as you like, at any time. You also have access to instructors who lead specially designed group exercise online classes, seven days a week with SilverSneakers LIVE. Additionally, SilverSneakers Community gives you options to get active outside of traditional gyms at recreation centers, parks and other neighborhood locations. SilverSneakers also connects you to a support network and online resources through SilverSneakers On-Demand videos and the SilverSneakers GO mobile app. You also get access to Burnalong® with a supportive virtual community thousands of classes for all interests and abilities. Your SilverSneakers membership also gives you GetSetUp, with hundreds of interactive online classes on hour or less, ranging from nutrition to mindfulness and more. Activate your no cost online account at SilverSneakers.com to view your SilverSneakers Member ID number and explore everything SilverSneakers has to offer.
Always talk with your healthcare provider before starting an exercise program.
1. Participating locations (“PL”) are not owned or operated by Tivity Health, Inc. or its affiliates. Use of PL facilities and amenities is limited to terms and conditions of PL basic membership. Facilities and amenities vary by PL.
2. Membership includes SilverSneakers instructor-led group fitness classes. Some locations offer members additional classes. Classes vary by location.
Burnalong is a registered trademark of Burnalong, Inc. SilverSneakers is a registered trademark of Tivity Health, Inc. © 2024 Tivity Health, Inc. All rights reserved.
SummaCare is committed to helping members stop smoking for good. Call 877.471.2101 (TTY 711) to speak to a tobacco treatment specialist and enroll in the no cost QuitCare telephonic counseling program and choose nicotine replacement therapy. Learn more about QuitCare.
Experienced registered nurses have accurate, up-to-date information about almost any health topic. A nurse can answer your questions, offer support and help you make decisions about any non-emergency health situation. All at no cost to you. Call 800.379.5001 (TTY 711) to speak to a registered nurse. Learn more about the 24-Hour Nurse Line.
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. Learn more about WebMD Health Manager.
If you would like your monthly premium taken directly out of your savings/checking account or charged to a credit card, please print the Direct Debit/Credit Card Authorization Form. Send the completed form to:
SummaCare
P.O. Box 3620
Akron, OH 44309-3620
You will receive a letter from us informing you when your request will become effective. For a listing of your Electronic Banking Rights, click here.
You may also sign up for direct debit payments by phone by calling SummaCare Member Services at 800.996.6250 (TTY 711).
The Centers for Medicare & Medicaid Services (CMS) requires health plans like SummaCare to provide the cost-sharing subsidy to Medicare beneficiaries who are eligible for low-income subsidies even if our system and the system at CMS do not yet reflect that eligibility.
SummaCare is required to provide you with the tools you need to submit a request to have our system updated to meet your Low Income Subsidy level as awarded to you by the Social Security Administration (SSA). Learn more about Low Income Subsidy eligibility and how to have your subsidy level updated.
If you would like your monthly premium automatically deducted from your Social Security check, please print the Premium Withhold from Social Security Form. Send the completed form to:
SummaCare
P.O. Box 3620
Akron, OH 44309-3620
You will receive a letter from us informing you when your request will become effective.
*Automatic deduction from your monthly Social Security benefit check. (The Social Security deduction may take two or more months to begin after Social Security approves the deduction. In most cases, if Social Security accepts your request for automatic deduction, the first deduction from your Social Security benefit check will include all premiums due from your enrollment effective date up to the point withholding begins. If Social Security does not approve your request for automatic deduction, we will send you a paper bill for your monthly premiums.)
If you would like to appoint a representative who can act on your behalf, please download and complete an Appointment of Representative form. Send the completed form to:
SummaCare
P.O. Box 3620
Akron, OH 44309-3620
If you paid out-of-pocket for a service or supply and would like to request reimbursement, please complete the Medicare Claim Form and send it, along with an itemized bill from your doctor or supplier to:
SummaCare
1200 E. Market Street, Suite 400
Akron, OH 44305
If you would like to add supplemental dental to your 2026 SummaCare Medicare Advantage Plan for an additional $37 per month, please complete the 2026 Delta Dental Enrollment Form and return to the address on the form.
The Over-the-Counter (OTC) benefit catalog lists covered non-prescription drugs and everyday items you can use your OTC Benefit Bucks allowance toward purchasing using your SummaCare &more card.
Members can:
Visit: summacare.com/overthecounter
Call: 855.263.6673 (TTY 711)
Or use the 'andmore' mobile app to place orders and find additional details.
If you would like to request that a drug be covered under your SummaCare Medicare Advantage plan, please complete the Medicare Part D Coverage Determination Request Form - Updated October 1, 2021.
Once you print and complete the form, please mail or fax it to:
MedImpact Healthcare Systems, Inc.
10181 Scripps Gateway Court
San Diego, CA 92131
Fax: 858.790.7100
Coverage determinations can also be made by phone:
Phone: 877.391.1109
If you paid out-of-pocket for your prescription drugs and would like to request reimbursement, please complete the Medicare Part D Prescription Drug Claim Form and send it, along with the appropriate prescription receipts/labels to:
MedImpact Healthcare Systems, Inc.
PO Box 509108
San Diego, CA 92150-9108
Fax: 858.549.1569
E-Mail: claims@medimpact.com
You’ll receive an annual allowance to use toward the purchase of standard eyeglasses and frames or contact lenses. You have the freedom to visit any vision provider you choose. Simply submit a vision claim form and your receipt to us and you’ll be reimbursed up to your annual allowance.
SummaCare Claims
PO Box 3620
Akron, OH 44309-3620
Some healthcare services require prior authorization (approval by SummaCare in advance). To request prior authorization, please complete the Prior Authorization Request Form for Services or the Prior Authorization Request Form for Drugs Covered Under the Medical Benefit. Send the completed form to:
SummaCare
P.O. Box 3620
Akron, OH 44309-3620
To waive the collection of payment from a member, providers should complete the Waiver of Liability Statement and send it to:
SummaCare
Attn: Appeals Coordinator
P.O. Box 1107
Akron, OH 44309-1107
If we make a Part C (medical) or Part D (prescription drug) 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 made. As a SummaCare Medicare Advantage member, you may also request a drug be covered under your SummaCare Medicare Advantage plan.
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.
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.
To request a year to date aggregate number of grievances or appeals received by SummaCare you may contact us through the below channels:
Email: appeals@summacare.com
Telephone: 330.996.8885
Write: ATTN: Appeals & Grievances, SummaCare, PO Box 1107, Akron, OH 44309-1107
The Medicare Program rates how well Medicare Advantage performs in different categories (for example, detecting and preventing illness, rating from patients, patient safety and customer service). Learn more about SummaCare's 2026 CMS Star Rating.
All of SummaCare's Medicare Advantage plans include preventive dental services and some include comprehensive dental coverage. Benefits may vary based on plan selected. Please view your Evidence of Coverage (EOC) for more details.
Through our partnership with Delta Dental of Ohio, you’re covered for two cleanings and exams, one fluoride treatment, an X-ray plus visits for dental pain through the Delta Dental Medicare Advantage PPO network.
If you would like to add supplemental dental to your 2026 SummaCare Medicare Advantage Plan, please complete the 2026 Delta Dental Enrollment Form and return to the address on the form.
Learn more about what's included in the 2026 Medicare Advantage Plans.
Learn how to access the care and prescription coverage you need during a declared disaster or public health emergency. This page explains how SummaCare supports Medicare members during emergencies, including temporary coverage flexibilities, out-of-network care access and waived referral requirements when applicable. You’ll also find preparedness tips, safety resources and guidance on what to do before, during and after severe weather or other emergencies.
Learn what to do if the geographic area in which you live is declared a state of disaster or emergency.
If the Governor of your state, the U.S. Secretary of Health and Human Services, or the President of the United States declares a state of disaster or emergency in your geographic area, you are still entitled to care from your plan.
Please visit the following website: medicare.gov for information on how to obtain needed care during a disaster.
Generally, if you cannot use a network provider during a disaster, your plan will allow you to obtain care from out-of-network providers at in-network cost sharing. If you cannot use a network pharmacy during a disaster, you may be able to fill your prescription drugs at an out-of-network pharmacy. Please refer to your Evidence of Coverage for more information. Read more.
Current SummaCare Medicare Advantage Members: Refer someone to SummaCare and get a gift card!
If you are a current SummaCare Medicare Advantage member and know someone who's turning 65 or thinking about retiring, tell them about SummaCare!
If they request more information about our Medicare Advantage plans you'll receive a $15 Bob Evans gift card.
Be sure to have them identify you when they request information and your gift will be on its way to you within 30 days. Requesting SummaCare information is easy. Have them visit summacare.com/refer or call us at 888.330.1541 (TTY 711)!
Must be Medicare eligible. One offer per person. Available to individuals not already enrolled in a SummaCare Medicare Advantage plan. Quantities are limited. This gift is without obligation to enroll.
As a member of SummaCare you may or may not be called by one of our vendors to offer you a service or information on behalf of SummaCare. Learn more.
Learn more about your rights and responsibilities when ending your SummaCare Medicare membership. This page explains voluntary and involuntary disenrollment, important enrollment periods, how to switch coverage and what happens to your benefits during the transition. You’ll also find guidance on maintaining coverage, avoiding potential late enrollment penalties and where to get additional support if needed.
As part of your SummaCare Medicare Advantage plan, you receive coverage for a wide variety of preventive and comprehensive dental services at no extra monthly premium. Find a Delta Dental provider or call Delta Dental Customer Service at 800.330.2732 for assistance. Learn more about dental services included with your coverage.
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 Ascencia Contour products through any in-network pharmacy. Abbott products are also available through HOMELINK.
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. Call HOMELINK at 844.358.2549 (TTY 711) to begin using this benefit. Home Safety Devices Document.
Use your SummaCare Visa card to spend your Benefit Bucks quarterly allowance on non-prescription OTC health-related items at participating national retailers or have them shipped right to your door. If you have a preference for a brand-name or generic product, choose which to purchase when shopping at participating retailers. The Over-the-Counter (OTC) benefit catalog lists items covered and includes an order form and other instructions on how to obtain items.
You’ll receive an annual allowance to use toward the purchase of standard eyeglasses and frames or contact lenses. You have the freedom to visit any vision provider you choose. Simply submit a vision claim form and your receipt to us and you’ll be reimbursed up to your annual allowance.
SummaCare Claims
PO Box 3620
Akron, OH 44309-3620
SummaCare Medicare members can receive a free fitness membership with access to basic amenities, group exercise classes and online resources. Learn more.
You’re covered to speak with a licensed physician by web, phone or mobile app through Teladoc Health for primary care provider, dermatology and/or behavioral health visits.
You’re covered for a defined number of trips to medical appointments. This service is available Monday-Friday only. 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 or electric wheelchair transport at least 72 hours in advance; wheelchair and ambulatory sedan trips scheduled 48 hours in advance. To schedule transportation, call HOMELINK at 844.358.2549 (TTY 711).
| Season | Days | Times |
|---|---|---|
| Oct 1 – Mar 31 | 7 days a week | 8:00 a.m. – 8:00 p.m. |
| Apr 1 – Sep 30 | Mon – Fri | 8:00 a.m. – 8:00 p.m. |
Outside these hours, you may leave us a message and a representative will return your call the next business day.