Low Income Subsidy

Best Available Evidence for Low Income Subsidy Beneficiaries

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). For more information on how to have your subsidy level updated, please call SummaCare Customer Service or visit the CMS website and download the appropriate form(s).

For more information about adjusted plan premiums for those who are eligible to get extra help to pay for Medicare prescription drug plan costs, please click on the link below to view our Plan Premium Summary Sheet for Low Income Subsidy:

2022 Plan Premium Summary Sheet for Low Income Subsidy - MAPD
2023 Plan Premium Summary Sheet for Low Income Subsidy - MAPD

You may be able to get extra help to pay for your prescription drug premiums and costs. To see if you qualify for getting extra help, call: 1.800.MEDICARE (800.6334227). TTY/TDD users should call 877.486.2048, 24 hours a day/7 days a week; The Social Security Administration at 800.772.1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY/TDD users should call 800.325.0778; or your State Medicaid Office.

SummaCare
P.O. Box 3620
Akron, OH 44309-3620

For other services, equipment and drugs that do require prior authorization, it is your network provider’s responsibility to obtain prior authorization from SummaCare.