2023 Additional Plan Benefits

Part D Prescription Drug Coverage

(not included with the Amber (HMO) plan)
Most plans conveniently include Part D Prescription Drug Coverage, including $0 copays for Tier 1 preferred generic drugs, Tier 6 Select Care drugs (includes vaccines) and common over-the-counter (OTC) drugs – even through the coverage gap!

Enhanced Dental Coverage through the Delta Dental Network

You're covered for a wide variety of services including cleanings and exams as well as extractions, root canals, bridges, crowns and dentures on most plans! And, we've increased our annual maximum on most of our plans. Supplemental dental coverage can be purchased for an additional monthly premium.

Vision Coverage

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 diagnostic and routine vision exams for a $0 copay.

Hearing Aid Coverage

You’re covered for one hearing aid per ear every year from our formulary, after paying a $395 or $695 copay per hearing aid, for select models.

Over-the-Counter (OTC) Items

New for 2023! Use your SummaCare VISA card to spend your Benefits Bucks quarterly allowance on non-prescription OTC health-related items at more than 62,000 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, shipped right to your home. Learn more.

Assist America®

Assist America provides global emergency travel assistance when you’re more than 100 miles from home or in a foreign country. Assist America gives you peace of mind while traveling, knowing that a single phone call will give you access to a vast network of resources to help coordinate care on your behalf during any medical travel emergency.

Travel Coverage

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. Note: You still must use SummaCare network providers for Part D prescription drugs 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.

Acupuncture Services

Most plans include coverage for general acupuncture services. If you have chronic low back pain, you’re covered on all plans.

Therapeutic Massage Services

You’re covered for therapeutic massage services performed by in-network providers on most plans.

Health Coaching and Condition Management

Health Coaching is a one-on-one telephone 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.

SummaCare partners with Medtronic to offer Healthy Home Monitoring to target chronic conditions. SummaCare Medicare Advantage members may receive a call from Medtronic regarding enrollment in this in-home monitoring program.

Health Manager Powered by WebMD®

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

Preventive Health Reminders and Incentives!

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 for using key preventive care services, including:

• Annual Wellness Visit $50
• Breast Cancer Screening $10
• Colorectal Cancer Screening $10

QuitCare

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 patches.

Papa Pals

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.

Telehealth Services

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®. Teladoc visits can be scheduled 24 hours a day, 365 days a year.

Diabetes Supplies

Receive supplies to monitor your blood glucose including test strips, lancet devices and lancets and glucose-control solutions for no cost when using Abbott and/or Lifescan products.

Home Safety Devices

You may qualify for coverage for home safety devices, such as grab bars, shower stools and more.

Transportation

You’re covered for a defined number of trips to medical appointments. Most trips can be scheduled in as little as 15 minutes and you can see providers throughout SummaCare’s 33-county service area.

BrainHQ

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.

PERS (Personal Emergency Response System)

 

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 (GPSenabled to work outside the home).

24-Hour Nurse Line

You’ll have access to a registered nurse 24 hours a day, seven days a week who can answer your medical questions.

SilverSneakers®

The SilverSneakers fitness program is the nation’s leading wellness program for Medicare beneficiaries. You’ll receive a fitness membership at no cost to you with access to basic amenities, group exercise classes and online resources at over 17,000 participating fitness locations.

Meal Delivery

You are covered for meals that fuel healthy living! Following a hospital stay or if you have diabetes with a high A1C level, you can receive home-delivered, nutritious meals to help you focus on rest and recovery.