At SummaCare, it’s personal. Your needs come first. Our six 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.
You’re covered for one hearing aid per ear every year; choose from a wide variety of hearing aids and pay a $395, $695, $1,195, $1,495, $1,895 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 chairs 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 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 participating retailers nationwide.
Five of six 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.
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. 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.
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 Topaz (HMO) or Quartz (HMO) plans.
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. BrainHQ is not covered on the 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.
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.
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 offers support to smokers/nicotine users who are ready to kick the habit. Quitting specialists will enroll members in our no-cost QuitCare counseling program. Members may also choose to receive a limited supply of no-cost nicotine replacement therapy.
If you are diagnosed with complex health issues, 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. Learn more about SummaCare's Care Management program.
