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NEW! Jade (HMO) with Bene-Flex™

Take control of your benefits with our new Jade (HMO) Plan.

You select the benefits to add to already-built-in comprehensive medical and prescription drug (Part D) coverage.

Here’s how it works: In addition to core supplemental benefits listed below, you select a total of FIVE additional supplemental benefits to add to your plan.

Core Benefits

Part D Prescription Drug Coverage
Jade features Part D Prescription Drug Coverage, including $0 copays for Tier 1 preferred generic drugs, Tier 6 vaccines and common over-the-counter (OTC) drugs – even through the coverage gap!

Dental Coverage
Through our partnership with Delta Dental of Ohio, you’re covered for two cleanings and exams, an X-ray plus visits for dental pain through the Delta Dental Medicare Advantage PPO network. And, New for 2023! Enhanced Dental Coverage through the Delta Dental Network!

Vision Coverage
You’ll receive an annual reimbursement 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 $395 per hearing aid for Level 1 hearing aids and $695 per hearing aid for Level 2 hearing aids. And, all routine hearing exams are covered for a $0 copay.
Travel Coverage
If you travel to the states of Arizona, Florida, or Texas, you’ll receive in-network coverage for medical benefits received by any Medicare-approved provider.

Our plans 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.

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.

Tier 1 - Pick 3

Massage Therapy
You're covered for up to 10 therapeutic massage therapy visits.

Acupuncture
You're covered for up to 10 general acupuncture visits.

Fitness Tracker
One Fitbit® fitness tracker per calendar year. These wearable health and wellness devices encourage physical activity through accountability and achievements for better health outcomes. Each Fitbit must be ordered through SummaCare’s vendor, Tivity Health.

Toenail Trimming
Up to six visits per calendar year. Trimming performed by in-network podiatrists.

Nutrition Coaching
Up to four visits per calendar year. Services provided by a SummaCare registered dietitian or via Teladoc.

BrainHQ Memory Fitness
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.

Tier 2 - Pick 1

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.

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.

Chiropractic Care
Up to 10 office visits and all manipulations from in-network chiropractors are included in Jade plan coverage.

Transportation
You're covered for up to 24 one-way 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.

Indoor Air Quality*
One air purifier per calendar year. Benefit available to members who have an identified high risk of adverse health outcomes due to chronic respiratory conditions, participate with Care Management Services, or who meet program criteria. The purifier must be obtained through HOMELINK or members will be responsible for the full cost of the unit.

* Requires a diagnosis of COPD - including asthma, chronic bronchitis and/or emphysema.

Post-Discharge or Chronic Care** Meal Delivery
Healthy, fully-prepared, nutritious meals created by chefs and registered dieticians and delivered directly to your home. Choose either 28 meals post-discharge or 84 meals for chronic care.

** Requires a diagnosis of diabetes mellitus and/or congestive heart failure.

Tier 3 - Pick 1

Flex Card for Vision, Dental & Hearing
Up to $550 Benefit Bucks on your SummaCare VISA card to be used to pay dental, hearing or vision providers directly for any out-of-pocket expenses you may incur. The card is not a credit card. The debit card may not be redeemed for cash or used to pay for another individual’s expenses. Unused balances will not roll over to the next calendar year. If a provider does not accept debit card payments or if there is a card transaction failure, members may submit a claim form for reimbursement along with the original printed, itemized provider receipt.

Healthy Grocery Allowance**
$40 allowance per month. Benefit may be used to purchase healthy grocery items—an essential step in managing chronic medical conditions and helping maintain or improve your overall health. Items such as tobacco or alcohol products are excluded. Unused grocery benefit balances will not roll over to the next month or calendar year. Make purchases using your SummaCare VISA card at any of more than 62,000 participating retailers nationwide.

** Requires a diagnosis of diabetes mellitus and/or congestive heart failure.

PERS (personal Emergency Response System)
The PERS (Personal Emergency Response System), offered through ConnectAmerica, provides 24/7 emergency assistance and care — and is GPS-enabled to work outside the home.

Home Safety Devices
$400 for home safety devices, such as grab bars, shower stools and more.

Find

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