Choosing the Right Medicare Coverage: An Interview with SummaCare’s Medicare Advantage Advisor, Logan Yates

Navigating Medicare can feel overwhelming. To help make sense of it all, we sat down with a representative from SummaCare to talk through some of the most common questions people have when deciding between Medicare Advantage and Original Medicare. Whether you're approaching eligibility or helping a loved one explore coverage, these questions provide a quick guide to understanding your options.

Q: What is the difference between Medicare Advantage and Original Medicare?

A: A Medicare Advantage plan, also known as Medicare Part C, is an all-in-one bundled healthcare plan offered through private insurance companies like SummaCare for those who are Medicare-eligible. With a Medicare Advantage plan, you receive bundled hospital (Part A), medical (Part B) and usually Part D prescription coverage plus dental, hearing and vision benefits included under one plan premium. Original Medicare covers hospital (Part A) and medical (Part B) only. You would need to purchase prescription drug coverage (Part D) separately with an Original Medicare plan and would not have any supplemental coverage for dental, vision and hearing.

Q: What extra benefits could I get with a Medicare Advantage plan, specifically SummaCare?

A: All plans include many extra benefits such as dental, hearing and vision coverage. As a member, you’ll also get an over-the-counter quarterly allowance on any of our plans that can be used at many retailers nationwide. Members also receive a no-cost SilverSneakers® fitness membership that can be used at participating gyms and for in-person or online fitness classes, plus a fitness app to take on the go.

Q: What happens if I need care while traveling or out of state?

A: We offer worldwide emergency coverage. In addition, you’re covered with in-network benefit coverage through any Medicare-approved provider in Arizona, Florida and Texas on all of our plans for up to 12 months. Plus, Topaz (HMO), Quartz (HMO) and Ruby (HMO) members gain coverage in North Carolina and South Carolina in addition to Arizona, Florida and Texas—ideal for snowbirds who head south for the winter.

Q: Can I switch plans later if my needs change?

A: Yes! If you’re already on a Medicare plan, you can swap your old plan for a new one during the Annual Enrollment Period that runs October 15 to December 7, with an effective start date of January 1 of the following year. Or, during the Open Enrollment Period (OEP) for Medicare Advantage, current members can make changes to their plan from January 1 to March 31—switching plans or returning to Original Medicare with the caveat that only one change is allowed during this period. Outside of these windows, beneficiaries must have a qualifying Special Election Period (SEP), like moving or loss of creditable coverage, to make a plan change.

Q: Who can I call if I have questions or problems with my plan?

SummaCare is an HMO and HMO-POS plan with a Medicare contract.  Enrollment in SummaCare depends on contract renewal. Other providers are available in our network. From October 1 through March 31, a representative will be available to take your call from 8:00 a.m. until 8:00 p.m., seven days a week.  From April 1 through September 30, a representative will be available to take your call from 8:00 a.m. until 8:00 p.m., Monday through Friday.  Outside these hours, you may leave us a message and a representative will return your call the next business day. Benefits may vary based on plan selected and county availability. H3660_SC2409_M 01252026.