Premium Breakdown. SummaCare Medicare Jade with Bene-FlexTM (HMO) has a monthly premium of $20.00. This amount includes your Part C and D premiums but does not include your Part B premium. The following is a breakdown of your monthly premium with Part B costs included. Part B.COVID 19 Response: SummaCare Hospital Floor to SNF Program. Program ends 4/30/2022 The SummaCare Hospital Floor to SNF Program is ending 4/30/2022. All SNF’s and Hospitals should return to following SummaCare Prior Authorization processes for SNF Admission beginning 5/1/2022. For questions, please call 330.996.8625. After-Hours AuthorizationsSummaCare’s plans are Health Maintenance Organization (HMO) plans available to individuals and families living in Summit, Stark, Portage and Medina counties and feature the SC Connect network. This means that all care except for emergency or urgent care situations must be through this network of providers. SummaCare’s plans do not require ...Welcome Brokers. SummaCare provides a variety of plans to meet your customers' needs, from small and large employers to self-employed groups, Medicare eligibles and those looking for individual and family coverage. Attention Brokers who sell our Individual and Family Plans: We’re pleased to announce that we’ll be transitioning … SummaCare Medicare Garnet H3660-053 (HMO) Ohio. Medicare. Health. SummaCare Medicare Garnet (HMO) H3660-053. SummaCare Medicare Advantage Plans | Local HMO. Why Trust U.S. News. 344. Insurance ... From April 1 through September 30, a representative will be available to take your call from 8:00 a.m. to 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. Material ID: H3660_20_962NS_C 05052023. SummaCare is actively monitoring the COVID-19 ... As a SummaCare member with a Preferred Provider Organization (PPO) plan, you’ll have access to thousands of providers who are part of your SummaCare network. Find your doctor today by using our online provider search. Your Member Account. Your member account is the online source for benefits information.SummaCare utilizes one prior authorization list for all fully-insured PPO health insurance plans and Medicare plans. Please use the forms below when requesting prior authorization for these services. These forms include the information which is necessary for a prior authorization determination Prior Authorization Request Form for Services- …Check out SummaCare’s Individual & Family plans for 2023! You can get health insurance for yourself and your family, which includes: Comprehensive medical and pharmacy benefits. 3 FREE office visits on many plans to your SummaCare Primary Care Physician (PCP)* and outpatient mental health services for each person on …Your SummaCare Individual & Family plan includes: Comprehensive medical and pharmacy benefits. 3 FREE office visits on most plans to your SummaCare Primary Care Provider (PCP)* and outpatient mental health services for each person on your policy. Telehealth visits (through Teladoc® Health and …Nov 2, 2023 · More than 1 in 5 people in Ohio are 65 and older, and there are a variety of Medicare and Medicare Advantage plans in the state. The average monthly premium in 2024 for a Medicare Advantage plan ... SummaCare Offshore Subcontracting Attestation 1 SummaCare, referred to as “the Company” must ensure its vendors have read and understand all requirements pertaining to federal regulations for services that are performed by workers, regardless of whether the workers are employees of American or foreign …SummaCare’s goal is to offer the highest quality healthcare to our members. This is accomplished, in part, by building a provider network of physician and practitioner professionals who meet our standards. Through the process of "credentialing," all new physicians and practitioners in the network are reviewed to assure their professional ...Nov 7, 2023 · SummaCare is an HMO and HMO-POS plan with a Medicare contract. Enrollment in SummaCare depends on contract renewal. 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. All SummaCare plans include comprehensive prescription drug benefits, but your prescription drug coverage varies by the plan in which you are enrolled. If you are not sure which prescription drug coverage applies to you, please contact SummaCare Customer Service at 800-996-8701. SummaCare Medicare has been in Northeast Ohio since 1996 and has more than 22,000 members in northern Ohio. SummaCare’s Medicare Advantage plans have an extensive network of more than 22,000 providers and 75 hospitals. SummaCare is an HMO and HMO-POS plan with a Medicare contract. Enrollment in SummaCare depends upon contract renewal. SummaCare Medicare Sapphire (HMO-POS) is a Medicare Advantage (Part C) Plan by SummaCare Medicare Advantage Plans. Premium: $79.00. Enroll Now. This page …Dr. Shauna Guthrie, MD. 23 mi from Boydton, VA. Family Physician. 123 Horner St, Henderson, NC 27536. I’m a Family Medicine and Preventive Medicine Physician. More importantly, I grew up in rural areas of KS and MO and know first-hand what it’s like to avoid going to the doctor because of lack of …SummaCare is an HMO and HMO-POS plan with a Medicare contract. Enrollment in SummaCare depends on contract renewal. From October 1 through March 31, a representative will be available to take your call from 8:00 a.m. until …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.SummaCare | 1200 East Market Street, Suite 400, Akron, OH 44305-4066Call the SummaCare 24-Hour Nurse Line. If you are unsure if your symptoms are serious enough to wait until your next doctor's visit, call SummaCare's 24-Hour Nurse Line at 800.379.5001 (TTY 771). Registered nurses are available to assist you 24 hours a day, seven days a week. They can assist you with specific medical questions; provide …SummaCare Adds Aultman Health Foundation to its Medicare and Commercial Lines of Business. AKRON, Ohio, July 16, 2018 – SummaCare announced today that it is adding Aultman Health Foundation to its Medicare and Commercial lines of business. The agreement effective date is July 13, 2018. “Offering comprehensive networks for our …Of course, every study is conducted on a different group of people, and individual results vary. Click any benefit below to learn more about the studies behind the benefit. Call … AKRON, Ohio, October 1, 2023—Beginning October 15, Medicare-eligible individuals may select one of SummaCare’s updated Medicare Advantage plans for 2024. Medicare’s Annual Enrollment Period runs through December 7. Based in Akron, SummaCare’s Medicare Advantage plan service area includes 33 northern Ohio counties and gives Medicare ... SummaCare | 1200 East Market Street, Suite 400, Akron, OH 44305-4066If you’re not currently a SummaCare member and are unsure which network to search, please call SummaCare Member Services at 330.252.5922 or 844.751.0436.As a SummaCare Medicare Advantage plan member, you have a quarterly allowance to purchase Over-the-Counter (OTC) items included in this catalog. To order, simply go to summacareotc.com or call 855.435.5111 (TTY 711) or mail your completed order form. Your order will be shipped directly to your door. …SummaCare Medicare Advantage Network now includes Cuyahoga County’s three largest health systems. AKRON, Ohio, October 10, 2023 – SummaCare has announced that The MetroHealth System joined its extensive Medicare Advantage provider network effective August 1, 2023. Under terms of the agreement, SummaCare Medicare members now …Inpatient hospital - psychiatric. $340 per day for days 1 through 5 / $0 per day for days 6 through 90. Outpatient group therapy visit with a psychiatrist. $35 copay. Outpatient individual therapy ...SummaCare is an HMO and HMO-POS plan with a Medicare contract. Enrollment in SummaCare depends on contract renewal. 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 …Oct 1, 2023 · SC Select is a specialized PPO network that includes access to more than 16,000 providers and some of the area's finest hospitals, including Summa Health System and University Hospitals. SC Select also features access to statewide providers and emergency and urgent care services nationwide through our affiliation with First Health Network. Summa Health's MyChart online portal gives you secure access to your personal health information 24/7. Sign up for MyChart and gain online access to your health records, physicians, appointments and more. Login. Add a Family Member.If you think SummaCare or its providers, contractors, vendors or business associates are not following the rules for your advance directives, you may file a grievance with SummaCare or you may file a complaint with the state survey and certification agency (Ohio’s is the Department of Health) by calling 800.669.3534 or call the SummaCare ...Call the SummaCare 24-Hour Nurse Line. If you are unsure if your symptoms are serious enough to wait until your next doctor's visit, call SummaCare's 24-Hour Nurse Line at 800.379.5001 (TTY 771). Registered nurses are available to assist you 24 hours a day, seven days a week. They can assist you with specific medical questions; provide …SummaCare | 1200 East Market Street, Suite 400, Akron, OH 44305-4066Oct 4, 2021 · SummaCare is an HMO and HMO-POS plan with Medicare contract. Enrollment in SummaCare depends upon contract renewal. Other providers are available in our network. Media Contact: Shannon Kew. Phone: 234.312.5432. Beginning October 15, Medicare-eligible individuals may select comprehensive and affordable medical and pharmacy benefits with new and ... SummaCare is pleased to offer PregnancyCare to high-risk expectant moms. This program helps you manage your health during pregnancy. You also receive support right after your baby is born. Enrollment in the program is free and confidential. Wellness Services. SummaCare’s wellness programs and services can help you live a healthier, happier life. SummaCare Medicare Garnet H3660-053 (HMO) Ohio. Medicare. Health. SummaCare Medicare Garnet (HMO) H3660-053. SummaCare Medicare Advantage Plans | Local HMO. Why Trust U.S. News. 344. Insurance ... SummaCare offers Medicare Advantage plans, employer group insurance and individual and family plans. Additionally, SummaCare offers a full range of self-funded products …Summa Health System is one of the largest integrated healthcare delivery systems in the state. Formed in 1989 with the merger of Akron City and St. Thomas Hospitals, this nonprofit system now encompasses a network of: Hospitals. Community-based health centers. A health plan (SummaCare) A multi-specialty group practice. An entrepreneurial entity.Our Individual & Family plans, which feature the SC Connect network, are available to individuals and families living in Summit, Portage, Stark and Medina counties. The SC Connect network provides access to many of the finest physicians, facilities and hospitals, including Summa Health, Akron Children’s Hospital and Mercy …MedImpact is SummaCare’s Pharmacy Benefit Manager and is responsible for processing pharmacy claims for SummaCare members. MedImpact also handles pharmacy benefit customer service and utilization management requests on SummaCare’s behalf. To reach MedImpact, members should call the …Mar 15, 2024 · Although Medicare Advantage plans are often advertised as having a zero-dollar premium, you still need to pay your Medicare Part B premium. The Part B premium in 2024 is $174.70, which is $9.80 ... Melissa Rusk Vice President, Operations. Melissa Rusk CLSSBB, CPC is the Vice President of Operations at SummaCare in Akron Ohio. In this role, Melissa is responsible for directing and providing leadership to SummaCare’s operational departments including Claims Processing and Support, BPO Operations, …SummaCare, Akron, Ohio. 1,227 likes · 50 talking about this · 44 were here. Health insurance for you, your family and your business.SummaCare Medicare Advantage Network now includes Cuyahoga County’s three largest health systems. AKRON, Ohio, October 10, 2023 – SummaCare has announced that The MetroHealth System joined its extensive Medicare Advantage provider network effective August 1, 2023. Under terms of the agreement, SummaCare Medicare members now …DiabetesCare. DepressionCare. HeartCare. KidneyCare. SummaCare’s Condition Management programs are available at no cost to you. Enrollment is optional and you may opt-out at any time. For more information about or to enroll in any of SummaCare’s Condition Management programs, call 877.888.1164 (TTY …Most SummaCare members have access to Teladoc™ Health as part of your coverage. You’re covered to speak with a licensed physician by web, phone or mobile app through Teladoc Health for primary care provider, dermatology and/or behavioral health visits that can be scheduled 24 hours a day, 365 days a year. SummaCare Medicare Garnet H3660-053 (HMO) Ohio. Medicare. Health. SummaCare Medicare Garnet (HMO) H3660-053. SummaCare Medicare Advantage Plans | Local HMO. Why Trust U.S. News. 344. Insurance ... View the latest issue of The Source, SummaCare's Employer e-Newsletter, or view archives of The Source to find news and updates from SummaCare. Exciting News From SummaCare. SummaCare Adds Aultman to Networks. The Source, April 2017. The Source, March 2017. The Source, Dec 2016SummaCare | 1200 East Market Street, Suite 400, Akron, OH 44305-4066MedImpact is SummaCare’s Pharmacy Benefit Manager and is responsible for processing pharmacy claims for SummaCare members. MedImpact also handles pharmacy benefit customer service and utilization management requests on SummaCare’s behalf. To reach MedImpact, members should call the SummaCare customer service number on the back …SummaCare Medicare P.O. Box 3620 Akron, OH 44309-3620. 2024 Medicare Advantage Plans. 2024 MAPD Plan Enrollment Application Select this application if you are enrolling in a 2024 Garnet, Topaz, Jade, Ruby, Sapphire or Emerald plan. 2024 MA Plan Enrollment Application Select this application if you …On average, practices spend nearly 50% less time submitting and tracking prior authorizations vs. before SamaCare. Schedule a Demo. "It’s amazing to track everything on one site... Once the information is captured in the system, it lives there and is easy to locate. We now spend less time on the phone and more time with patients." SummaCare Medicare has been in Northeast Ohio since 1996 and has more than 22,000 members in northern Ohio. SummaCare’s Medicare Advantage plans have an extensive network of more than 22,000 providers and 75 hospitals. SummaCare is an HMO and HMO-POS plan with a Medicare contract. Enrollment in SummaCare depends upon contract renewal. DiabetesCare. DepressionCare. HeartCare. KidneyCare. SummaCare’s Condition Management programs are available at no cost to you. Enrollment is optional and you may opt-out at any time. For more information about or to enroll in any of SummaCare’s Condition Management programs, call 877.888.1164 (TTY …Your SummaCare Individual & Family plan includes: Comprehensive medical and pharmacy benefits. 3 FREE office visits on most plans to your SummaCare Primary Care Provider (PCP)* and outpatient mental health services for each person on your policy. Telehealth visits (through Teladoc® Health and …SummaCare's 2022 Medicare Advantage Plans Now Available. Date: 10/04/2021. AKRON, Ohio, October 4, 2021– Beginning October 15, Medicare-eligible …SummaCare is an HMO and HMO-POS plan with a Medicare contract. Enrollment in SummaCare depends on contract renewal. Every year, Medicare evaluates plans based on a 5-star rating system. SummaCare Medicare has been recognized with a 4.5-Star (out of 5) overall rating for 2024 from the Centers for Medicare and Medicaid …Meet your members where they are with flexible support to assist older adults and families in overcoming social barriers to health and well-being. Nearly 100 health plans and employers work with Papa in a shared mission to help Medicare Advantage, Medicaid, and Special Needs Plan members live and feel better. …Alan Fehlner joined SummaCare in March 2020 as Chief Financial Officer. Prior to joining SummaCare, Alan served as CFO for Health First Health Plans in Florida where he lead financial planning and analysis, Medicare Advantage and ACA bids and helped deliver record earnings four years in a row. Prior to his work at Health …Tier 3 - Pick 1. 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.The following SummaCare Medicare Advantage Plans plans offer Medicare Advantage coverage. Medicare Advantage plans are an alternative way to get your Original …World Health Organization. What if I have more questions about SummaCare’s coverage of COVID-19? If you are a provider and have additional questions, please call SummaCare Provider Support Services at 330.996.8400 or 800.996.8401. SummaCare created an online resource to help providers answer commonly asked …2023 Summacare Comprehensive Formulary Small Group And Individual Prescription Drug Benefits The following is a listing by drug class of medications most commonly prescribed under the SummaCare Prescription Drug Benefit. Brand-name drugs are capitalized and generic drugs are listed in lowercase. Prescription drug benefits vary, but in mostCoinsurance: Your share of the costs of a covered health care service, calculated as a percent (for example, 20%) of the allowed amount for the service. You pay coinsurance plus any deductibles you owe. Copayment: A fixed amount (for example, $15) you pay to the healthcare provider for a covered health care service, usually paid at the time of ... SummaCare Medicare Garnet H3660-053 (HMO) Ohio. Medicare. Health. SummaCare Medicare Garnet (HMO) H3660-053. SummaCare Medicare Advantage Plans | Local HMO. Why Trust U.S. News. 344. Insurance ... Mobile, informed and connected. Login page for SigmaCare, enter account, username and password.Summa Health System, headquartered in Akron, Ohio, is one of Ohio's largest integrated healthcare delivery systems. Find a Summa location near you.SummaCare offers seven Medicare Advantage plans for eligible individuals in northern Ohio, including a new Jade plan with Bene-Flex™. Bene-Flex lets members …Oct 1, 2022 · SummaCare offers BrainHQ, a proven brain training program that can help you think faster, focus better, and remember more. BrainHQ is your online headquarters for brain training. Each BrainHQ exercise is based on the science of brain plasticity—the ability of the brain to change itself. These exercises sharpen your brain’s memory, attention ... To determine what formulary/drug list to search, please refer to the RxGRP code on your SummaCare Member ID card and search/view the formulary with the corresponding code. As a SummaCare member, you have access to the latest in medical treatments including prescriptions drugs.SummaCare Medicare Advantage Network now includes Cuyahoga County’s three largest health systems. AKRON, Ohio, October 10, 2023 – SummaCare has announced that The MetroHealth System joined its extensive Medicare Advantage provider network effective August 1, 2023. Under terms of the agreement, SummaCare Medicare members now …SummaCare plans offer access to healthcare providers through both the SummaCare contracted network and affiliate networks - minimizing employee out-of-pocket costs when participating providers are used.. The Preferred Choice Network T he Preferred Choice Network is an exclusive network offering preferred access to three of the area’s premier …Provider Engagement Specialists. If you have not met with your assigned Provider Engagement Specialist or would like to schedule an in-office training or meeting to address any questions regarding the authorization process, claims issues, appeals, SummaCare products/benefits or Plan Central training, please contact the …SummaCare's Condition Management programs provide specialized services to members who have been diagnosed with conditions such as asthma, depression, diabetes, heart failure and high-risk pregnancy. Our wellness services help identify at-risk members and possible interventions, encouraging lifestyle changes aimed at reducing risk.SummaCare is an HMO and HMO-POS plan with Medicare contract. Enrollment in SummaCare depends upon contract renewal. Other providers are available in our network. Media Contact: Shannon Kew. Phone: 234.312.5432. Beginning October 15, Medicare-eligible individuals may select comprehensive and affordable medical and pharmacy benefits with new …SummaCare is an HMO and HMO-POS plan with a Medicare contract. Enrollment in SummaCare depends on contract renewal. For accommodation of persons with special needs at sales meetings call 888.464.8440 (TTY 800.750.0750).SummaCare Offshore Subcontracting Attestation 1 SummaCare, referred to as “the Company” must ensure its vendors have read and understand all requirements pertaining to federal regulations for services that are performed by workers, regardless of whether the workers are employees of American or foreign …Most Recent Provider/Pharmacy Directory (Northwest Region) Need other materials? Please describe what you need below and we will contact you. You should receive your items within five business days. Questions? Email Broker Services at [email protected] or call 330.996.5673. Request SummaCare Medicare Advantage plan materials from ...SummaCare Pricing Transparency. As part of the Transparency in Coverage Act, health plans are required to post Machine-Readable Files (MRFs) containing the following costs for items and services when accessing care: In-Network Rate File: Rates for all covered items and services between the plan or issuer and in-network providers. Allowed Amount ...
Alan Fehlner joined SummaCare in March 2020 as Chief Financial Officer. Prior to joining SummaCare, Alan served as CFO for Health First Health Plans in Florida where he lead financial planning and analysis, Medicare Advantage and ACA bids and helped deliver record earnings four years in a row. Prior to his work at Health …. Viconica
Oct 1, 2022 · SummaCare offers BrainHQ, a proven brain training program that can help you think faster, focus better, and remember more. BrainHQ is your online headquarters for brain training. Each BrainHQ exercise is based on the science of brain plasticity—the ability of the brain to change itself. These exercises sharpen your brain’s memory, attention ... SummaCare is an HMO and HMO-POS plan with a Medicare contract. Enrollment in SummaCare depends on contract renewal. Every year, Medicare evaluates plans based on a 5-star rating system. SummaCare Medicare has been recognized with a 4.5-Star (out of 5) overall rating for 2024 from the Centers for Medicare and Medicaid …Nov 7, 2023 · SummaCare is an HMO and HMO-POS plan with a Medicare contract. Enrollment in SummaCare depends on contract renewal. 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. Your SummaCare Individual & Family plan includes: Comprehensive medical and pharmacy benefits. 3 FREE office visits on most plans to your SummaCare Primary Care Provider (PCP)* and outpatient mental health services for each person on your policy. Telehealth visits (through Teladoc® Health and …SummaCare Medicare Emerald (HMO-POS) is a Medicare Advantage (Part C) Plan by SummaCare Medicare Advantage Plans. Premium: $169.00. Enroll Now. This page features plan details for 2024 SummaCare Medicare Emerald (HMO-POS) H3660 – 028 – 0 available in Northeast Ohio. IMPORTANT: This page has been updated with plan and premium …SummaCare is an HMO and HMO-POS plan with a Medicare contract. Enrollment in SummaCare depends on contract renewal. If you have questions about this form, please call Member Services at 330.996.8885 or (toll free) 800.996.6250 (TTY 711). From October 1 through March 31, a representative is available to takeSummaCare is an HMO and HMO-POS plan with a Medicare contract. Enrollment in SummaCare depends on contract renewal. For accommodations of persons with special needs at sales meetings call 888.464.8440 (TTY 711). If you experience any issues logging in, please use the Forgot Username or Forgot Password workflows or you can call the helpdesk at 234-475-6789. Communicate with your doctor. Get answers to your medical questions from the comfort of your own home. Access your test results. No more waiting for a phone call or letter – view your results and ... SummaCare Medicare Sapphire (HMO-POS) is a Medicare Advantage (Part C) Plan by SummaCare Medicare Advantage Plans. Premium: $79.00. Enroll Now. This page …Report all possible cases of fraud, waste and abuse. Call or write us to report fraud, waste or abuse. Call the SummaCare Compliance Hotline at 800-361-3908 or 330-996-8821 and leave a message that includes: Write to us at: SummaCare Compliance Department F&A, P.O. Box 3620, Akron, Ohio 44309-3620. …Bill Epling joined SummaCare as President in August 2020, bringing more than 30 years of experience in the healthcare delivery and managed care industry. Prior to joining SummaCare, he most recently served as the president of EnvisionRx Options in Twinsburg. While at Envision, he was responsible for leading the overall operations and strategy ...The following SummaCare Medicare Advantage Plans plans offer Medicare Advantage coverage. Medicare Advantage plans are an alternative way to get your Original …Welcome Brokers. SummaCare provides a variety of plans to meet your customers' needs, from small and large employers to self-employed groups, Medicare eligibles and those looking for individual and family coverage. Attention Brokers who sell our Individual and Family Plans: We’re pleased to announce that we’ll be transitioning …Most SummaCare members have access to Teladoc™ Health as part of your coverage. You’re covered to speak with a licensed physician by web, phone or mobile app through Teladoc Health for primary care provider, dermatology and/or behavioral health visits that can be scheduled 24 hours a day, 365 days a year..