Summacare

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 ...

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 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).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.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 SummaCare customer service number on the back …Dec 26, 2023 · The SummaCare Medicare Formulary is a list of covered drugs under SummaCare Medicare Advantage plans. SummaCare will generally cover the drugs listed in our formulary as long as the drug is medically necessary, the prescription is filled at a network pharmacy (except in non-routine circumstances) and other plan rules are followed. 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 …EDI saves time, reduces cost and improves accuracy. SummaCare is pleased to provide EDI document processing for providers and employers. If you plan to submit HIPAA transactions to SummaCare, please complete the appropriate form below and return to: SummaCare Attn: EDI Support PO Box 3620 Akron, Ohio 44309-3620 …

The following SummaCare Medicare Advantage Plans plans offer Medicare Advantage plus Prescription Drug plan coverage to Ohio residents. Medicare Advantage plus Prescription Drug plans are an ... The following SummaCare Medicare Advantage Plans plans offer Medicare Advantage coverage. Medicare Advantage plans are an alternative way to get your Original …Aug 28, 2023 · Find Your Doctor. Find Your Drug. Find Your Pharmacy. Find a Document. If you are experiencing symptoms meeting the definition of an emergency, as defined in your plan documents, you should immediately call 911. If this is not an emergency, start with the selection tool below to choose your plan type and then a provider who can meet your needs. SummaCare | 1200 East Market Street, Suite 400, Akron, OH 44305-4066 When you click the button titled "Adjustment Request," a window will appear with various options so we can understand why you feel your claim should be adjusted. If you have any questions, please contact Provider Support Services at [email protected] or call 330.996.8400 or 800.996.8401. Dispute & Claim Adjustment Requests. 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 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 ...

Company Summary: SummaCare is one of Ohio’s only provider-owned health insurance companies, and is based in Akron, Ohio. They were established in the early 1990’s as a product offering for well-built and self-funded employers. From that time on, they have expanded regionally to connect the needs of Medicare beneficiaries, individuals and ...SummaCare is proud of the quality network providers we offer to our membership and we invest a considerable amount of time to credential and maintain the data that goes into our printed and online directories. We appreciate your responses to our quarterly outreach to double check your directory listing.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. SummaCare Medicare Ruby (HMO) is a Medicare Advantage (Part C) Plan by SummaCare Medicare Advantage Plans. Premium: $50.00. Enroll Now. This page features plan details for 2024 SummaCare Medicare Ruby (HMO) H3660 – 044 – 0 available in Northeast & Northwest Ohio. IMPORTANT: This page has been updated with plan and premium data for 2024.

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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- …EDI saves time, reduces cost and improves accuracy. SummaCare is pleased to provide EDI document processing for providers and employers. If you plan to submit HIPAA transactions to SummaCare, please complete the appropriate form below and return to: SummaCare Attn: EDI Support PO Box 3620 Akron, Ohio 44309-3620 …SummaCare | 1200 East Market Street, Suite 400, Akron, OH 44305-4066Zippia gives an in-depth look into the details of SummaCare, including salaries, political affiliations, employee data, and more, in order to inform job seekers about SummaCare. The employee data is based on information from people who have self-reported their past or current employments at SummaCare.

SummaCare offers Medicare, individual and employer health plans in Ohio. Learn about their 4.5-star rating, vision coverage, events and blog. 10 Medicare Advantage Plans from SummaCare. Coverage varies by plan. Select a Medicare Advantage Plan below to view details about the coverage it provides: Plan CodePlan Name. H3660:028-0 SummaCare Medicare Emerald (HMO-POS) H3660:029-0 SummaCare Medicare Sapphire (HMO-POS) H3660:044-0 SummaCare Medicare Ruby (HMO) Jan 23, 2024 · SummaCare Medicare Advantage plan members enjoy $0 copay for diabetic supplies and services. To order a select brand list of diabetes testing supplies sent to your home, call HOMELINK at 844.358.2549 (TTY 800.750.0750). OR. Visit a retail pharmacy to get any brand of diabetes testing supplies. 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 …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 …As of your effective date, SummaCare in-network healthcare services will be provided by the SCConnect network of doctors and hospitals. SCConnect is an exclusive network of providers and is available to residents and businesses located in Medina, Stark, Summit and Portage counties.We are able to offer efficient care at …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 ...PRIOR AUTHORIZATION REQUEST Please Fax To Inpatient 234-542-0811. Radiology, Radiation Oncology, Medication Oncology, Lab And Genomic Testing 800-540-2406.

SummaCare offers all-in-one Medicare plans that cover medical, prescription, dental and extra benefits. Learn about the different types of plans, network providers, formulary and …

Tim & Marie C., Akron Members since 2008, 2010. When you join a SummaCare Medicare Advantage plan, you’ll discover benefits worth staying for. Watch our real members explain why 96% of our members stay year after year.At SummaCare, our goal is to provide members with the tools they need to become their healthiest — and happiest — self. That’s why we created Plan Central, so you can manage your health and wellness all from one convenient, online location. Through Plan Central, you will enjoy 24-hour, secure access to the following and more:SummaCare’s 24-Hour Nurse Line: 800.379.5001 (TTY 800.750.0750) National Domestic Violence Hotline: 800.799.7233 (TTY 800.787.3224) or text “LOVEIS” to 866.331.9474. 988 Suicide & Crisis Lifeline: Call or text 988 for assistance with any mental-health related distress—whether thoughts of suicide, mental health, …The following SummaCare Medicare Advantage Plans plans offer Medicare Advantage coverage. Medicare Advantage plans are an alternative way to get your Original Medicare coverage.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 …Summa Health System, headquartered in Akron, Ohio, is one of Ohio's largest integrated healthcare delivery systems. Find a Summa location near you.SM-22-61377/CS/T/1-22 Steps to become a SummaCare provider: Step 1 Complete and email this form, additional information pages and all required documentation (your file) to [email protected]. Step 2 SummaCare Contracting will review your completed file to determine network needs (incomplete files may be …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 …

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Plan Types. SummaCare offers a range of plan options designed to meet the needs of individuals and families looking for health insurance. Plan categories are based on how you and the plan share your health care costs. Generally, plans in categories with lower premiums pay less of your total costs. Categories with higher premiums usually pay more. SummaCare's 2022 Medicare Advantage Plans Now Available. Date: 10/04/2021. AKRON, Ohio, October 4, 2021– Beginning October 15, Medicare-eligible …Enter your NPN Number: Enter your password: Login When you click the button titled "Adjustment Request," a window will appear with various options so we can understand why you feel your claim should be adjusted. If you have any questions, please contact Provider Support Services at [email protected] or call 330.996.8400 or 800.996.8401. Dispute & Claim Adjustment Requests. 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 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 … Published in SummaCare Medicare Insurance Plans. HealthPlanOne is a licensed and certified representative of Medicare Advantage HMO, PPO and PPFS organizations and ... SummaCare Medicare Advantage plan members enjoy $0 copay for diabetic supplies and services. To order a select brand list of diabetes testing supplies sent to your home, call HOMELINK at 844.358.2549 (TTY 800.750.0750). OR. Visit a retail pharmacy to get any brand of diabetes testing supplies.As a SummaCare member, your OTC benefit allows you to choose from hundreds of useful, everyday items. In addition to ordering items online via summacareotc.com, by phone or …SummaCare will generally cover the drugs listed in our formulary as long as the drug is medically necessary, the prescription is filled at a network pharmacy (except in non-routine circumstances) and other plan rules are followed. SummaCare covers both brand name drugs and generic drugs. Generic drugs have the same active-ingredient formula as ...SummaCare Medicare Sapphire (HMO-POS) is a Medicare Advantage (Part C) Plan by SummaCare Medicare Advantage Plans. Premium: $79.00. Enroll Now. This page features plan details for 2024 SummaCare Medicare Sapphire (HMO-POS) H3660 – 029 – 0 available in Northeast & Northwest Ohio. IMPORTANT: This page has been updated with plan and … ….

Oct 2, 2023 · 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). agree to submit the corrections to SummaCare Inc in an updated EFT Authorization Agreement. NOTE: SummaCare Inc makes claim payments based on the National Provider Identifier assigned to the provider. When a provider is paid to a group or practice, all other providers under that same group or practice will also be paid by Electronic Fund Transfer.Coinsurance: 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 ... All SummaCare Medicare Advantage Prescription Drug plans offer extra benefits not covered by Original Medicare. These include Part D prescription drug coverage, as well as dental, vision, hearing aid coverage, a quarterly allowance for non-prescription over-the-counter health related items and acupuncture services. SummaCare's 2022 Medicare Advantage Plans Now Available. Date: 10/04/2021. AKRON, Ohio, October 4, 2021– Beginning October 15, Medicare-eligible …AKRON, Ohio--(BUSINESS WIRE)--Akron, Ohio-based Summa Health and General Catalyst’s Health Assurance Transformation Corporation (HATCo) announced today that the two organizations have signed a ... All SummaCare plans include comprehensive prescription drug benefits, but your prescription drug coverage varies by the plan in which you are enrolled. Search for a drug using our Find Your Drug tool or view a formulary below. Commercial. 2024 SummaCare Commercial Drug Formulary (SUM01, SUM02, SUM11, SUM14, SUM15, SUM16)- Updated March 1, 2024 SummaCare providers may confidentially report a potential violation of our compliance policies or any applicable regulation by utilizing any of the methods indicated below. As a SummaCare Network Provider, your organization/office must adopt and enforce a zero-tolerance policy for retaliation or retribution against anyone who reports suspected ... 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.Enter your NPN Number: Enter your password: Login Summacare, [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1]