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, …website at www.summacare.com for the latest versions of SummaCare’s Drug Formulary and Medicare Part D Formulary. Phone: 888-783-1780 To obtain prior authorization for prescription drugs, please contact our Pharmacy Benefit Manager (PBM), MedImpact, at the number listed below. Please also visit our website at …SummaCare is a provider-owned, regional health insurance company headquartered in Akron, Ohio. It offers Medicare Advantage plans, individual and family plans, employer group plans and health ...The person being referred cannot already be a SummaCare Medicare Advantage plan member. The person being referred cannot be someone who is an active Summa Health employee, SummaCare employee or Summa Health volunteer. The person being referred must be residing in one of the 33 Northern Ohio service area counties: Allen, Ashland, …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 2022 from the Centers for Medicare and Medicaid Services (CMS).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 provides a high-quality, low-cost comprehensive, community-focused health plan that maximizes service with our integrated health system and choice to our providers, members and employers. We are committed to a thorough and effective Quality Management Program that follows the principles of Continuous Quality Improvement to …Zippia 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 a variety of Medicare Advantage plans in Ohio, with different levels of coverage, benefits and costs. Find out more about the 2022 HMO plan, which includes prescription drug coverage, low copays, fitness programs and more. Download the summary of benefits to compare the plan details and see if it suits …Aug 2, 2021 · SummaCare offers health insurance plans for employer groups and individuals. This year marks the 25th anniversary SummaCare offering Medicare Advantage products. First offered in 1996, they include medical and prescription drug (Part D) coverage and have an extensive network of more than 22,000 providers and 75 hospitals, including Summa Health. Aug 2, 2021 · SummaCare offers health insurance plans for employer groups and individuals. This year marks the 25th anniversary SummaCare offering Medicare Advantage products. First offered in 1996, they include medical and prescription drug (Part D) coverage and have an extensive network of more than 22,000 providers and 75 hospitals, including Summa Health. SummaCare offers a variety of Medicare Advantage plans in Ohio, with different levels of coverage, benefits and costs. Find out more about the 2022 HMO plan, which includes prescription drug coverage, low copays, fitness programs and more. Download the summary of benefits to compare the plan details and see if it suits …As a member of a SummaCare Medicare Advantage Plan, you have an Over-the-Counter (OTC) benefit every quarter. This benefit allows you to get OTC products you may need. Simply order online, through the mobile app, call 855.435.5111 (TTY: 711), or mail your completed order form. Your order will be shipped directly to your door. REMEMBERSign in to WebEx. Email Address: Password.SummaCare offers Medicare, individual and employer health plans in Ohio. Learn about their 4.5-star rating, vision coverage, events and blog.SummaCare has contracted with thousands of providers and many of the area’s hospitals and facilities to provide services to our members. SummaCare Medicare Advantage Plans. Find Your Doctor or Hospital using our online search. View and/or print from the options below: Northeast Region SCMedicare Provider Directory 1 - Updated March 29, 2024Find out how to contact SummaCare Member Services by phone or online form. You need to provide your Member ID number, group number, date of birth, name, address, phone … 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 offers affordable medical insurance for employers, individuals, families and Medicare eligibles in Ohio. Explore local health plans you can count on.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 …Summa Health offers a variety of healthcare plans, services and locations for patients in the Akron/Canton area. SummaCare is the health insurance arm of Summa Health, …SummaCare offers Medicare Advantage plans, employer group insurance and individual and family plans. Additionally, SummaCare offers a full range of self-funded products …Over-the-Counter (OTC) Benefit Catalog. 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 www.SummaCareOTC.com or call (855) 435-5111 (TTY: 711), or mail your completed order form. Your order will be shipped directly to …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 … Use your SummaCare Visa card to spend your Benefits Bucks quarterly allowance on non-prescription OTC health-related items at more than 68,000 retailers — or have them shipped right to your door. You’ll receive a quarterly amount to spend on non-prescription OTC health-related items like vitamins, pain relievers, cough and cold medicines ... Behavioral Health, Coordination of Care Form. Annually, SummaCare participates in behavioral healthcare clinical studies as part of NCQA requirements. The requirements' intent is to look at the coordination of care between medical and behavioral healthcare practitioners in order to improve health outcomes. Coordination of Care Form. 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 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. About SummaCare. SummaCare is a provider-owned, regional health insurance company headquartered in Akron, Ohio. 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 is consistently recognized for excellence in its industry. The Centers for Medicare and Medicaid Services (CMS) granted SummaCare Medicare Advantage plans a 4.5/5-star rating for 2022. U.S. News & World Report named SummaCare a “Best Insurance Company for 2022 Medicare Advantage Plans.”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.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 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 … 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 P.O. Box 3620 Akron, OH 44309-3620. Medicare Claim Form. If you paid out-of-pocket for a service or supply and would like to request reimbursement, please complete the Medicare Claim Form and send it, along with an itemized bill from your doctor or supplier to: SummaCare 1200 E. Market Street, Suite 400 Akron, OH 44305Of 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 …SBAMelissa 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 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.The following SummaCare Medicare Advantage Plans plans offer Medicare Advantage plus Prescription Drug plan coverage to Ohio residents. Medicare Advantage plus … 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 ... 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 …The following SummaCare Medicare Advantage Plans plans offer Medicare Advantage coverage. Medicare Advantage plans are an alternative way to get your Original …The person being referred cannot already be a SummaCare Medicare Advantage plan member. The person being referred cannot be someone who is an active Summa Health employee, SummaCare employee or Summa Health volunteer. The person being referred must be residing in one of the 33 Northern Ohio service area counties: Allen, Ashland, …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.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 …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 … Medicare Advantage Plans (age 65 and older) Medicare Advantage plans are offered through private insurance companies, like SummaCare. They are designed for those who are eligible for Medicare and they offer more coverage and lower out-of-pocket costs than Original Medicare. Some plans include extra benefits not offered by Original Medicare. Oct 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’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 ...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 …SummaCare, Akron, Ohio. 1,227 likes · 50 talking about this · 44 were here. Health insurance for you, your family and your business.SummaCare’s partnership with our pharmacy benefit manager provides quality pharmacy benefits to our members. All SummaCare plans include comprehensive prescription drug benefits. Search for drug using our Find Your Drug tool or view a formulary below.; For questions about your prescription drug coverage, please contact SummaCare at …Sign in to WebEx. Email Address: Password.Nov 10, 2022 · SummaCare is proud to share our 2023 Medicare Advantage Plan recently earned a 5-Star Rating (out of five stars) from the Centers for Medicare and Medicaid Services (CMS). This is an increase from our 4.5-Star Rating in 2022, which underscores our hard work, dedication and commitment to providing high-quality products and services to our ... SummaCare and the Greater Akron Chamber have partnered to offer Northeast Ohio small businesses a multiple employer welfare arrangement (MEWA). The Chamber Health Benefits Plan is a self-funded health benefits option that allows employers with 50 employees or fewer to join together to share in the healthcare costs of their employees.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 …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 …www.summacareotc.com | SummaCare Medicare. To place an OTC order over the phone call: 1-855-435-5111 (TTY: 711) MEMBER SERVICES Contact Line: Please first call the number found on the back of your member ID card for accurate and faster service. SummaCare is an HMO and HMO-POS plan with a Medicare contract. 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 The following SummaCare Medicare Advantage Plans plans offer Medicare Advantage coverage. Medicare Advantage plans are an alternative way to get your Original Medicare coverage.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 …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 2016SBASummaCare is a provider-owned, regional health insurance company headquartered in Akron, Ohio. It offers Medicare Advantage plans, individual and family plans, employer group plans and health ...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- … Medicare Advantage Plans (age 65 and older) Medicare Advantage plans are offered through private insurance companies, like SummaCare. They are designed for those who are eligible for Medicare and they offer more coverage and lower out-of-pocket costs than Original Medicare. Some plans include extra benefits not offered by Original Medicare. Oct 10, 2022 · SummaCare is a provider-owned, regional health insurance company headquartered in Akron, Ohio. It offers Medicare Advantage plans, individual and family plans, employer group plans and health management services throughout Northern Ohio. SummaCare is consistently recognized for excellence in its industry. 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.Sign in to WebEx. Email Address: Password.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.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.SummaCare | 1200 East Market Street, Suite 400, Akron, OH 44305-4066SummaCare | 2,114 followers on LinkedIn. Personal attention you deserve | SummaCare is headquartered in Akron, Ohio and is one of the region's only provider-owned health …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 …We would like to show you a description here but the site won’t allow us.2024 Health plan information for SummaCare Standard Bronze by SummaCare. Skip to content. Facts on Health Insurance. Find Health Plans. Get Help from a licensed agent. 1-877-668-0904 ; M-F 9am-10pm, Sat 12pm-8pm EST; Get Help. 1-877-668-0904 ; Enroll Now. Home > Health Plans > SummaCare Standard Bronze.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 ... 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 ... Summa Health is a nonprofit integrated healthcare delivery system in Northeast Ohio, United States. The Greater Akron Chamber (Ohio) documents Summa Health as the largest employer in Summit County with more than 7,000 employees. Summa provides comprehensive emergency, acute, critical, outpatient and long-term/home care.. Summa Health's integrated healthcare …Mar 12, 2024 · If you elect to enroll in our optional supplemental dental plan, you’ll pay an additional $35 per month in order to obtain the following additional benefits. You must keep paying your Medicare Part B premium and your SummaCare Medicare plan premium. The optional supplemental dental coverage has a calendar year maximum of $2,000 for Amber (HMO ... Zippia 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 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 ...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 …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. …
SummaCare | 1200 East Market Street, Suite 400, Akron, OH 44305-4066. Make a car
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 ...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 …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 ...Oct 11, 2023 · 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 are enrolling in the 2024 Amber plan. 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 2022 from the Centers for Medicare and Medicaid Services (CMS). Summa Health System — Akron and Barberton Campuses are a recipient of the Healthgrades 2024 America’s 50 Best Hospitals Award™. This places Summa Health among the top one percent of all hospitals for clinical care and patient outcomes across treatment of the most common conditions and procedures. Read more. 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 … 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 ... Find Your Drug. SummaCare’s partnership with our pharmacy benefit manager provides quality pharmacy benefits to our members. Search for a drug using our Find Your Drug tool or view a formulary below. 2024 SummaCare Marketplace (Small Group and Individual) Standard Prescription Drug Formulary (effective January 1 through December 31, 2024 ...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.For more information on SummaCare Medicare Advantage plans for 2023, please call 888.464.8440 (TTY 800.750.0750). You may also visit SummaCare’s website for more information, summacare.com. SummaCare is an HMO and HMO-POS plan with a Medicare contract. Enrollment in SummaCare depends on contract renewal.PRIOR AUTHORIZATION REQUEST Please Fax To Inpatient 234-542-0811. Radiology, Radiation Oncology, Medication Oncology, Lab And Genomic Testing 800-540-2406.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.HATCo is a new company owned by General Catalyst, one of the largest venture capital firms in the U.S. In recent years, it’s raised hundreds of millions of dollars to focus on health care. Dr. Marc Harrison, a former Cleveland Clinic executive and pediatric emergency care physician, joined General Catalyst to launch and lead HATCo in October.Providers. SummaCare is focused on keeping your patients healthy using all Health Services programs available to them. To refer members for Health Services programs, please call SummaCare’s Health Services Management at 330.996.8931 or toll free at 877.888.1164 or email [email protected]. You may also send referrals through ...SummaCare’s partnership with our pharmacy benefit manager provides quality pharmacy benefits to our members. All SummaCare plans include comprehensive prescription drug benefits. Search for drug using our Find Your Drug tool or view a formulary below.; For questions about your prescription drug coverage, please contact SummaCare at ….