mysummacare - ehealthinsurance...summacare individual solutions 2015 plan highlights enrollment...
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Health insurance plans for individuals and families.
We’re right here for you.
MySummaCare.com• Get a quote• Use our Premium Savings Calculator to see if you qualify for a savings on your premium• Compare SummaCare plans• Search for your doctors• Enroll in a plan of your choice
Call us at 888-291-3417 and we can assist you over the phone.
YOU MAY QUALIFY FOR LOWER COSTS ON MONTHLY PREMIUMS!
Source: 2014 Federal Poverty Level (FPL) Guidelines By Family Size
To be eligible for savings in the form of a tax credit on your monthly premium, you must be under age 65 and not eligible for coverage through your employer, Medicare or Medicaid. Tax credits are based upon income, household size and plan options available in your area. Get an estimate of potential savings available to you by using the Premium Subsidy Calculator at MySummaCare.com.
1 $11,670 – 46,680
2 $15,730 – 62,920
3 $19,790 – 79,160
4 $23,850 – 95,400
5 $27,910 – 111,640
6 $31,970 – 127,880
7 $36,030 – 144,120
8 $40,090 – 160,360
Householdsize
You may qualify if your annual household income
is between:
888-291-3417 MySummaCare.com
This product is underwritten by Summa Insurance Company and administered by SummaCare.
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Affordable plans with extra benefi ts!Get the most out of your health insurance dollar by joining SummaCare. All plans include:
• Comprehensive medical and pharmacy benefi ts
• 3 Free offi ce visits to your SummaCare Primary Care Physician* for each person on your policy
• Unlimited lifetime benefi ts
• Health and wellness benefi ts including:
– Free preventive health screenings
– Free annual fl u vaccine
• Additional benefi ts including:
– Vision discounts from EyeMed Vision Care
– Disease management programs to help manage chronic conditions
New for 2015! Choose SCConnect, a limited network of physicians, facilities and hospitals including Summa Health System, Mercy Medical Center (Canton) and Akron Children’s Hospital. The SCConnect network is available to residents in Summit, Stark, Portage and Medina counties and offers effi cient care at lower costs. Visit MySummaCare.com to confi rm your provider is part of the SCConnect network.
* SummaCare Primary Care Physicians are physicians with specialties in: Family Medicine, General Practice, Internal Medicine, Pediatrics and Obstetrics/Gynecology
In-Network Benefi t GOLD750-LT
SILVER2750-LK
SILVER5000-LH
BRONZE6450-LD
VALUE-L0(only offered to
qualifi ed individuals)
Plan Deductible (Individual / Family)
$750 / $1,500
$2,750 / $5,500
$5,000 / $10,000
$6,450 / $12,900
$6,600 / $13,200
Member Co-Insurance You pay 20% You pay 20% You pay 30% You pay 0%
after deductibleYou pay 0%
after deductible
Annual Out-of-Pocket
Maximum (Individual / Family)
$6,600 / $13,200
$6,600 / $13,200
$6,600 / $13,200
$6,450 / $12,900
$6,600 / $13,200
Primary Care Physician*
Offi ce Visits
$0 copay for fi rst 3 visits;
then $20 copay**
$0 copay for fi rst 3 visits;
then $20 copay**
$0 copay for fi rst 3 visits;
then $25 copay**
$0 copay for fi rst 3 visits; then pay $0
after deductible
$0 copay for fi rst 3 visits; then pay $0
after deductible
Specialist Offi ce Visits
$40 copay** $40 copay** $50 copay** You pay $0 after deductible
You pay $0 after deductible
Inpatient Hospital Stays
You pay 20% after deductible
You pay 20% after deductible
You pay 30% after deductible
You pay $0 after deductible
You pay $0 after deductible
Prescription Drugs$15 copay for up to a 30-day generic supply
$15 copay for up to a 30-day generic supply
$15 copay for up to a 30-day generic supply
You pay $0 after deductible
You pay $0 after deductible
SummaCare Individual Solutions 2015 Plan Highlights
Enrollment Timeline • November 15, 2014: This is the fi rst day you can
enroll in your plan of choice for 2015 coverage. • December 15, 2014: This is the last day you can
enroll in your plan of choice for coverage to be effective January 1, 2015.
• January 15, 2015: This is the last day you can enroll in your plan of choice for coverage to be effective February 1, 2015.
• February 15, 2015: This is the last day of Open Enrollment. You must have enrolled in your plan of choice by this date to ensure that you are not penalized for not having insurance. If you enroll by this date, your coverage will be effective March 1, 2015.
• If you experience a life-changing event during the year such as marriage, birth of a child or a change in job status, you may be eligible for a Special Election Period and can enroll in your plan of choice at that time.
generic supply generic supply after deductible after deductible
Visit MySummaCare.com for a full Summary of Benefi ts.* SummaCare Primary Care Physicians are physicians with specialties in: Family Medicine, General Practice, Internal Medicine, Pediatrics and Obstetrics/Gynecology
** Copay is not subject to deductible
Silver 2750-LK and Silver 5000-LH are offered with lower out-of-pocket costs for qualifying individuals. Bronze 6450-LD can be paired with a Health Savings Account (HSA). Contact your fi nancial institution for more information.
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