SummaCare Medicare Sapphire Overview
SummaCare Medicare Sapphire for Cuyahoga County, Ohio, by SummaCare Secure, is a Health Maintenance Organization Medicare Advantage Plan with a Point of Service Option (HMO-POS) available to seniors on Medicare. A HMO-POS plan has a flexible provider network that lets its members use healthcare providers outside of the plan network for certain situations or certain types of treatment. When out-of-network services are used members pay additional point-of-service fees.
The monthly premium for this HMO-POS plan is $65.00 In addition to the premium, members make co-payments when they use most healthcare services. A schedule of co-payments and co-insurances can be found on the co-payments page.
SummaCare Medicare Sapphire Quality Rating
To help seniors compare Medicare Advantage plans, Medicare rates the relative quality of all plans. After a full year on the market, each plan receives a one to five-star over-all mark, with one star being the lowest quality and five stars the highest quality.
The CMS has awarded SummaCare Medicare Sapphire Above Average as compared to all others (as of 15 October, 2013).out of 5 stars. That means Medicare deems this plan
SummaCare Medicare Sapphire Out-of-Pocket Expenses
By law, Medicare Advantage plans have an out-of-pocket limit of $6,700 per year. That said, plans can offer an out-of-pocket maximum as low as $3,400 per year. This plan's out-of-pocket spending limit is $3,400 per year. This amount is not inclusive of your monthly premium or the cost of your prescriptions. It's only what you pay when you receive heathcare services.
What this means to you is that you will no longer make co-payments or co-insurance payments when your out-of-pocket spending reaches $3,400. This is your safety net in the event of a critical illness or a serious accident. It protects you from serious financial liability and it should be carefully considered along with the premium and the co-payments.When comparing SummaCare Medicare Sapphire with traditional Medicare benefits, don't forget that you pay about twenty percent of all healthcare expenses covered by Part A and Part B, but there is no out-of-pocket limit. In other words, you have a lot of risk unless you get a Medigap policy to cover the gaps.
Compare Medicare Health Insurance Plans
Make sure you get the best health insurance for your unique situation. Compare SummaCare Medicare Sapphire with these Medicare Advantage plans:
- SummaCare Medicare Emerald
- SummaCare Medicare Ruby
- WellCare Value
- Blue Medicare Access Value
- Anthem Medicare Preferred Select
SummaCare Medicare Sapphire is available in the following Ohio cities: Berea, Chagrin Falls, Gates Mills, North Olmsted, Cleveland, Lakewood, Rocky River, Euclid, Beachwood, Independence, North Royalton, Strongsville, Maple Heights, Olmsted Falls, Solon, Bay Village, Brecksville, Brookpark, Westlake, Bedford, Broadview Heights, and all other areas of Cuyahoga County.
CMS File Date: January 14, 2014.
This Medicare health insurance catalog is maintained by 10/26/2014.and was last updated on