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
After its first year on the market, the CMS (Centers for Medicare and Medicaid Services) gives each Medicare Advantage plan an overall one to five star rating. The unbiased quality assessment assists people when comparing plans. Medicare Advantage plans with five stars have the highest quality, whereas a one star plan has the lowest 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
Medicare Advantage plans are limited to a maximum out-of-pocket limit of $6,700 (annually). This out-of-pocket limit does not include your prescriptions or your monthly premiums. It only applies to your costs for healthcare services.
Although the mandatory limit is $6,700, the CMS allows plans to offer a lower limit that can be as low as $3,400. The out-of-pocket limit on this plan is $3,400. Be sure to take into consideration, along with the premium and the co-payments, when making your enrollment decision.
If you are comparing SummaCare Medicare Sapphire with your traditional Medicare benefits, it's important to remember that there are no limits to your out-of-pocket expenses with Medicare Part A or Medicare Part B. If you keep your traditional Medicare benefits, the only way to avoid high medical bills is to purchase Medicare Supplement insurance to supplement your coverage.
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:
- Kaiser Permanente Medicare Plus Basic III
- Kaiser Permanente Medicare Only Basic
- SummaCare Medicare Emerald
- Kaiser Permanente Medicare Plus II
- Aetna Medicare Standard Plan
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 9/30/2014.and was last updated on