How Much Does SummaCare Medicare Emerald Cost?
The premium on this plan is $180.00 per month. That includes your prescription drugs, as well. Plus, you must continue to pay your monthly Medicare Part B premium. Co-payments and/or co-insurances also apply with most healthcare services, except preventive care mandated by CMS (see H3660-028 Summary of Benefits below).
Although the health plan itself does not have a deductible, the prescription drug plan does. It's $0.00 per year. That means you have first dollar coverage.
IMPORTANT: When evaluating this plan, look past the monthly premium. Identify the costs of the healthcare services you use most. Only then will you uncover the plan's value for your personal situation.
What is the Maximum Out-of-Pocket (MOOP) Limit?
Unlike Original Medicare, Medicare Advantage plans must set an annual Maximum Out-of-Pocket limit on inpatient and outpatient healthcare services. The SummaCare Medicare Emerald plan MOOP is $3,400 . Once you reach this amount of spending on your co-payments, all of your Medicare Part A and Part B services will be covered at no additional charge.
Plans can set their MOOP at a voluntary level of $0 to $3,400 (for in-network services) or a mandatory $3,401 to $6,700 (in-network). Combined totals for in-network and out-of-network are generally higher.
NOTE: MOOP does not include what you spend on monthly premiums. It also does not apply to your prescription drugs or Part D deductible.
CRITICAL: It is important to evaluate the combined annual MA/MAPD premiums and MOOP versus what you might expect to pay for a Medicare Supplement in Ashtabula County. Some Medicare Supplements offer less overall financial risk than Medicare Advantage.
Medicare 5-Star Ratings
In this section we show you the quality rating for this SummaCare plan. Each year CMS rates health plans (Part C) in five broad categories and drug plans (Part D) in four broad categories. We do not recommend joining a plan with an overall rating less than 3.0. The following marks will give you an idea of the level of care you will receive if you join this health plan.
Does SummaCare Medicare Emerald include Medicare Part D?
This plan includes prescription drug coverage (Medicare Part D). If you have regular prescriptions, it's critical that you evaluate your costs using the plan's formulary.
In addition to the monthly premium and Part D deductible, the drug plan has copayments (fixed dollar amount) and/or coinsurances (percentage) that you must pay when you pickup your medications. Here's the drug coverage schedule for this plan:
How Much are the Copays & Co-Insurance?
In this Summary of Benefits section we outline high-level information about the plan's co-payment and co-insurance costs for inpatient, outpatient, preventive care, transportation and other healthcare services. For complete details or assistance call: 1-855-266-4865.
SummaCare Medicare Emerald vs. Medigap
To compare SummaCare Medicare Emerald with a Medigap plan (Medicare supplemental insurance), you need to evaluate your healthcare and financial needs. Look at the total potential cost with each plan type, not just the monthly premium, and choose how you want to use medical care (locally or nationally).
To help you make a better decision, we created our How-to Choose the Best Medicare Plan guide. It will help you understand how to compare SummaCare Medicare Emerald with Medicare Supplement plans in Ohio.
For more information about this plan, call the Enrollment Assistance line, or visit the Enrollment Website or the plan website:
For assistance 24 hours a day, call 800-633-4227. TTY users should call 877-486-2048. If you qualify for Medicare but have not yet enrolled or verified your enrollment status, you can do so on the Social Security Administration website. You can learn more about the Medicare Advantage program on www.medicare.gov. To learn more about this plan, visit the SummaCare Medicare website.
Additional Medicare Plan Options in Ashtabula County
Are you eligible for a Ashtabula County, OH Medicare Special Needs Plan (SNP)? SNPs are a special type of Medicare Advantage plan designed to help people with special needs. Here are some of the SNP plans in your area:
- UnitedHealthcare Dual Complete LP1 (Local HMO), for Dual-Eligible beneficiaries
- Anthem MediBlue Dual Advantage (Local HMO), for Dual-Eligible beneficiaries
- Allwell Dual Medicare (Local HMO), for Dual-Eligible beneficiaries
- UnitedHealthcare Nursing Home Plan 2 (Local PPO), for Institutional beneficiaries
Not qualified for an SNP? Here are some additional plans you might consider:
- Anthem MediBlue Preferred (HMO)
- Aetna Medicare Premier Plus 1 (PPO)
- Anthem MediBlue Access Core (PPO)
- AARP Medicare Advantage Plan 7 (HMO)
- SummaCare Medicare Sapphire (HMO-POS)
SummaCare Medicare Emerald is available to Medicare beneficiaries living in Andover, Ashtabula, Austinburg, Conneaut, Dorset, Geneva, Jefferson, Kingsville, North Kingsville, Orwell, Pierpont, Rock Creek, Rome, Unionville, Williamsfield, Windsor, and all other areas of Ashtabula County, Ohio; Medicare plans are the same throughout the County.
On this page our goal is to help consumers: Compare SummaCare Medicare Emerald with all 2020 Medicare Advantage Plans in Ashtabula County, Ohio: HMO-POS plan, $180.00/mo, $3,400 MOOP. Did we succeed?