Business Details
33 Years
experience
Your Trusted Partner for Comprehensive Health Insurance Solutions
SummaCare Health Insurance has been dedicated to providing personalized health insurance solutions since 1993. As a community-focused partner, we prioritize coordinated care and direct attention to meet the unique needs of individuals, families, and businesses. Our strategic partnership with Health Assurance Transformation Corporation (HATCo) enhances our ability to deliver innovative healthcare solutions. With a 4.5-Star rating from Medicare and a 97% member retention rate, we combine decades of experience with a commitment to quality. Our offerings include Medicare Advantage plans, employer-sponsored coverage, and individual/family insurance, supported by a network spanning 20 Ohio counties.We emphasize preventive care, wellness programs like Silver Sneakers, and access to cutting-edge benefits such as BrainHQ cognitive training. Our integration with Summa Health ensures seamless clinical excellence and value-based care. We maintain transparency through resources like our Vital Coverage blog and 24/7 Nurseline support. Recognized by the National Committee for Quality Assurance (NCQA), we remain one of Ohios top three commercial insurers, driven by a mission to improve community health outcomes.
Services
Medicare Advantage Plans
Individual & Family Insurance
Employer Health Plans
MEWA Solutions
Self-Funded Options
Pharmacy Benefits
Preventive Dental Coverage
Hearing Aid Coverage
Vision Benefits
Travel Coverage
Details
- Year established: 1993
Highlights and features
- We offer 97% year-over-year Medicare member retention.
- Our Medicare Advantage plans hold a 4.5-Star rating from CMS.
- We provide BrainHQ cognitive training benefits for members.
- We include Silver Sneakers gym memberships in select plans.
- We offer standalone VSP vision coverage available to non-members.
Associations and certifications
- National Committee for Quality Assurance (NCQA)
Services
Medicare Advantage Plans
Our Medicare Advantage plans combine medical, prescription drug, vision, dental, and hearing benefits. With $0 premiums on select plans, members gain access to a network spanning Northern Ohio and travel coverage in AZ, FL, and TX. Backed by a 4.5-Star CMS rating, these plans emphasize preventive care and chronic disease management.
Employer Health Plans
We offer fully-insured and self-funded group plans for businesses of all sizes. MEWA solutions cater to small employers, while large groups receive customized benefits. Our NCQA-ranked commercial plans cover 20 Ohio counties with network options that reduce costs while maintaining access to top-tier providers.
Individual & Family Insurance
Available through ACA-compliant PPO plans in Summit, Stark, Portage, and Medina counties. Metal-tier options (Bronze, Silver, Gold) balance premiums and out-of-pocket costs. Financial assistance eligibility checks help members find affordable coverage with access to SCConnect network providers.
Pharmacy Benefits
All Medicare Advantage plans (except Amber HMO) include Part D coverage with $0 copays for Tier 1-2 drugs. Our formulary supports brand and generic medications, with specialty pharmacy services for chronic conditions like MS and rheumatoid arthritis.
Wellness Programs
Members access Silver Sneakers fitness memberships, BrainHQ cognitive training, and preventive dental/vision benefits. These programs promote proactive health management and reduce long-term care costs through early intervention and lifestyle support.
People
Bill Epling
President
Leading SummaCare since 2022, Bill Epling brings decades of healthcare administration experience. He oversees strategic growth initiatives and maintains our community-focused mission established in the 1990s through partnerships like the Greater Akron Chamber collaboration.
Questions
What is Medicare Advantage?
Medicare Advantage (Part C) offers all Original Medicare benefits plus extras like vision, dental, and hearing aids through private insurers.
How do I qualify for financial assistance?
Eligibility depends on household income and family size. Use our online tool to estimate subsidies for individual/family plans.
Can small businesses access group plans?
Yes, through our MEWA partnership with the Greater Akron Chamber, offering affordable options for businesses with fewer than 50 employees.
What pharmacy networks do you use?
We partner with Delta Dental and national pharmacy chains. Check our website to confirm specific pharmacy participation.
Do you cover out-of-state care?
Yes, our Amber, Topaz, and Quartz HMO plans include in-network coverage in Arizona, Florida, and Texas for travelers.
How do I find in-network providers?
Use our online provider directory or contact Member Services to locate doctors, hospitals, and specialists within our SCConnect network.
Videos
