SummaCare Bronze 6650 HSA with SCConnect Network

Plan Type: HMO
Plan Tier: Bronze
Medical Deductible - Individual: $6,650
Medical Deductible - Family: $13,300
Drug Deductible - Individual: Included in Medical
Drug Deductible - Family: Included in Medical
Out of Pocket Max - Individual: $6,650
Out of Pocket Max - Family: $13,300
Primary Care Visit: No Charge after Deductible
Specialist Visit: No Charge after Deductible
Emergency Room: No Charge after Deductible
Hospital - Physician: No Charge after Deductible
Hospital - Facility: No Charge after Deductible
Link to Full SBC: https://www.summacare.com/Libraries/SOBs/2019SummaCareBronze6650HSA.pdf
Plan Brochure: https://www.summacare.com/Libraries/SBCs/2019SummaCareBronze6650HSA.pdf

Other Coverage:

Child Dental: No
Adult Dental No

Prescription Drug Pricing:

Generic Drugs: No Charge after Deductible
Non-Preferred Brand Drugs: No Charge after Deductible
Preferred Brand Drugs: No Charge after Deductible
Specialty Drugs: No Charge after Deductible
Link to Full Policy Formulary: http://www.summacare.com/Libraries/Formularies/2019Formulary.pdf

About The Carrier

SummaCare offers affordable medical insurance for employers, individuals, families and Medicare eligible individuals. It is our goal to consistently exceed our members’ expectations. That’s why you can expect the same great customer service with every interaction you have with SummaCare.

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