SummaCare Silver 5000 with SCConnect Network and 3 Free PCP Visits

Plan Type: HMO
Plan Tier: Silver
Medical Deductible - Individual: $5,000
Medical Deductible - Family: $10,000
Drug Deductible - Individual: $500
Drug Deductible - Family: See Plan Brochure
Out of Pocket Max - Individual: $7,900
Out of Pocket Max - Family: $15,800
Primary Care Visit: $10
Specialist Visit: $50
Emergency Room: $300 Copay after deductible
Hospital - Physician: 30% Coinsurance after deductible
Hospital - Facility: 30% Coinsurance after deductible
Link to Full SBC: https://www.summacare.com/Libraries/SOBs/2019SummaCareSilver5000.pdf
Plan Brochure: https://www.summacare.com/Libraries/SBCs/2019SummaCareSilver5000.pdf

Other Coverage:

Child Dental: No
Adult Dental No

Prescription Drug Pricing:

Generic Drugs: $5
Non-Preferred Brand Drugs: 40% Coinsurance after deductible
Preferred Brand Drugs: $50
Specialty Drugs: 40% Coinsurance 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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