SummaCare

Resources & Self Service

Resources

• Prior Authorization List – Find out which services and provider-administered medications require prior authorization.
• Prior Authorization Fax Form
• Pharmacy Benefits Guide – Find out which prescription drugs have limitations (prior authorization, step therapy and quantity limits).
• Member Rights and Responsibilities
• Clinical Practice Guidelines – See clinical recommendations for specific medical conditions and appropriate preventive care.
• Advance Directives – Learn the importance of executing an advance directive.
• Women's Health and Cancer Rights Act of 1998
• FAQ – Get the answers to our most frequently asked questions.
• My Benefits - Access your personal benefit information.
• Health & Wellness Tools – Access the tools and services available to you.
• Notice of Privacy Practices
• Terms of Use/Privacy Policy for web site
• Fraud and Abuse Policy

Forms

• Request a new ID card
• Request a copy of your benefit information
• Change your address
• Change your PCP 
• Download an Information Release Form to allow SummaCare to discuss your insurance plan or care coordination needs with an outside person or organization
• Download the Coordination of Benefits Form to update SummaCare about your other insurance coverage
• Medical Claim Form for out-of-network services received
• Pharmacy Claim Form for reimbursements when prescriptions are paid for out-of-pocket
• Deductible Credit Transfer Form for applying expenses from your previous plan's deductible

Member Newsletters

SummaCare sends biannual newsletters to keep you informed about important benefit information and the latest health & wellness news to help you live a happier, healthier life.

Quality Management

Contact Us

We know benefit details and health decisions aren't always easy. We're here to help.