Plan Design Summary
As of January 1, 2008, SummaCare Secure will be offering three plan designs: Silver, Gold and Platinum. Each offer different monthly premiums and out-of-pocket expenses. All plans include comprehensive prescription drug coverage.
The chart below compares common benefit categories and their level of coverage under the Silver, Gold and Platinum plans. For a complete list, refer to the Summary of Benefits.
| Benefit Category | Silver Plus | Gold Plus | Platinum |
|---|---|---|---|
| Monthly Plan Premium | $0 (You must continue to pay the Medicare Part B Premium) |
$65 (You must continue to pay the Medicare Part B Premium) |
$150 (You must continue to pay the Medicare Part B Premium) |
| Primary Care Physician Office Visits | $0 | $0 | $0 |
| Specialist Office Visits | $30 per visit | $25 per visit | $0 |
| Inpatient Hospital Stays | $175 each day for days 1-10 $0 each day for days 11-90 |
$100 each day for days 1-10 $0 each day for days 11-90 |
$0 |
| Emergency Room Services | $50 per visit anywhere in the world | $50 per visit anywhere in the world | $50 per visit anywhere in the world |
| Vision Services | $30 for each eye exam | $25 for each eye exam | $0 |
| Yearly Out-of-Pocket Maximum | $3,000 (copayments for prescription drugs do not count toward this maximum) |
$2,000 (copayments for prescription drugs do not count toward this maximum) |
N/A |