To place an OTC order over the phone call: 1-855-435-5111 (TTY: 711)
MEMBER SERVICES Contact Line: Please first call the number found on the back of your member ID card for accurate and faster service.
SummaCare is an HMO and HMO-POS plan with a Medicare contract. They offer two types of Medicare Advantage Prescription Drug (MAPD) plans (HMO and HMO-POS) and an HMO Medicare Advantage (MA) plan without prescription drug coverage. Their plan names are as follows:
- Amber
- Ruby
- Sapphire
- Topaz
- Garnet
- Emerald
Their Medicare Advantage plans cover everything Original Medicare covers and more! See the Summaries of Benefits for coverage amounts, limitations and copays for each of these:
Preventive Dental Coverage – coverage for a cleaning, an X-ray and an exam every year plus visits for dental pain through the Delta Dental Medicare Advantage PPO network.
Prescription Eyewear Allowance – provides an annual allowance to use toward the purchase of frames/lenses or contact lenses – with the freedom to visit any vision provider you choose. A reimbursement form along with your receipt will be required to be submitted so that you can be reimbursed up to your annual allowance.
Hearing Aid Coverage – coverage for select models of one hearing aid per ear every three years, after you pay a $795 copay per hearing aid.
Free Gym Memberships through SilverSneakers – a fitness program for Medicare beneficiaries. Allows you to receive a free fitness membership with access to basic amenities, group exercise classes and online resources.
Services through Teladoc – a provision to speak with a licensed physician by web, phone or mobile app through Teladoc for primary care physician, dermatology and/or behavioral health visits that can be scheduled 24/7 every day of the year.
Transportation Services – coverage for trips to routine medical appointments to an in-network provider or a provider within SummaCare’s service area through a vendor called Homelink.
Home Safety Devices – certain diagnoses may qualify for coverage for home safety devices, such as grab bars, shower stools and more, if ordered by your doctor.
Therapeutic Massage & Acupuncture Services – Select plans offer coverage for general acupuncture services performed by in-network providers.
Some of their plans come with a benefit for over-the-counter (OTC) items which covers OTC health and wellness products including first-aid supplies, pain relievers, cough/cold and allergy medicines, and more. With this OTC benefit, members receive an allowance to use once every quarter.
What is the Over the Counter Benefit?
It is a supplemental over-the-counter (OTC) benefit that allows members to order OTC medications at no additional cost. It is an allowance provided for Over-the-Counter items. This benefit will help with the cost of necessary health care items that are not covered as a medical or pharmacy expense under your plan. In addition, it can help you save money on a wide selection of over the counter products like pain relievers, cold medications, first aid supplies, dental care and much more.
Why use the OTC benefit?
- You Will Save Money — Members can get OTC items they need without spending money out of pocket. Get an allowance per each quarter to use on a wide range of health-related items such as cold remedies and personal care items.
- Easy Access — OTC orders are delivered straight to members’ homes. No need to drive anywhere.
- Save Your Time — One less trip to the pharmacy means members get to spend more time on what matters most.
- Shipping is free — There are no shipping or handling fees.
No Extra Costs!
These products are all provided at no extra cost but by using a credit / pre-determined allowance provided under the benefit. The orders will be shipped to their home at no extra charge.
Currently SummaCare allows their members to take advantage of their OTC benefit by using the online OTC program. The online OTC center makes it possible for current eligible plan members to easily order items using their home delivery services. Members who are eligible for this health benefit program are able to order over-the-counter products online from the comfort of home by going online, calling an order in or mailing it in. With this supplement benefit, their members can order items such as:
- Cough and cold allergy medicines
- Vitamins
- Medicines for the eyes
- Pain medicine
- Products for the stomach and bowel
- First aid care
- Hygiene products
- Mosquito spray
- Mouth and teeth cleansing products
- Skin care
- & a lot more!
These products are all provided at no extra cost when part of an eligible plan. They simply use credits / a pre-determined allowance provided under the benefit. The orders are shipped to their home at no extra charge. There are three ways that members of this program can submit their prescription orders:
- Eligible members can go online (see below on how to set up an account). This is the fastest, easiest, and most convenient way to order 24/7.
- Eligible members can call over the phone: 1-855-435-5111 (TTY: 711)
- Eligible members can order by mail: send the order form included with the catalog to the OTC Servicing Center, PO Box 526266, Miami, FL 33152-9819.
DO YOU QUALIFY?
You will need to make sure you check your plan’s Summary of Benefits of your personal current plan to confirm if a plan offers this benefit. If it does, you must also check the plan’s specific OTC allowance frequency, as it can be either monthly or quarterly. The allowance amount varies and depends on the plan. You may call the number provided at the beginning of this article for direction.
Only some plans include a quarterly allowance. The credits can be used to pay for select over-the-counter medications and supplies, including allergy medication, digestive health treatments, first aid supplies, pain relievers, and more. If your plan includes this benefit, review your Evidence of Coverage to find your exact quarterly allowance amount.
Why you should create an OTC online account:
- Browse the OTC products that are available to you
- Access a digital copy of your OTC catalog
- Monitor your available balance while you shop
- Track your order and view your order history
- Manage your account
- And more!
NOTE: please visit the site directly to verify the details and obtain more information.
- https://www.summacare.com/medicare/whatsnew
- https://www.summacare.com/medicare/plan-benefits
- https://www.summacare.com/medicare-members/member-resources
NOTICE: This information is not a complete description of benefits available. Contact the company directly for more information about their plans.
If you need to access the sign in or registration page, follow the easy steps below. We have provided a quick guide for you to find out how you can sign in to a current account or activate a new online account and gain access to manage it online. Be sure you have your personal information on hand.
What you need to register / sign in to a Summa Care OTC account online:
- Internet Access
- Member ID information
- Personal information
- Email address
Below are the steps you need to follow to register for a new online account:
- Visit: www.summacareotc.com in your internet browser on your device.
- Click on the “Not Registered? Signup Now” button and you will be directed to: https://www.summacareotc.com/Account/Register.aspx
- Type in your name in the fields provided.
- Type in your Health Plan Member ID Number on your Blue Shield Card in the field provided.
- Select your State.
- Input your date of birth in the field provided.
- Type in your email address in the fields provided.
- Create your User Name & Password.
- Select your Security Questions and provide the corresponding answers.
- Click on the “Register” button.
- Continue to move forward and provide all the required information until you receive a successful registration confirmation.
If you successfully registered you will receive an email verification showing that all is good with your registration. You will now have full access to your online account and can begin taking advantage of the SummarCare OTC online pharmacy benefits that your plan includes if you qualify.
Below are the steps you will need to follow to login to a current account:
- Visit: https://www.summacareotc.com in your internet browse on your device.
- Type in your Username in the field provided.
- Type in your current Password in the field provided.
- Click on the “Log in” button.
- Begin managing your online account.
Important Useful Tips for creating / processing / submitting your order:
- It is extremely important to note that you will only be allowed to place one (1) order at a time depending how long each benefit period lasts our plan offers the allowance. No partial orders are allowed. You must submit the full order at once or lose the remaining balance.
- Any and all unused benefits will expire; they will NOT roll over to the next benefit period. Also, you will not be allowed to request a partial or submit multiple orders. Because of this, you will need to make sure to submit a complete order of all the items you need for the benefit period when submitting your order online or over the phone.
- You are not allowed to order more than your allotted benefit amount. For example: if your total benefit is $20 and your order total is $20.95, you will have to delete or remove items from your order to bring the order total back down to be within the allotted benefit amount in order to submit the request. You will need to make sure that the total amount due is within your allotted monthly benefit amount.
- OTC items are available through home delivery only. Allow 5-7 business days from the time your order is placed for delivery.
- OTC products may not be purchased at a local retail pharmacy or through any source other than the SummaCare OTC benefit channels listed above.
- RETURN POLICY: Due to the personal nature of these products, returns are not accepted.
2020 OTC SummaCare Catalog / Catalogue:
If you still have questions about your plan, you may call the phone number found on the back of your health plan member card.
Member Services Phone Number: 855-435-5111 VDN 2602
