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Covered
SummaCare provides coverage for a range of treatments and situations that support the health and wellness of its members. Among covered services are preventive care, such as vaccinations and screening tests, and primary care visits to diagnose and treat illnesses. They also cover specialist care, including referrals to allergists for conditions like asthma and allergy immunotherapy to help manage and potentially alleviate allergic reactions. Coverage extends to various medications prescribed by healthcare providers, hospital stays, surgical procedures, and emergency medical services. Rehabilitation services such as physical therapy, as well as mental health care and substance abuse treatment, are also covered. Members can benefit from maternity and newborn care, ensuring support throughout pregnancy and after birth. SummaCare aims to provide comprehensive health coverage that addresses the needs of its diverse clientele.
Uncovered
SummaCare may not cover treatments deemed experimental or investigational, including certain drugs not approved by the FDA. Cosmetic surgery, services related to weight loss, non-emergency care received outside the service area, or treatments not deemed medically necessary may also be excluded. Additionally, long-term custodial care, private nursing, and some alternative therapies like acupuncture might not be covered. Dental care, except as a result of injury, and routine foot care are typically not covered under their plans.
