SummaCare Gold 750 with SCConnect Network and 3 Free PCP Visits

Plan Type: PPO
Plan Tier: Gold
Medical Deductible - Individual: $750
Medical Deductible - Family: $1,500
Drug Deductible - Individual: Included in Medical
Drug Deductible - Family: Included in Medical
Out of Pocket Max - Individual: $7,350
Out of Pocket Max - Family: $14,700
Primary Care Visit: $10
Specialist Visit: $50
Emergency Room: $300 Copay after deductible
Hospital - Physician: 20% Coinsurance after deductible
Hospital - Facility: 20% Coinsurance after deductible
Link to Full SBC:
Plan Brochure:

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:

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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