Akron-based SummaCare is expanding into several new markets next year with its Medicare managed-care plans.
The insurer — part of Summa Health System — will start offering optional managed-care coverage in 2013 to Medicare enrollees in Allen, Ashland, Defiance, Lucas and Seneca counties.
SummaCare has about 24,400 enrollees in its Medicare managed-care plans, which currently are available to residents of Ashtabula, Carroll, Columbiana, Cuyahoga, Erie, Geauga, Huron, Lake, Lorain, Mahoning, Medina, Portage, Sandusky, Stark, Summit, Trumbull, Tuscarawas and Wayne counties.
SummaCare is Summit County’s largest Medicare managed-care insurer with more than 14,100 enrollees, according to government data.
Some of the new counties are adjacent to SummaCare’s existing Medicare managed-care footprint, said Jim Loveless, vice president for Medicare and individual products.
The insurer also decided to expand into additional counties “to be more attractive to employer groups that have retirees across Northeast Ohio,” Loveless said.
“It allows us to be more accessible to some of the employer groups,” he said.
The move into new territories was possible after SummaCare secured agreements with Catholic Health Partner’s Mercy hospitals throughout Northwest Ohio and St. Rita’s Medical Center in Lima.
In addition, SummaCare’s Medicare is adding Humility of Mary Health Partners’ hospitals to its Medicare-managed network starting Jan. 1.
The managed-care plans — as well as stand-alone prescription drug coverage known as Medicare Part D plans — are optional for everyone who’s eligible for Medicare, the federal health insurance program for people 65 and older and some younger disabled Americans.
Some companies also offer retiree coverage through the Medicare managed-care plans, known as Medicare Advantage plans.
Beginning this year, SummaCare is working with ExtendHealth, a company that helps employers nationwide transition retirees from traditional group-based Medicare supplemental coverage to individual Medicare Advantage or Medigap supplement plans.
The federal government contracts with private insurance companies and helps pay the premium to provide drug coverage and/or managed care to Medicare recipients who sign up for the optional plans.
The Medicare Part D prescription drug plans are marketed statewide, while the Medicare managed-care plans vary from county to county.
Insurers are permitted under federal regulations to begin marketing their plans for 2013 and answering customers questions on Monday.
Open enrollment begins Oct. 15 and continues through Dec. 7. Changes are effective Jan. 1.
Cheryl Powell can be reached at 330-996-3902 or email@example.com. Follow Powell on Twitter at twitter.com/abjcherylpowell.