SummaCare Medicare Advantage 2027: The Six Gemstone Plans and Where Each One Is Sold

Source: our analysis of CMS 2027 Plan Benefit Package and plan-county files, contract H3660 (SummaCare Inc.), individual plans only.

Emerald and Sapphire are HMO-POS plans, which add some coverage outside the SummaCare network at a higher cost share. The other four are standard HMOs, so outside emergencies and urgent care you generally need SummaCare network providers.

Our analysis of CMS 2027 plan data

That makes SummaCare a regional choice, not a statewide one. Ohio has 176 individual Medicare Advantage plans for 2027 by our count, and SummaCare’s six are about 3% of them. See every insurer and county in our Ohio Medicare Advantage guide.

SummaCare’s 2027 Summary of Benefits for Ruby gives a sense of how its premium plans are built:

Source: SummaCare 2027 Ruby (HMO) Summary of Benefits.

A $4,200 in-network cap is on the low side for Medicare Advantage, but it comes with a monthly premium. The other gemstone plans have their own premiums and copays, so read each plan’s 2027 Summary of Benefits rather than assuming they match Ruby.

One of SummaCare’s 2027 plans is called SummaCare Medicare Quartz (HMO). It has nothing to do with Quartz Medicare Advantage, a separate insurer that files 19 HMO plans for 2027 in Wisconsin, Iowa and Minnesota, according to the same CMS files. If you are in Ohio and searching “Quartz Medicare,” make sure the plan ID begins with H3660, SummaCare’s contract.

The same caution applies to plan names in general. “Ruby,” “Topaz” and “Amber” are SummaCare product names; they do not tell you the benefit level. Compare the actual premium, out-of-pocket maximum and drug tiers side by side.

SummaCare’s quality ratings page says its Medicare Advantage plans “earned a 4 out of 5 stars for 2027” from CMS. In 2022, SummaCare announced that its 2023 Medicare Advantage plan had earned a 5-star rating, so 2027’s 4 stars is a step down from that peak.

Four stars still meets the level Medicare uses for quality bonus payments, which plans often put toward extra benefits. It does not give SummaCare the special year-round enrollment window that only 5-star plans get. Compare all carriers on our 2027 star ratings page.