Medical Mutual Overview 2 One of the largest health insurance companies in Ohio 85 years of Ohio healthcare innovation and expertise Mutual company Owned by more than 15 million members Focus on member health and wellness ID: 776842
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MedMutual Advantage PPO Plan Overview
Slide2Medical Mutual Overview
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One of the largest health insurance companies in Ohio
85+ years of Ohio healthcare innovation and expertiseMutual company Owned by more than 1.5 million membersFocus on member health and wellnessCommitment to Ohio communities and local businesses
Slide3MedMutual Advantage Plan Overview
Slide4General Medicare Structure
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Nation’s largest health insurance program
Covers approximately 60+ million peopleFour primary parts
Part A
Original Medicare
Part B
Original Medicare
Part C
Medicare Advantage
Part D
Prescription Drug
Hospital Insurance
Medical Insurance
Combines Parts A and B
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For a complete list of benefits, refer to your Evidence of Coverage
Plan Highlights
Member Cost
Notes
Deductible
$500 per year
Certain services are subject to the deductible.
Max. Out-of-Pocket
$3,000 per year
Includes copayments & other costs for medical services paid throughout the year.
Inpatient Hospital Care
15% coinsurance
Outpatient Hospital Surgery
15% coinsurance
Doctor’s Office Visits
15% coinsurance
Preventive Care
$0
Review the Summary of Benefits for preventive care services.
Emergency Care
$120 copay
If admitted to the hospital, the fee is waived.
Urgent Care Visit
$30 copay
Applied to each covered visit.
Diagnostic Services, Labs, Imaging
15% coinsurance
Durable Medical Devices, Prosthetic Devices
15% coinsurance
All diabetic supplies have $0 cost share.
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Diverse wellness program options
SilverSneakers
®: Access more than 16,000 fitness centers nationwideWW® (formerly Weight Watchers): Programs for health and meal managementHome meals program: After an inpatient hospital stay, members are eligible to receive a one-week course of meals. 2 meals a day for 7 days delivered to their home24-hour Nurse Line: Clinical experts to answer health questions
QuitLine
: Cessation program and support to eliminate tobacco use
Wellness Programs
Slide7Network Overview
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Group Medicare Advantage PPO Plan
In-network, full-benefit coverage for services incurred anywhere in the US or US territories
Must use providers that accept Medicare
No travel restrictions
Providers that accept Medicare or MedMutual Advantage plans can be found using search tools
https://www.medicare.gov/
https://providersearch.medmutual.com/
PPO Network Service Area
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More than 34,000 quality healthcare provider options, including:
Akron General
Cleveland ClinicMercy HealthMetroHealthOhioHealthOhio State University Wexner Medical CenterPremier HealthTriHealthUniversity Hospitals
In-Network Provider Examples
Slide10Actively Manage Your Health
Slide11Medical Mutual Plan Benefit Summary
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Comprehensive plan with rich benefits
More than 34,000 providers in OhioExtensive wellness program optionsExperienced Medicare Customer Care teamSmooth retiree transition from current plan to new MedMutual Advantage plan
Slide12Thank You!