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ABOUT MEDICARE

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HEALTH INSURANCE EDUCATION

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PLANS AND PRODUCTS

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IN THE NEWS

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Recent: October 2024 Mutual News Bulletin

Recent: Magellan Rx Management Services Changed its Name to Prime Therapeutics Effective Oct 1, 2024

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Policies and Standards

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POLICIES AND STANDARDS

Accessibility Standards

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Medical Necessity Criteria and Clinical Review Guidelines

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MEDICAL MUTUAL RESOURCES

Chronic Condition Management Program

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First tier, Downstream or Related Entities

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EXTERNAL RESOURCES

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Optum® EDC Analyzer™

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FORMS

Acute Discharge Planning Worksheet

Inpatient Behavioral Health Fax Form

Inpatient Medical Fax Form

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Member Forms

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Prior Approval Form

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Provider Information Form

Request for Medicare Prescription Drug Coverage Determination Form

Request for Redetermination of Medicare Prescription Drug Denial Form

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Medicare

Individuals and Families Category Arrow

Employers

Go to Medicare Overview

MEDICARE ADVANTAGE PLANS

MedMutual Advantage Plans

Dental, Vision and Hearing Coverage

Extra Programs and Services

Important Plan Information

MedMutual SeniorCare™

Upcoming Events

MEDICARE SUPPLEMENT INSURANCE PLANS

Our Medicare Supplement Insurance Plans

MedMutual Supplement Plus

Extra Benefits and Opportunities

ENROLLMENT INFORMATION

Medicare Eligibility Rules

When to Enroll

How to Enroll

MedMutual Advantage Member Resources

ABOUT MEDICARE

Understanding Medicare

The Parts of Medicare

Find the Plan that Fits Your Needs

Go to Individuals and Families Overview

PLANS AND PRODUCTS

Medical

Dental

Vision

Short-term

Accident and Critical Illness

Life

HEALTH AND WELLNESS PROGRAMS

Wellness Programs

Chronic Condition Management, Case Management and Maternity Programs

HEALTH INSURANCE EDUCATION

How to Get Health Insurance

What is Individual Health Insurance

Employer vs. Individual Insurance

How a Deductible Can Lower Your Premium

How to Select a Doctor

Types of Health Insurance Plans

Understanding an HSA

Understanding Health Insurance Costs

FAQs

Glossary

Go to Employers Overview

PLANS AND PRODUCTS

Small Group Health Plans

Midsize Group Health Plans

Large Group Health Plans

Dental

Vision

Life and Disability

Accident, Critical Illness and Hospital Indemnity

Health Savings Accounts (HSAs)

Flexible Spending Accounts (FSAs)

Health Reimbursement Arrangements (HRAs)

Prescription Drug

Federal Employees Health Benefit Program

HEALTH AND WELLNESS PROGRAMS

Workplace Wellness Programs

Add-On Programs

Employee Programs to Manage Chronic Conditions

Maternity Program

Case Management Program

Utilization Management and Medical Policy and Review

EMPLOYER RESOURCES

Tools and Resources

Prescription Drug Information

Mutual Appreciation Program

Value-Based Contracting

Transparency in Coverage Compliance

Creditable Coverage

Member Resources Category Arrow

Go to Members Overview

MEMBER RESOURCES

Forms

FAQs

Mobile App

News

Policies and Standards Category Arrow

Resources

Forms

Go to Providers Overview

IN THE NEWS

Main News Feed

Recent: October 2024 Mutual News Bulletin

Recent: Magellan Rx Management Services Changed its Name to Prime Therapeutics Effective Oct 1, 2024

Go to Providers Overview

POLICIES AND STANDARDS

Accessibility Standards

Clinical Practice Guidelines

Laboratory Management Policies

Medical Drug Management

Medical Necessity Criteria and Clinical Review Guidelines

Medical Policies

Prescription Drug Information

Prior Approval and Investigational Services

Reimbursement Policies

Go to Providers Overview

MEDICAL MUTUAL RESOURCES

Chronic Condition Management Program

Claims Edit System

Clinical Supply Materials

Continuity and Coordination of Care

Credentialing

Cultural Competency Resources

EFT and ERA

First tier, Downstream or Related Entities

Health Outcomes Survey Tip Sheet

Healthcare Technology Assessment

HEDIS Documentation Reference Guide

MedCommunity Resources

Medical Mutual Service Accounts

Outpatient Ambulatory Surgery Classification Groups

Risk Adjustment Information

EXTERNAL RESOURCES

Behavioral Health Shared Decision-Making Tools

Optum® EDC Analyzer™

Routine Test Management Provider Webinar

The Waco Guide

Go to Providers Overview

FORMS

Acute Discharge Planning Worksheet

Inpatient Behavioral Health Fax Form

Inpatient Medical Fax Form

Medical Record Attestation Form

Member Forms

Network Provider Enrollment Form

Prior Approval Form

Provider Action Request Form

Provider Information Form

Request for Medicare Prescription Drug Coverage Determination Form

Request for Redetermination of Medicare Prescription Drug Denial Form

Waiver of Liability Form

Broker Resources Category Arrow

Go to Brokers Overview

BROKER RESOURCES

What Makes Medical Mutual Different

Broker Tools

Become an Appointed Producer

Corporate Profile Category Arrow

Senior Community Events Category Arrow

News

Careers

Go to About Us Overview

CORPORATE PROFILE

Mission and Vision

Leadership

Subsidiaries

Accreditation and Awards

Community Outreach

Compliance Information

Diversity, Equity & Inclusion

Member Rights and Responsibilities

Quality Improvement Program

Go to Community Outreach Overview

SENIOR COMMUNITY EVENTS

Outstanding Senior Volunteer Awards

Toledo Senior Appreciation Tour

Past Senior Events

Go to About Us Overview

NEWS AND INFORMATION

Newsroom

Medical Mutual Blog

Go to Careers Overview

WORK AT MEDICAL MUTUAL

Culture

Benefits

Awards

Department Overviews

Students and Recent Grads

Frequently Asked Questions

Current Openings

Certificate Books

Certificate books describe what is covered by your plan. View all of our 2024 certificate books below.

HMO Plans

HMO CLE-CARE

HMO BRONZE HSA 6100

HMO SILVER 3530-4250

HMO GOLD 2520-1500

HMO MEDFLEX

HMO BRONZE HSA 6100

HMO SILVER 3530-4250

HMO GOLD 2520-1500

PPO Plans

PPO BRONZE HSA 6100

PPO SILVER 3530-4250

PPO GOLD 2520-1500

Dental Plans

MMO Dental Plan 4

MMO Dental Plan 4 with Ortho

MMO Dental Plan 5

Vision Plans

MMO EyeMed Vision Only

MMO VSP Vision Only