Affordable Routine Care
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$0 copay for primary care and specialist visits on Signature HMO-POS
- $0 copays for Tier 1 and Tier 2 prescription drugs through mail-order and retail on Signature HMO-POS
Extra Coverage That Matters
- Enhanced dental coverage up to $3,000 on Signature HMO-POS
- Over-the-counter allowance up to $280 on Signature HMO-POS
- Increased $250 eyewear allowance on Signature HMO-POS
- $499 copay for Standard hearing aids on all plans
Peace of Mind with Out-of-Pocket Protection
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Maximum out-of-pocket as low as $3,900 on our Signature HMO-POS plan
| MedMutual Advantage Signature HMO-POS | MedMutual Advantage Classic HMO | MedMutual Advantage Secure HMO-POS | MedMutual Advantage Access PPO | |
|---|---|---|---|---|
| Plan Number | H6723-006-007 | H6723-001-003 | H6723-005-002 | H4497-005-004 |
| Good Fit For: * Learn more about our customer personas |
Value Seeker Experience Seeker |
Managing Care Needs | Receiving Extra Help | Value Seeker Experience Seeker |
| Premium | $0 | $0 | $30 | $0 |
| MOOP | $3,900 | $4,900 | $4,200 | IN: $6,775 OON: $11,000 |
| PCP | $0 | $0 | $0 | IN: $0 OON: $10 |
| Specialist | $35 | $40 | $30 | IN: $35 OON: $55 |
| Podiatry | $35 | $40 | $30 | IN: $35 OON: $55 |
| Inpatient | $325 (Day 1-6) | $290 (Day 1-7) | $335 (Day 1-6) | IN: $370 (Day 1-5) OON: 40% |
| Outpatient (Surgical) | $355 | $310 | $375 | IN: $345 OON: $400 |
| Diagnostic | CT: $100 MRI: $125 PET: $125 |
CT: $100 MRI: $175 PET: $175 |
CT: $100 MRI: $175 PET: $175 |
CT: $100 MRI: $175 PET: $175 OON: 40% for all |
| ER (waived if admitted within 24 hours) | $110 | $110 | $110 | $110 |
| Urgent Care | $35 | $35 | $30 | IN/OON: $40 |
| Rx Deductible | $0 | $95 (excludes Tier 1 and 2) | $0 | $0 |
| Preferred Rx Copays – 30 Day Retail | Tier 1: $0 Tier 2: $0 Tier 3: $42 Tier 4: 50% Tier 5: 31% Tier 6: $0 |
Tier 1: $0 Tier 2: $5 Tier 3: $42 Tier 4: 50% Tier 5: 31% |
Tier 1: $0 Tier 2: $5 Tier 3: $42 Tier 4: 50% Tier 5: 31% |
Tier 1: $4 Tier 2: $8 Tier 3: $42 Tier 4: 50% Tier 5: 33% Tier 6: $0 |
| Preferred Rx Copays – 90 Day Mail Order | Tier 1: $0 Tier 2: $0 Tier 3: $110 Tier 4: 50% Tier 5: NC Tier 6: $0 |
Tier 1: $0 Tier 2: $0 Tier 3: $110 Tier 4: 50% Tier 5: NC |
Tier 1: $0 Tier 2: $10 Tier 3 : $110 Tier 4: 50% Tier 5: NC |
Tier 1: $0 Tier 2: $0 Tier 3: $110 Tier 4: 50% Tier 5: NC Tier 6: $0 |
| Visitor/Travel Benefit | $7,500 | $7,500 | $7,500 | $7,500 |
| Dental | - $3,200 (preventive & comprehensive) - 30-50% coinsurance up to benefit maximum (50-70% OON) - Dentures and implants included (50% OON) |
- $3,000 (preventive & comprehensive) - 30-50% coinsurance up to benefit maximum |
- $850 (preventive & comprehensive) - 30-50% coinsurance up to the benefit maximum (50% OON) |
- $2,000 (preventive & comprehensive) - 30-50% coinsurance (50-70% OON) |
| OTC | Annually: $280 Quarterly: $70 (no rollover) |
Annually: $320 Quarterly: $80 (no rollover) |
Annually: $320 Quarterly: $80 (no rollover) |
Annually: $240 Quarterly: $60 (no rollover) |
| Grocery Allowance | Not included | Not included | Not included | Not included |
| Vision | Exam: $0 Allowance: $250 |
Exam: $0 Allowance: $200 |
Exam: $0 Allowance $100 |
Exam: $0 IN, 40% OON Allowance $100 |
| Hearing | Exam: $0 Hearing Aid Copay: As low as $499 |
Exam: $0 Hearing Aid Copay: As low as $499 |
Exam: $0 Hearing Aid Copay: As low as $499 |
Exam: $0 IN, 40% OON Hearing Aid Copay: As low as $499 OON 40% |
Members must qualify for Special Supplemental Benefit for the Chronically Ill (SSBCI). No rollover. Restrictions apply.