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Medical Insurance Plans
Picking the right health insurance plan for you and your family is an important decision. With Medical Mutual, we make it easy to find a health plan that you’ll feel confident in.
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Plan and Network Overview
Medical Mutual Individual and Family Plans utilizes four Health Maintenance Organizations (HMO) networks throughout Ohio that provide access to doctors and hospitals at a lower rate. Use our Provider Search Tool to see if your doctors are included in our network.1
We offer three different plan types within our HMO networks, giving you the flexibility to pick the best option for you.
- Copay Plans – Copay plans offer a fixed cost for things like office visits, prescription drugs and specialty visits.
- High-deductible Plans – High-deductible plans have lower monthly premiums but higher deductibles. Most of our high-deductible plans can be paired with a Health Savings Account (HSA), which gives you tax benefits and more control over your healthcare expenses.
- Young Adult Essentials Plan – Young Adult Essentials plans are available to anyone under the age of 29 that is looking for coverage that protects them from significant medical costs, like a hospital stay.
Member Perks
Our Individual and Family plans come with a suite of extra member perks that help support you and your family’s health, all at no additional cost. Once enrolled, you can log in to your My Health Plan account – our online health platform tool – to sign up for these programs.
- Wellness Rewards Program – Get up to $100 in reward cards with our Wellness Rewards Program for completing designated health and wellness activities like completing an online health assessment, getting a preventive care checkup and more.3
- Discounted WW® Membership - Save almost 50% off standard WW (Weight Watchers reimagined) membership rates when you enroll in a Digital or Digital + Studio.
- $0 On-Demand Telemedicine – Our plans include telemedicine for a $0 copay on select plans, allowing you to meet with a provider through live video chats using either a computer or mobile device.4
- $0 Generic Prescription Drugs – Medical Mutual offers $0 generic preventive prescription drugs on select plans that help you manage your health conditions.5 View a complete list of drugs that qualify for this benefit.
Prescription Drug Coverage
All of our Individual and Family plans include prescription drug coverage. You can view our ACA Advantage Formulary PDF to see if your medication is covered.
Dental and Vision Products
Our dental and vision plans cover many preventive and major services that help strengthen your health coverage from your Individual and Family plan.
Ready to Shop?
Use our online enrollment tool to get an instant quote, call us at 1-844-583-3072 or call your licensed insurance agent.
Tax Subsidy Estimator
If you are buying health insurance on your own, tax subsidies can help you cover some of your costs. Use our calculator to see if you qualify.
MCG Guidelines
MCG Guidelines are used to make coverage decisions for medical and mental health or substance use disorder benefits.
Prior Approval
Certain services and drugs require prior approval before you have the procedure or service—especially if the service or drug is considered experimental or investigational and not eligible for coverage. Prior approval is not a guarantee of payment; payment is based on your benefits and contract provisions.
This information only provides a partial listing of benefits. This is not a contract for insurance. No person other than an officer of Medical Mutual may agree, orally or in writing, to change the benefits listed here. The contract or certificate will contain the complete listing of covered services.
1Medical Mutual Individual and Family plans are not available in all Ohio counties.
2Only one pet is eligible per contract.
3You have from January 1st through October 31st to complete activities and earn rewards. All activities including your Annual Provider Visit and Preventive Care Visit must take place between these dates under your Medical Mutual policy. Only the contract holder and spouse/domestic partner are eligible to participate and earn rewards. You must be 18 or older to participate in this program.
4Visits must be from an on-demand telemedicine provider in your network. For a list of providers, please visit MyHealthPlan at member.medmutual.com.
5HSA plans do not qualify for this benefit.