Choose a Health Plan that Meets Your Needs Medical Mutual Personal Health Insurance Guide PPO AND HMO HEALTH PLANS

Choose a Health Plan that Meets Your Needs 2016 Medical Mutual Personal Health Insurance Guide PPO AND HMO HEALTH PLANS We’re Here to Help Let Us H...
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Choose a Health Plan that Meets Your Needs 2016 Medical Mutual Personal Health Insurance Guide

PPO AND HMO HEALTH PLANS

We’re Here to Help Let Us Help You Understand Your Options

With so many health insurance options available, it is important to find the health plan that is right for you. Medical Mutual can help you understand your options and choose a plan that fits your unique needs. Contents Options. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Benefits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Financial Assistance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Helpful Terms. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Get Started. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 - 6 PPO Plan Highlights. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 - 8 HMO Plan Highlights . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9 -10 Why Choose Medical Mutual . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Open Enrollment Open enrollment begins November 1, 2015, and goes through January 31, 2016. If you don’t enroll in a plan by the deadline, you may not be able to get health insurance until January 1, 2017, and you may be subject to federal penalties. To make sure you have coverage by January 1, 2016, enroll by December 15, 2015.

Special Enrollment Once open enrollment is closed, you still may be able to get health insurance if you have a qualifying or special event. Special enrollment periods last 60 days after these events, and may include marriage, birth or adoption, divorce or loss of job and employer sponsored coverage. You will need proof of your special event to enroll. 1

Options We Have Plans to Fit Your Needs

Medical Mutual offers two plan options: plans compatible with a health savings account (HSA) and plans with the traditional copay.

HSA-Compatible Plans OVERVIEW

BEST FOR

Copay Plans

Lower monthly payment with more

Higher monthly payment with

upfront out-of-pocket expenses.

fixed costs.

People who prefer low monthly

People who prefer fixed costs for

payments and the tax advantages of

common healthcare services.

an HSA. (There is a federal tax incentive when you put money into an HSA.)

DETAILS

These plans provide quality health

These plans provide fixed costs for

insurance combined with tax benefits

doctor visits and prescription drugs.

by diverting some of your income

Your copay for a particular service

into an HSA. An HSA is an investment

doesn’t change no matter how much

account you can draw from to pay out-

the doctor charges or how much the

of-pocket healthcare expenses.

prescription costs.

This document is only a brief summary of benefits and services. Our plans have exclusions, limitations and terms under which the plan may be continued in force or discontinued. Please refer to the certificate book for a complete explanation of benefits, exclusions and limitations.

2

Benefits Preventive Care

Preventive care is included in our individual plans at no additional cost. Many services—including wellness visits, immunizations and screenings for cancer and other diseases—are available at no charge. For many preventive services, you will not pay any deductible, copays or coinsurance. All individual health insurance plans must include some level of coverage in the following categories:

Hospitalization

Prescription Drugs

Emergency Services

Maternity and Newborn Care

Pediatric Services

Rehabilitative Services

Mental Health and Substance Use Disorder Services

Preventive and Wellness Services

Laboratory Services

Sample Chart Number of people in household

2014 annual family income levels to qualify1

1

$46,680 or below

2

$62,920 or below

3

$79,160 or below

4

$95,400 or below

can also go online to MedMutual.com to use our Tax

5

$111,640 or below

Subsidy Estimator.

6

$127,880 or below

7

$142,440 or below

8

$158,520 or below

Did you know? You may be eligible for a tax subsidy to help you pay for health insurance. Use the chart to get an idea of whether you and your family may qualify for a tax subsidy. You

1. 2  014 modified adjusted gross income levels are the latest available; assistance will be based on estimated 2015 modified adjusted gross income.

3

Helpful Terms

Premium

Copay (or copayment)

The amount you pay each month for your health

The amount you pay a healthcare provider at the

insurance plan.

time you receive services. For instance, you may have to pay a copayment for each covered visit to

Deductible

your doctor. Not all plans require a copayment.

The amount you pay before health plan benefits are provided. On a family policy, the entire family

Maximum Out Of Pocket (MOOP)

deductible must be met before benefits are paid

The maximum dollar amount you would pay

by the health insurance plan for any individual

in a year including deductibles, copays and

family member.

coinsurance. It does not include your monthly premium. The entire family MOOP must be met

Coinsurance

before services pay at 100 percent.

The percentage of a medical bill you share with your insurance company after you’ve paid your

Metal Level

deductible. For example, if you have a $100

The government defined four metal levels to

doctor’s bill and your plan covers 80 percent, the

describe the amount of coverage a plan offers—

coinsurance amount you owe to the doctor’s office

platinum, gold, silver and bronze. The levels can

is 20 percent, or $20.

help people understand what their potential out-ofpocket costs may be.

HMO (Health Maintenance Organization) HMO plans are usually more affordable than PPO

PPO (Preferred Provider Organization)

plans, but they have a smaller network of doctors

PPO plans may have a higher premium, but they

and hospitals. With an HMO plan, you must use

offer a larger network and more flexibility when

an exclusive network of doctors and hospitals. If

selecting a doctor or hospital. With a PPO plan,

you use an out-of-network provider, you will not be

you can use an out-of-network provider, but doing

covered except for emergency care.

so will usually require higher out-of-pocket costs.

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What do people talk about when they talk about health insurance plans?  Prevention coverage and wellness support?  Exclusive doctors and facilities?  Catastrophic illness and emergency coverage?  Affordable prescriptions?  The ability to manage healthcare online?  Managing the high cost of healthcare?  All of the above. That’s why Medical Mutual offers a variety of plans to fit your healthcare needs.

5

MedMutual Market (on exchange) and MedMutual (off exchange) PPO Plans PPO plans are offered statewide and give you

Clermont, Clinton, Darke, Greene, Hamilton,

more flexibility when choosing a provider from

Highland, Miami, Montgomery, Preble, Shelby

our SuperMed network. Our SuperMed network

and Warren. All MedMutual PPO plans (off the

has one of the largest networks of providers and

exchange) are available statewide.

hospitals in the state of Ohio. Because of this, you

PPO plans do not require you to choose a primary

have more doctors and hospitals to choose from.

care physician (PCP) when you enroll. No referrals

Some of our MedMutual Market PPO plans (on

are necessary to see a specialist. Precertification

exchange) are not available to individuals who live

may be necessary for some services such as

in the Southwest region. Those counties include

hospital admissions, outpatient surgeries and

Adams, Brown, Butler, Champaign, Clark,

invasive diagnostic tests.

®

MedMutual Market (on exchange) and MedMutual (off exchange) HMO Plans Medical Mutual has been serving members in Ohio

HMO plans are designed to provide the care you need

for over 80 years and we are pleased to introduce

in an exclusive healthcare network. The network will

HMO plans for 2016 Open Enrollment. Our HMO

determine how and where you receive care. With a

plans are available to individuals who live in select

MedMutual Market or MedMutual HMO Mercy plan,

counties in Northwest and Southwest Ohio. The

you may only receive services from Mercy Health

Northwest region includes Lucas and Wood counties. providers or at Mercy facilities without paying outThe Southwest region includes Butler, Clermont and

of-network charges. If you choose a MedMutual

Hamilton counties. Our HMO plans can be purchased Market or MedMutual HMO Promedica plan, you may both on and off the exchange. When you choose

only receive services from Promedica providers and

an HMO plan, your care will be managed within a

facilities without paying out-of-network charges.

certain provider network. In the Northwest, you can

Our HMO plans do not require you to choose a

choose HMO plans where Mercy Health or Promedica primary care physician (PCP) when you enroll. providers are the exclusive networks for care. In the

No referrals are necessary to see a specialist.

Southwest, HMO plans have Mercy Health providers

Precertification may be necessary for some services

as the exclusive network for care.

such as hospital admissions, outpatient surgeries, and invasive diagnostic tests.

Deciding Between a PPO and an HMO If you have a choice between these two types of plans, consider your medical needs, availability of HMOs in your area and income. If you’re looking at an HMO, take a close look at the exclusive network to determine if the choices of doctors and medical facilities are enough to meet your needs. A PPO gives you more freedom, including the potential to be covered for medical bills outside the network, but your costs may be higher. 6

Plan Highlights PPO Plans Explore Your Health Insurance Options Individual Marketplace (On exchange) If you qualify for a subsidy, choose from these plans. Please note, subsidies are not available for the Young Adult Essentials Plan. The values below are for in-network services only 1.

Deductible* (Single/Family)

PPO On Exchange Plans

Coinsurance

Maximum Out of Pocket4 (Single/Family)

Office Visit Copay PCP/ Specialist Urgent Care

ER Copay6

Prescription Drugs Generic/Pref Brand/Non Pref Brand and Specialty

Provider Network

Market 1000 is available to individuals who live in all counties except Lucas, Wood, Clermont, Butler and Hamilton. Members choosing these plans will have access to the SuperMed provider network. Med Mutual Market 1000

$1,000/$2,000

20%

$6,500/$13,000

$25/$50

$250

15/30/50%8 30-day supply

SuperMed

These plans are available to individuals who live in all counties except Adams, Brown, Butler, Champaign, Clark, Clermont, Clinton, Darke, Greene, Hamilton, Highland, Miami, Montgomery, Preble, Shelby and Warren counties. Members choosing these plans will have access to the SuperMed provider network. MedMutual Market 1750

$1,750/$3,500

25%

$6,850/$13,700

$30/$60 then 25%

$300/25%

$30/$60/50%8 30-day supply

SuperMed

MedMutual Market 17502 (200% - 250% FPL)

$1,500/$3,000

25%

$5,450/$10,900

$30/$60 then 25%

$300/25%

$30/$60/50%8 30-day supply

SuperMed

MedMutual Market 17502 (150% - 200% FPL)

$800/$1,600

10%

$1,200/$2,400

$30/$60 then 10%

$300/10%

$30/$60/50%8 30-day supply

SuperMed

MedMutual Market 17502 (139% - 150% FPL)2

$100/$200

10%

$500/$1,000

$30/$60 then 10%

$300/10%

$30/$60/10%8 30-day supply

SuperMed

MedMutual Market 4000 HSA5

$4,000/$8,000

0%

$4,000/$8,000

Deductible

Deductible

Deductible

SuperMed

MedMutual Market 4000 HSA (200% - 250% FPL)

$3,000/$6,000

0%

$3,000/$6,000

Deductible

Deductible

Deductible

SuperMed

MedMutual Market 4000 HSA2 ** (150% - 200% FPL)

$1,250/$2,500

0%

$1,250/$2,500

Deductible

Deductible

Deductible

SuperMed

MedMutual Market 4000 HSA2 ** (139% - 150% FPL)

$500/$1,000

0%

$500/$1000

Deductible

Deductible

Deductible

SuperMed

5,2

These plans are available to individuals who live in all Ohio counties and have access to the SuperMed providers. MedMutual Market 2400

$2,400/$4,800

20%

$6,850/$13,700

Deductible/ Coinsurance

Deductible/ Coinsurance

Deductible/ Coinsurance

SuperMed

MedMutual Market 24002 (200-250% FPL)

$1,500/$3,000

20%

$5,450/$10,900

Deductible/ Coinsurance

Deductible/ Coinsurance

Deductible/ Coinsurance

SuperMed

MedMutual Market 24002 (150-200% FPL)

$350/$750

20%

$2,250/$4,500

Deductible/ Coinsurance

Deductible/ Coinsurance

Deductible/ Coinsurance

SuperMed

MedMutual Market 24002 (139-150% FPL)

$100/$200

10%

$1,000/$2,000

Deductible/ Coinsurance

Deductible/ Coinsurance

Deductible/ Coinsurance

SuperMed

7

Office Visit Copay PCP/ Specialist Urgent Care

ER Copay6

Prescription Drugs Generic/Pref Brand/Non Pref Brand and Specialty

PPO On Exchange Plans

Deductible* (Single/Family)

Coinsurance

Maximum Out of Pocket4 (Single/Family)

MedMutual Market 5000

$5,000/$10,000

40%

$6,850/$13,700

Deductible/ Coinsurance

$300/ Deductible

40/80/50%8 30-day supply

SuperMed

MedMutual Market 6000 HSA5

$6,000/$12,000

0%

$6,000/$12,000

Deductible

Deductible

Deductible

SuperMed

MedMutual Market Young Adult Essentials3

$6,850/$13,700

0%

$6,850/$13,700

$407/Deductible

Deductible

Deductible

SuperMed

Provider Network

Individual Private Marketplace (Off exchange) Plans sold off the exchange do not qualify for a subsidy. These plans are available to individuals who live in all Ohio counties and have access to the SuperMed providers.

Office Visit Copay PCP/ Specialist Urgent Care

Prescription Drugs Generic/Pref Brand/Non Pref Brand and Specialty

Deductible* (Single/Family)

Coinsurance

Maximum Out of Pocket4 (Single/Family)

MedMutual 1750

$1,750/$3,500

25%

$6,850/$13,700

$30/$60 then 25%

$300/25%

$30/$60/50%8 30-day supply

SuperMed

MedMutual 2500

$2,500/$5,000

30%

$6,850/$13,700

$35/$707

$300

20/40/50%8 30-day supply

SuperMed

MedMutual 3500

$3,500/$7,000

30%

$6,000/$12,000

$25/$507

$300

20/40/50%8 30-day supply

SuperMed

MedMutual 4000 HSA5

$4,000/$8,000

0%

$4,000/$8,000

Deductible

Deductible

Deductible

SuperMed

MedMutual 5000

$5,000/$10,000

40%

$6,850/$13,700

Deductible/ Coinsurance

$300/ Deductible

40/80/50%8 30-day supply

SuperMed

MedMutual 6000 HSA5

$6,000/$12,000

0%

$6,000/$12,000

Deductible

Deductible

Deductible

SuperMed

PPO Off Exchange Plans

ER Copay6

Provider Network

This is only a summary of benefits and copayments, coinsurance and deductibles. For a complete list of benefits please refer to the benefit certificate. Pediatric dental is embedded in all off exchange plans. *All plans have an embedded deductible. Any combination of family members may satisfy the family deductible. However, if one family member meets their individual deductible, services will begin to pay for that particular family member. Any combination of family members may satisfy the family out of pocket, and services will begin to pay at 100 percent. However, if one family member meets their individual amount, services will begin to pay at 100 percent for that particular family member. **This plan does not qualify as an HSA product. Specialty Drugs will have a 30 day mail order limit for all products. Footnotes 1. In-network services include providers, hospitals and facilities where Medical Mutual has negotiated rates. 2. Members may be eligible for the cost share subsidy plan designs. The federal government determines eligibility based on household size, income and Federal Poverty Level (FPL) of the applicant. 3. Young Adult Essentials is offered to individuals ages 21 up to (but not including) 30, or individuals with financial hardship circumstances as defined by the federal government. 4. MOOP represents the maximum out of pocket and includes deductibles, copays and coinsurance. 5. Health Saving Accounts (HSA) are an investment account that can be drawn from to pay out-of-pocket healthcare expenses. 6. Non-emergency use of the emergency room is not covered. 7. Office visits for the following provider specialties are combined for visits one through three: PCP, specialists and urgent care office visits. Once the visit limit is met, additional visits are subject to deductible and coinsurance (if applicable for that product design). The Young Adult Essentials plan has an office visit copay limit applied to PCP providers only for visits one through three. 8. The retail copay for the non-preferred brand and specialty tiers is 50 percent up to a $350 maximum per script. Mail order copay for non-preferred brand is 50 percent up to a $1,050 maximum per script. Mail order specialty drugs will have a 30-day supply and are subject to a 50 percent coinsurance up to a $350 max/script. The copay for mail order generic and preferred brand drugs is three times the retail amount.

8

Plan Highlights HMO Plans Explore Your Health Insurance Options Individual Marketplace (On exchange) If you qualify for a subsidy, choose from these plans. The values below are for in-network services only 1. Services outside of the exclusive network are not covered, except for emergency services.

HMO On Exchange Plans

Deductible* (Single/Family)

Coinsurance

Maximum Out of Pocket 3 (Single/Family)

Office Visit Copay PCP/ Specialist Urgent Care

ER Copay 5

Prescription Drugs Generic/ Pref Brand/ Non Pref Brand and Specialty

Provider Network

These plans are only available to individuals who live in Lucas, Wood, Butler, Clermont and Hamilton counties only. Members choosing these plans have access to Mercy Health providers only. MedMutual Market HMO 1000 Mercy

$1,000/$2,000

20%

$6,500/$13,000

$25/$50

$250

$15/$30/50%6 30-day supply

Mercy Health

MedMutual Market HMO 1750 Mercy

$1,750/$3,500

25%

$6,850/$13,700

$30/$60 then 25%

$300/25%

$30/$60/50%6 30-day supply

Mercy Health

MedMutual Market HMO 1750 Mercy 2 (200% - 250% FPL)

$1,500/$3,000

25%

$5,450/$10,900

$30/$60 then 25%

$300/25%

$30/$60/50%6 30-day supply

Mercy Health

MedMutual Market HMO 1750 Mercy 2 (150% - 200% FPL)

$800/$1,600

10%

$1,200/$2,400

$30/$60 then 10%

$300/10%

$30/$60/50%6 30-day supply

Mercy Health

MedMutual Market HMO 1750 Mercy 2 (139% - 150% FPL)

$100/$200

10%

$500/$1,000

$30/$60 then 10%

$300/10%

$30/$60/10%6 30-day supply

Mercy Health

MedMutual Market HMO 4000 HSA4 Mercy

$4,000/$8,000

0%

$4,000/$8,000

Deductible

Deductible

Deductible

Mercy Health

MedMutual Market HMO 4000 HSA4,2 Mercy (200% - 250% FPL)

$3,000/$6,000

0%

$3,000/$6,000

Deductible

Deductible

Deductible

Mercy Health

MedMutual Market HMO 4000 Mercy 2 ** (150% - 200% FPL)

$1,250/$2,500

0%

$1,250/$2,500

Deductible

Deductible

Deductible

Mercy Health

MedMutual Market HMO 4000 Mercy 2 ** (139% - 150% FPL)

$500/$1,000

0%

$500/$1000

Deductible

Deductible

Deductible

Mercy Health

$6,000/$12,000

0%

$6,000/$12,000

Deductible

Deductible

Deductible

Mercy Health

MedMutual Market HMO 6000 HSA4 Mercy

These plans are only available to individuals who live in Lucas and Wood counties only. Members choosing these plans have access to Promedica providers only.

9

MedMutual Market HMO 1000 Promedica

$1,000/$2,000

20%

$6,500/$13,000

$25/$50

$250

$15/$30/50%6 30-day supply

Promedica

MedMutual Market HMO 1750 Promedica

$1,750/$3,500

25%

$6,850/$13,700

$30/$60 then 25%

$300/25%

$30/$60/50%6 30-day supply

Promedica

MedMutual Market HMO 1750 Promedica2 (200% - 250% FPL)

$1,500/$3,000

25%

$5,450/$10,900

$30/$60 then 25%

$300/25%

$30/$60/50%6 30-day supply

Promedica

MedMutual Market HMO 1750 Promedica2 (150% - 200% FPL)

$800/$1,600

10%

$1,200/$2,400

$30/$60 then 10%

$300/10%

$30/$60/50%6 30-day supply

Promedica

MedMutual Market HMO 1750 Promedica2 (139% - 150% FPL)

$100/$200

10%

$500/$1,000

$30/$60 then 10%

$300/10%

$30/$60/10%6 30-day supply

Promedica

Office Visit Copay PCP/ Specialist Urgent Care

ER Copay 5

Prescription Drugs Generic/ Pref Brand/ Non Pref Brand and Specialty

Provider Network

Deductible* (Single/Family)

Coinsurance

Maximum Out of Pocket 3 (Single/Family)

MedMutual Market HMO 4000 HSA4 Promedica

$4,000/$8,000

0%

$4,000/$8,000

Deductible

Deductible

Deductible

Promedica

MedMutual Market HMO 4000 HSA4,2 Promedica (200% - 250% FPL)

$3,000/$6,000

0%

$3,000/$6,000

Deductible

Deductible

Deductible

Promedica

MedMutual Market HMO 4000 Promedica2 ** (150% - 200% FPL)

$1,250/$2,500

0%

$1,250/$2,500

Deductible

Deductible

Deductible

Promedica

MedMutual Market HMO 4000 Promedica2 ** (139% - 150% FPL)

$500/$1,000

0%

$500/$1,000

Deductible

Deductible

Deductible

Promedica

$6,000/$12,000

0%

$6,000/$12,000

Deductible

Deductible

Deductible

Promedica

HMO On Exchange Plans

MedMutual Market HMO 6000 HSA4 Promedica

Individual Private Marketplace (Off exchange) Plans sold off the exchange do not qualify for a subsidy. The values below are for in-network services only 1. Services outside of the exclusive network are not covered, except for emergency services.

Deductible* (Single/Family)

HMO Off Exchange Plans

Coinsurance

Maximum Out of Pocket 3 (Single/Family)

Office Visit Copay PCP/ Specialist Urgent Care

ER Copay5

Prescription Drugs Generic/ Pref Brand/ Non Pref Brand and Specilaty

Provider Network

These plans are only available to individuals who live in Lucas, Wood, Butler, Clermont and Hamilton counties only. Members choosing these plans only have access to Mercy Health providers. MedMutual HMO 1750 Mercy

$1,750/$3,500

25%

$6,850/$13,700

$30/$60 then 25%

$300/25%

$30/$60/50%6 30-day supply

Mercy Health

MedMutual HMO 4000 HSA4 Mercy

$4,000/$8,000

0%

$4,000/$8,000

Deductible

Deductible

Deductible

Mercy Health

MedMutual HMO 6000 HSA Mercy

$6,000/$12,000

0%

$6,000/$12,000

Deductible

Deductible

Deductible

Mercy Health

4

These plans are only available to individuals who live in Lucas and Wood counties only. Members choosing these plans only have access to Promedica providers. MedMutual HMO 1750 Promedica

$1,750/$3,500

25%

$6,850/$13,700

$30/$60 then 25%

$300/25%

$30/$60/50%6 30-day supply

Promedica

MedMutual HMO 4000 HSA4 Promedica

$4,000/$8,000

0%

$4,000/$8,000

Deductible

Deductible

Deductible

Promedica

MedMutual HMO 6000 HSA4 Promedica

$6,000/$12,000

0%

$6,000/$12,000

Deductible

Deductible

Deductible

Promedica

This is only a summary of benefits and copayments, coinsurance and deductibles. For a complete list of benefits please refer to the benefit certificate. Pediatric dental is embedded in all off exchange plans. *All plans have an embedded deductible. Any combination of family members may satisfy the family deductible. However, if one family member meets their individual deductible, services will begin to pay for that particular family member. Any combination of family members may satisfy the family out of pocket, and services will begin to pay at 100 percent. However, if one family member meets their individual amount, services will begin to pay at 100 percent for that particular family member. **This plan does not qualify as an HSA product. Specialty Drugs will have a 30 day mail order limit for all products. Footnotes 1. In-network services include providers, hospitals and facilities where Medical Mutual has negotiated rates for the designated networks. 2. Members may be eligible for the cost share subsidy plan designs. The federal government determines eligibility based on household size, income and Federal Poverty Level (FPL) of the applicant. 3. MOOP represents the maximum out of pocket and includes deductibles, copays and coinsurance. 4. Health Saving Accounts (HSA) are an investment account that can be drawn from to pay out-of-pocket healthcare expenses. 5. Non-emergency use of the emergency room is not covered. 6. The retail copay for the non-preferred brand and specialty tiers is 50 percent up to a $350 maximum per script. Mail order copay for non-preferred brand is 50 percent up to a $1,050 maximum per script. Mail order specialty drugs will have a 30-day supply and are subject to a 50 percent coinsurance up to a $350 max/script. The copay for mail order generic and preferred brand drugs is three times the retail amount.

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Why Choose Medical Mutual We’re an Ohio Company Medical Mutual is the largest health insurance company headquartered in Ohio and serves more than 1.5 million Ohioans. We treat our customers like neighbors, because they usually are. When you call Medical Mutual, you speak directly to local Customer Care representatives. With 80 years in the Ohio health insurance business, you can be confident we’ll be here when you need us. We’re a Mutual Company

Check the Network

Being a mutual company means we focus on

The Medical Mutual SuperMed® network of

our members and not shareholders or stock

doctors and hospitals is one of the largest

analysts. We are owned by our members, so

health insurance provider networks in Ohio.

we put them at the center of our business.

Using in-network doctors and hospitals

We use our resources for their benefit and

means lower costs for you. Because of our

to invest in the Ohio communities where we

large network, you have a better chance of

live and work.

keeping the doctor and hospital you like.

MedMutual.com/mutual

MedMutual.com/checkthenetwork

Contact your broker to learn more.

© 2015 Medical Mutual of Ohio Z8067-IHP 10/15

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