Medical Mutual’s Benefit Plan Options
For the second year in a row, the State of Ohio offers a choice of three health benefits plans. Review the details about each plan to learn more so you can choose the plan that’s right for you.
Ohio Med PPO
With this option, you pay a higher premium, but have a lower deductible. After meeting your deductible, medical services will either be covered in full, or with coinsurance. This plan uses Medical Mutual’s SuperMed® PPO network, which is one of the largest in Ohio. To receive the highest level of benefits and avoid higher out-of-pocket costs, you’ll want to use in-network providers.
Ohio Med Narrow Network
This plan offers a smaller network called the MedFlex™ network and no out-of-network coverage (except for emergencies). You’ll enjoy the same in-network coverage as the Ohio Med PPO plan, but you’ll pay slightly lower premiums than the PPO plan. The Ohio Med Narrow Network plan may be the right choice for you if your doctor is already in the MedFlex network or you’re open to finding a new provider.
Ohio Med HDHP
With this option, you pay a lower premium but have a higher deductible. This means you pay more out-of-pocket before the health plan begins to cover costs, except for certain preventive services. This plan also uses Medical Mutual’s SuperMed® PPO network, which is one of the largest in Ohio. To receive the highest level of benefits and avoid higher out-of-pocket costs, you’ll want to use in-network providers.
With the HDHP, you pay 100% of the discounted charges for services, prescription drugs and other qualified health expenses until you meet your deductible.
To help you plan for and pay the higher deductible, the HDHP allows you to open a Health Savings Account (HSA) through Optum Bank. With an HSA, you can put money in a special bank account through pre-tax payroll deductions. You can then use this money to pay for qualified healthcare expenses as defined by the IRS. These expenses include deductibles and any coinsurance amounts. In addition, you don’t pay any taxes on money you use to pay for qualified health expenses.
To help you get started, the State of Ohio will make a contribution to your HSA of up to $1,000 for a single plan and $2,000 for a family plan*.
*Contribution for plan year July 1, 2023 to June 30, 2024. For questions regarding your contribution, see your payroll officer or call Employee Benefits Customer Service at 1-800-409-1205, Option 2.
Overview of Benefits
Medical Mutual covers the services you need to get and stay healthy, including:
- Office, urgent care and emergency room visits
- Preventive care and immunizations (most are covered at 100%, which means you have no out-of-pocket costs)
- Hospital care
- Lab tests
- Home health services
- Maternity and newborn care
- Outpatient therapies, including occupational, speech and physical therapy
Review the FY 2024 State of Ohio Benefit Guide to learn more about Medical Mutual’s benefits.
24-Hour Nurse Line and Telehealth Services
Enjoy peace of mind with around-the-clock guidance and answers to your health-related questions. Use Nurse Line and telehealth virtual visits to:
- Make decisions about a health issue, including whether you need to visit a doctor or emergency room (ER)
- Understand medical conditions diagnosed by your doctor and why you should follow your doctor’s care plan
- Prepare for doctor visits by knowing what questions to ask
- Care for minor injuries and illnesses at home
- Develop healthier lifestyle habits
Call our Nurse Line at 1-888-912-0636, any time, any day.
Learn more about LiveHealth Online telehealth virtual services.
Clinical Centers of Excellence
Medical Mutual’s Clinical Centers of Excellence network aims to address the high costs of complex care while improving quality for those in need of specialty care and procedures, such as bariatric (weight loss) surgery, cardiac care, knee and hip replacements, spine surgery, and transplants. We recognize select doctors and hospitals for the safe, effective care they provide to their patients. Each provider must meet rigorous standards and achieve overall quality measures for patient safety and outcomes, developed with input from the medical community.
Choosing a Clinical Center of Excellence could mean faster recovery times, fewer complications, and peace of mind now and in the future.
Here’s a list of Clinical Centers of Excellence providers who have earned this distinction.