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Benefits

Benefits below are for the plan year 7/1/2018 through 6/30/2019.

When you choose Medical Mutual, you get access to one of the largest networks of doctors and hospitals in Ohio. Learn more about the benefits available to you in the Benefit Guide brochure.

Medical Mutual’s PPO Plan

Medical Mutual offers State of Ohio employees a PPO plan. With a PPO plan, you will pay a copayment for things like office visits. For other services, you may have to pay for a certain percentage after you meet your deductible. See our helpful definitions below for a description of copays, deductibles and more.

PPO plans also feature a network. To receive the highest level of benefits and avoid higher out-of-pocket costs, you should use an in-network provider. Medical Mutual’s PPO network is one of the largest in Ohio and includes award-winning facilities, like the Cleveland Clinic, Ohio State Medical Center and Christ Hospital.

Helpful Definitions

Here are a few definitions to help you better understand Medical Mutual’s benefits:

  • Copayment (copay) – A fixed amount you pay to a healthcare provider at the time you receive services.
  • Deductible – The amount you pay for your healthcare services before Medical Mutual pays.
  • Coinsurance – A certain percent you must pay after you pay your deductible. You will also need to pay your copay. Coinsurance for Medical Mutual’s plan is 20%. So, Medical Mutual will pay for 80% of most services after you meet your deductible. You must pay for the remaining 20% (your coinsurance).
  • Out-of-pocket Costs – Costs you must pay. Out-of-pocket costs include your copays, deductible and coinsurance amounts.

Overview of Benefits

From everyday doctor visits to hospital stays, 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 of which are covered at 100%, so 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

For more details about Medical Mutual’s benefits, review the Medical Plan Description book.

Benefit Guides

Learn more about the benefits available to you in the Benefit Guide brochure.


Medical Plan Description Book

For more details about Medical Mutual's benefits, review the Medical Plan Description book.