Attention: Aetna Members

Transition of Care waivers are available if you receive treatment from non-network facilities and physicians, ensuring your care is uninterrupted and reimbursed at the highest benefit level. This waiver allows you a short period of time to continue services with an out-of-network provider while you select a network provider or while you complete treatment. Transitional care waivers are only provided for services which are covered benefits under your health plan.

When you meet the conditions outlined in the transitional care guidelines and obtain a waiver, the highest benefit level will apply. Even with a waiver, you may have to pay the difference between the non-contracted provider’s billed charges and what Medical Mutual pays. Transitional care waivers are handled on a case-by-case basis.

Medical Mutual and the State of Ohio are working hard to make sure you understand your health plan options. This video provides a brief overview of your choices and what to consider when making your selection.