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Online Forms - Member

The following forms are provided for your convenience.  If you have any questions please call the number on the back of your Medical Mutual ID card.

Claim Forms

  • Medical
    Mail this form to: Medical Mutual, PO Box 6018, Cleveland, OH 44101-1018

  • Dental

  • Hearing

  • Vision

  • Major Medical Prescription Drug
    Please Note: Use this form only if you forget your card at time of purchase. You will maximize your benefits and be guaranteed the lowest price when you use your ID card at time of purchase.

  • Medco® Prescription Drug
    Please Note: You will maximize your benefits and be guaranteed the lowest price when you use your ID card

  • FlexSave Health Care and Dependent Care
    Please Note: Your plan needs to be administered by Medical Mutual Services to use this form. Contact customer service at 800/525-9252 with questions.

  • FlexSave Parking and Transportation
    Please Note: Your plan needs to be administered by Medical Mutual Services to use this form. Contact customer service at 800/525-9252 with questions.

Miscellaneous Forms

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My Health Plan

Additional Online Forms

All member forms are available on My Health Plan.

All Member Forms

Find a Provider

Maximize your cost savings and avoid unexpected charges by finding providers in the Medical Mutual network.

Find a Provider

WebMD

Featured Content

Access exclusive health and wellness information and tools from Medical Mutual and the world's premier online source... WebMD.

Medical Mutual is committed to creating a diverse workforce.

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