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Medicare

Individuals and Families Category Arrow

Employers

Go to Medicare Overview

MEDICARE ADVANTAGE PLANS

MedMutual Advantage Plans

Dental, Vision and Hearing Coverage

Extra Programs and Services

Important Plan Information

MedMutual SeniorCare™

MEDICARE SUPPLEMENT INSURANCE PLANS

Our Medicare Supplement Insurance Plans

MedMutual Supplement Plus

Extra Benefits and Opportunities

ENROLLMENT INFORMATION

Medicare Eligibility Rules

When to Enroll

How to Enroll

MedMutual Advantage Member Resources

ABOUT MEDICARE

Understanding Medicare

The Parts of Medicare

Find the Plan that Fits Your Needs

Go to Individuals and Families Overview

PLANS AND PRODUCTS

Medical

Dental

Vision

Short-term

Accident and Critical Illness

Life

HEALTH AND WELLNESS PROGRAMS

Wellness Programs

Chronic Condition Management, Case Management and Maternity Programs

HEALTH INSURANCE EDUCATION

How to Get Health Insurance

What is Individual Health Insurance

Employer vs. Individual Insurance

How a Deductible Can Lower Your Premium

How to Select a Doctor

Types of Health Insurance Plans

Understanding an HSA

Understanding Health Insurance Costs

FAQs

Glossary

Go to Employers Overview

PLANS AND PRODUCTS

Small Group Health Plans

Midsize Group Health Plans

Large Group Health Plans

Dental

Vision

Life and Disability

Accident, Critical Illness and Hospital Indemnity

Consumer Driven Health Plans (CDHPs)

Prescription Drug

Federal Employees Health Benefit Program

HEALTH AND WELLNESS PROGRAMS

Workplace Wellness Programs

Add-On Programs

Employee Programs to Manage Chronic Conditions

Maternity Program

Case Management Program

Utilization Management and Medical Policy and Review

EMPLOYER RESOURCES

Tools and Resources

Prescription Drug Information

Mutual Appreciation Program

Value-Based Contracting

Transparency in Coverage Compliance

Creditable Coverage

Member Resources Category Arrow

Go to Members Overview

MEMBER RESOURCES

Forms

FAQs

Mobile App

Overview and News Category Arrow

Policies and Standards Category Arrow

Resources

Forms

PROVIDER HOME PAGE

For Providers

NEWS AND INFORMATION

In the News

Go to Providers Overview

CLINICAL POLICIES AND GUIDELINES

Clinical Practice Guidelines

Medical Necessity Criteria and Clinical Review Guidelines

Medical Policies

Prior Approval and Investigational Services

PHARMACY AND DRUG POLICIES

Medical Drug Management

Prescription Drug Information

REIMBURSEMENT AND ADMINISTRATIVE POLICIES

Reimbursement Policies

Laboratory Management Policies

Accessibility Standards

Go to Providers Overview

ENROLLMENT AND ADMINISTRATIVE

EFT and ERA

Credentialing

MedCommunity Resources

Ambulatory Surgical Classification Grouper Lists

Medical Mutual Service Accounts

QUALITY AND CARE PROGRAMS

Continuity and Coordination of Care

Chronic Condition Management Program

Health Outcomes Survey Tip Sheet

Clinical Supply Materials

Healthcare Technology Assessment

COMPLIANCE AND REGULATORY

No Surprises Act

Risk Adjustment Information

First tier, Downstream or Related Entities

Cultural Competency Resources

Claims Edit System

EXTERNAL RESOURCES

Optum Payment Integrity Portal

The Waco Guide

Routine Test Management Provider Webinar

Optum® EDC Analyzer™

Go to Providers Overview

AUTHORIZATION AND COVERAGE

Prior Approval Form

Member Forms

Request for Medicare Prescription Drug Coverage Determination Form

Request for Redetermination of Medicare Prescription Drug Denial Form

Transition of Care Waiver Request

FACILITY AND INPATIENT

Acute Discharge Planning Worksheet

Inpatient Behavioral Health Fax Form

Inpatient Medical Fax Form

CLAIMS AND BILLING

Electronic Claims Waiver Request

Medical Record Attestation Form

Waiver of Liability Form

PROVIDER UPDATES

Provider Information Form

Medicare Advantage Provider FDR Attestation Form

Network Provider Enrollment Form

Broker Resources Category Arrow

Go to Brokers Overview

BROKER RESOURCES

What Makes Medical Mutual Different

Broker Tools

Become an Appointed Producer

Corporate Profile Category Arrow

News

Careers

Go to About Us Overview

CORPORATE PROFILE

Mission and Vision

Subsidiaries

Accreditation and Awards

Community Outreach

Compliance Information

Engagement & Inclusion

Member Rights and Responsibilities

Prior Authorization Reporting

Quality Improvement Program

Go to About Us Overview

NEWS AND INFORMATION

Newsroom

Medical Mutual Blog

Go to Careers Overview

WORK AT MEDICAL MUTUAL

Culture

Benefits

Awards

Department Overviews

Students and Recent Grads

Frequently Asked Questions

Current Openings

Certificate Books

Certificate books describe what is covered by your plan. View all of our 2027 certificate books below.

PPO Plans

PPO BRONZE HSA 6500

PPO SILVER 3530-4250

PPO GOLD 2520-1500

Dental Plans

MMO Dental Plan 4

MMO Dental Plan 4 with Ortho

MMO Dental Plan 5

Vision Plans

MMO EyeMed Vision Plan

Page last updated on 10/26/2026