Learn about our 2023 Medicare Advantage plans Central Ohio, Cincinnati/Dayton and Toledo.

2023 Highlights

New MedMutual MyChoice™

New MedMutual MyChoice™ added to all $0 premium plans for Central Ohio, Cincinnati/Dayton and Toledo. This benefit is included at no additional cost and gives members a choice of two supplemental benefit packages so they can choose the coverage that works best for their health needs.

  • Option A: Up to $1,000 in additional dental coverage to use for fillings, crowns and other non-preventive dental work.
  • Option B: Up to $350 to cover copays and coinsurance (Access PPO only), vision and hearing expenses, over-the-counter items, transportation and meal delivery.

Enhanced Plan Designs Offer Greater Affordability

  • $0 monthly premiums and PCP copays available on select HMO and PPO plans.
  • New $0 mail-order copay for preferred Tier 1 and Tier 2 drugs on select HMO and PPO plans.
  • New $0 out-of-network deductible on Access PPO plan.
  • New lower maximum out-of-pocket (MOOP) on select HMO and PPO plans.
  • New lower outpatient services copay on select HMO and PPO plans.

Plan Overview

Purple indicates important enhancements for 2023.

  MedMutual Advantage® Signature HMO
MedMutual Advantage® Classic HMO  MedMutual Advantage® Secure HMO  MedMutual Advantage® Access PPO 
Premium  $0 $0 $30 $0
MOOP $4,200 $4,900 $4,200 $0 OON Deductible
$6,050 IN
$11,000 OON
 PCP $0 $5 $0 $0 IN
$10 OON

Specialist $35 $40 $30 $40 IN
$55 OON
Inpatient $335 (Day 1-6)
$310 (Day 1-7)
$335 (Day 1-6)
$385 (Day 1-5) IN
40% OON
Outpatient
(Surgical)
$350 $375 $380 $350 IN
$400 OON

Diagnostic CT: $100
MRI: $125
PET: $125
CT: $100
MRI: $175
PET: $175
CT: $100
MRI: $175
PET: $175
CT: $100 IN
CT: 40% OON
MRI: $175 IN
MRI: 40% OON
PET: $175 IN
PET: 40% OON
ER $90 $90 $90 $90
Urgent $35 $35 $30 $40
Rx Deductible
(excl. T1 & T2)
$0 $95 $95 $0
Preferred Rx Copays – 30 Day Retail
Tier 1: $4
Tier 2: $8
Tier 3: $42
Tier 4: 50%
Tier 5: 33%
Tier 6: $0
Tier 1: $0
Tier 2: $5
Tier 3: $42
Tier 4: 50%
Tier 5: 31%
Tier 6: N/A
Tier 1: $0
Tier 2: $5
Tier 3: $42
Tier 4: 50%
Tier 5: 31%
Tier 6: N/A
Tier 1: $4
Tier 2: $8
Tier 3: $42
Tier 4: 50%
Tier 5: 33%
Tier 6: $0
Preferred Rx Copays – 90 Day Mail Order
Tier 1: $0
Tier 2: $0
Tier 3: $110
Tier 4: 50%
Tier 5: N/A
Tier 6: $0
Tier 1: $0
Tier 2: $0
Tier 3: $110
Tier 4: 50%
Tier 5: N/A
Tier 6: N/A
Tier 1: $0
Tier 2: $10
Tier 3: $110
Tier 4: 50%
Tier 5: N/A
Tier 6: N/A
Tier 1: $0
Tier 2: $0
Tier 3: $110
Tier 4: 50%
Tier 5: N/A
Tier 6: $0
MedMutual Advantage Travel Plus™ $2,500 coverage for care received outside of Ohio $2,500 coverage for care received outside of Ohio $2,500 coverage for care received outside of Ohio $2,500 coverage for care received outside of Ohio
Dental $750 incl. preventive
Preventive $500 incl. preventive $1,000 incl. preventive
OTC See MedMutual MyChoice™ See MedMutual MyChoice™ $50 quarterly See MedMutual MyChoice™
MedMutual MyChoice™ Included

Option A: $1,000 additional dental coverage

Option B: $350 to cover hearing and vision expenses, over-the-counter items, transportation and meal delivery

Included

Option A: $500 additional dental coverage

Option B: $250 to cover hearing and vision expenses, over-the-counter items, transportation and meal delivery

Not included Included

Option A: $250 additional dental coverage

Option B: $150 to cover copays and coinsurance, hearing and vision expenses, over-the-counter items, transportation and meal delivery

 Extra Benefits These programs and services are included with all MedMutual Advantage plans and are designed to help members stay healthy, get better and recover comfortably.

• SilverSneakers® fitness membership – Access to 17,000+ facilities and numerous fitness classes
• WW® (Weight Watchers Reimagined) – Discounted membership rates for enrolling in a Digital, Digital + Studio and WW for Diabetes programs.
• Chronic Condition Management Program - Helps members manage chronic conditions and maintain their independence by providing a trained health coach to develop a personalized plan supplementing the care you get from your doctor.
• Member Assistance Program – High-risk members are paired with a personal advocate who can help coordinate in-network care and connect them with resources to help them better manage their health and remove barriers to care.
• Tobacco Cessation Program – One-on-one sessions with a trained coach who works with members on a quit plan and provides support.
• 24-Hour Nurse Line – A clinical expert provides answers to health questions 24 hours a day, seven days a week.
• Telemedicine – Members can connect with a health provider electronically to ask a medical question, get help with diagnosing common illnesses and get prescriptions.
• Palliative Care – Care coordination and home-based support services to help improve quality of life for members with serious illnesses.