2024 Medicare Plans: Select Ohio Counties
Adams, Allen, Auglaize, Champaign, Clinton, Coshocton, Crawford, Darke, Defiance, Erie, Fayette, Gallia, Guernsey, Hardin, Harrison, Henry, Highland, Huron, Jackson, Knox, Logan, Mercer, Monroe, Noble, Ottawa, Paulding, Pike, Preble, Putnam, Richland, Ross, Sandusky, Scioto, Shelby, Van Wert, Vinton, Washington and Williams Counties
Affordable Routine Care
- $0 monthly premium available on Classic HMO
- $5 copay for primary care visits on Classic HMO
- $0 copays for Tier 1 and Tier 2 prescription drugs through mail-order on Classic HMO
Extra Coverage That Matters
- New! Lower $499 copay for Standard hearing aids on all plans
- $100 eyewear allowance on Classic HMO and Access PPO
- SilverSneakers® fitness membership included at no additional cost on all plans
Purple indicates important enchantments for 2024.
| MedMutual Advantage Classic HMO |
MedMutual Advantage Select PPO | |
|---|---|---|
| Plan Number | H6723-001-002 | H4497-001-002 |
| Good Fit For: * Learn more about our customer personas |
Managing Care Needs | |
| Premium | $0 | $100 |
| MOOP | $5,150 |
$6,900 IN/$11,300 OON |
| PCP | $5 |
$10 IN 30% OON |
| Specialist | $35 | $35 IN 30% OON |
| Podiatry | $35 | $35 |
| Inpatient | $295 (Day 1-6) | $420 IN (Day 1-5) 30% OON |
| Outpatient (Surgical) | $435 | $450 IN 30% OON |
| Diagnostic | CT: $150 MRI: $225 PET: $225 |
CT: $150 IN/30% OON MRI: $225 IN/ 30% OON PET: $225 IN/30% OON |
| ER (waived if admitted within 24 hours) | $100 | $100 |
| Urgent Care | $45 | $45 |
| Rx Deductible (excl. T1 & T2) | $95 | $95 |
| Preferred Rx Copays – 30 Day Retail | Tier 1: $0 Tier 2: $5 Tier 3: $42 Tier 4: 50% Tier 5: 31% Tier 6: N/A |
Tier 1: $0 Tier 2: $10 Tier 3: $42 Tier 4: 50% Tier 5: 31% Tier 6: N/A |
| Preferred Rx Copays – 90 Day Mail Order | Tier 1: $0 Tier 2: $10 Tier 3: $110 Tier 4: 50% Tier 6: N/A |
Tier 1: $0 Tier 2: $10 Tier 3: $110 Tier 4: 50% Tier 6: N/A |
| Visitor/Travel Benefit | $2,500 | $2,500 |
| Dental | Preventive | Preventive |
| OTC | Not covered | $140 |
| Vision | $0 routine eye exam $100 eyewear allowance |
$0 routine eye exam $100 eyewear allowance |
| Hearing | $0 routine hearing exam Hearing aid copay as low as $499 |
$0 routine hearing exam Hearing aid copay as low as $499 |
| Enhanced Supplemental Benefits |
• SilverSneakers® membership included • WW® discounted membership • Chronic Condition Management Program offers health coaching to help members manage chronic conditions and maintain their independence • Member Assistance Program helps coordinate in-network care and connect high-risk members with resources to better manage their health • Tobacco Cessation Program offers one-on-one sessions with a trained coach who works with members on a quit plan • Telemedicine and a 24-Hour Nurse Line offer convenient access to clinical experts and healthcare providers • Meal Delivery and Transportation Services are provided after an inpatient hospital stay to help members as they transition home |
|