Medical Insurance Plans

Plan Options

We offer a variety of plan types with our Health Maintenance (HMO) products. Find a plan that meets your needs and your budget.

• Copay Plans – If you want fixed costs for things like office visits, prescription drugs and more, a copay plan may be right for you. We offer gold, silver and bronze copay options. Please note: our gold plan is only available on the Health Insurance Marketplace at Healthcare.gov.
• High-deductible Plans – High-deductible plans have lower monthly premiums and higher deductibles compared to Copay plans. Most of our high-deductible plans can be paired with a Health Savings Account (HSA), which gives you tax benefits and more control over your healthcare expenses. Medical Mutual offers silver and bronze high-deductible health plan options.
• Young Adult Essentials Plan – If you’re 29 or younger and looking for coverage that protects you from significant medical expenses, like a hospital stay, Medical Mutual's Young Adult Essentials plan may be a good choice. This plan is designed to protect you from very high medical costs with coverage that kicks in when you need a lot of care.

Our HMO Networks

Medical Mutual has partnered with several health systems to offer you high-quality HMO plan options. Getting a quote is a convenient way to see which plans are available in your area. Search our HMO networks to find covered providers:

• Mercy HMO
• OhioHealth HMO
• NE Ohio HMO
• Dayton HMO
• Adena HMO

Our HMO plans are offered in the following Ohio counties: Allen, Ashland, Ashtabula, Athens, Auglaize, Brown, Butler, Carroll, Clermont, Clinton, Champaign, Clark, Columbiana, Coshocton, Crawford, Cuyahoga, Darke, Defiance, Delaware, Erie, Fairfield, Fayette, Franklin, Fulton, Geauga, Greene, Hamilton, Hancock, Hardin, Henry, Highland, Hocking, Huron, Jackson, Knox, Lake, Licking, Lorain, Lucas, Madison, Mahoning, Marion, Medina, Mercer, Miami, Montgomery, Morrow, Ottawa, Paulding, Pickaway, Pike, Portage, Preble, Putnam, Richland, Ross, Sandusky, Seneca, Shelby, Stark, Summit, Tuscarawas, Trumbull, Union, Van Wert, Vinton, Warren, Wayne Williams, Wood and Wyandot.

Extra Plan Coverage

Once enrolled in a Medical Mutual plan, you get access to extra benefits that make managing and improving your health easy and convenient, all at no additional cost.

• Telemedicine – Care is just a click away with Firelands Virtual Care. Meet with a provider through live video chats using either a computer or mobile device, giving you the convenience of staying at home while still getting the quality care you expect¹. Log on to My Health Plan to view the on-demand Firelands Virtual Care providers in your network.
• $0 Generic Prescription Drugs – Medical Mutual offers handpicked $0 generic preventive prescription drugs on select plans, all at no additional cost². Examples of prescription drugs that are covered under this benefit include aspirin and propranolol. View a complete list of drugs that qualify for this benefit.
• Wellness Benefits – Medical Mutual has partnered with BravoHealth to offer you rewards for completing health-related activities such as getting a preventive care checkup, attending an online health education course and more. Depending on the type of activities you complete, you will be eligible to earn up to $100 in rewards cards, per calendar year³. Log in to your My Health Plan account to enroll in this program⁴.

Prescription Drug Coverage

Our medical plans also include prescription drug coverage. All plans have a list of prescription drugs they cover, known as a formulary. From the links below, you can view our High Performance Plus formulary or use the online search tool on the Express Scripts website to see medication coverage information for a specific drug in real time.

• High Performance Plus PDF
• High Performance Plus Online Search Tool

If you are already covered under your employer’s plan, log into your My Health Plan account to view your plan’s formulary.

A Note about Prescription Drug Coverage: If you receive any amount of financial assistance from a coupon, patient assistance program, provider, pharmacy, etc. for the required cost share, that amount shall not be considered an out-of-pocket expense and will not apply to deductibles and/or out-of-pocket maximums.

Additional Products

If you're looking for additional coverage to add to your health plan, consider our dental, vision and accident and critical illness options.