Medicare Materials Request Form Complete the form below to receive Medical Mutual Medicare Advantage plan documents in the mail. * Required Information Please correct the following errors: Tell us a little about yourself:* I am interested in a Medical Mutual Medicare Advantage plan. I currently am enrolled in a Medical Mutual Medicare Advantage plan. Please select a plan year:* 2023 Benefit Year How would you like your materials delivered?* Mail Delivery First Name* Last Name* Phone Number Email* Address* Address Line 2 City* State* --select-- Ohio Zip Code* County* --select-- Adams Allen Ashland Auglaize Brown Butler Carroll Champaign Clark Clermont Clinton Columbiana Coshocton Crawford Cuyahoga Darke Defiance Delaware Erie Fairfield Fayette Franklin Fulton Gallia Geauga Greene Guernsey Hamilton Hancock Hardin Harrison Henry Highland Hocking Holmes Huron Jackson Knox Lake Licking Logan Lorain Lucas Madison Mahoning Marion Medina Mercer Miami Monroe Montgomery Morgan Morrow Muskingum Noble Ottawa Paulding Perry Pickaway Pike Portage Preble Putnam Richland Ross Sandusky Scioto Seneca Shelby Stark Summit Trumbull Tuscarawas Union Van Wert Vinton Warren Washington Wayne Williams Wood Wyandot If you don't see your county listed, Medical Mutual does not currently offer plans in that area. Member ID* Group Number* Section Number* Materials Request Selected Material Total 0 Selected Item No Items Selected URL Please confirm below box* Confirm answers box must be checked Request Now Page last updated on 3/8/2023 Y0121_W0386_2023_M