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Medical Insurance Plans

Medical Mutual knows picking the right health insurance plan is important. That's why we offer a variety of plans that can fit any budget and meet your healthcare needs.

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 plan options.
  • 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.
  • 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:

  • Adena HMO - Fayette, Highland, Jackson, Pike, Ross, Vinton
  • Cincinnati HMO - Brown, Clermont, Hamilton
  • Dayton HMO - Butler, Champaign, Clark, Clinton, Darke, Greene, Miami, Montgomery, Preble, Shelby, Warren
  • Northern Ohio HMO - Allen, Ashland, Ashtabula, Auglaize, Carroll, Cuyahoga, Columbiana, Defiance, Erie, Fulton, Geauga, Hancock, Henry, Huron, Holmes, Lake, Lorain, Lucas, Mahoning, Medina, Mercer, Ottawa, Paulding, Portage, Putnam, Sandusky, Seneca, Stark, Summit, Trumbull, Tuscarawas, Van Wert, Wayne, Williams, Wood, Wyandot
  • OhioHealth HMO - Athens, Coshocton, Crawford, Delaware, Fairfield, Franklin, Guernsey, Hardin, Hocking, Knox, Licking, Madison, Marion, Morgan, Morrow, Muskingum, Noble, Perry, Pickaway, Richland, Union

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.

  • On-Demand Telemedicine – Care is just a click away with on-demand telemedicine. 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 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.

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. 

Request a Sales Appointment

Request an in-person or virtual appointment to meet with a sales agent one-on-one to review your options.

Ready to Shop?

Use our online enrollment tool to get an instant quote. You can also call us at 1-844-583-3072 or call your licensed insurance agent.

Tax Subsidy Estimator

If you are buying health insurance on your own, tax subsidies can help you cover some of your costs. Use our calculator to see if you qualify.

Certificate Books

View certificate books for our individual health plans.

Transparency Information

Learn more about transparency in qualified health coverage.

MCG Guidelines

MCG Guidelines are used to make coverage decisions for medical and mental health or substance use disorder benefits.

Prior Approval

Certain services and drugs require prior approval before you have the procedure or service—especially if the service or drug is considered experimental or investigational and not eligible for coverage. Prior approval is not a guarantee of payment; payment is based on your benefits and contract provisions.

Information about Our Rates

Learn more about our premium rates.

1Unlimited on-demand telemedicine is available on all plans. Please note, some plans are not eligible for a $0 copay.
2HSA plans do not qualify for this benefit.
3You have from January 1st through October 31st to complete activities and earn rewards. All activities including your Annual Provider Visit and Preventive Care Visit must take place between these dates under your Medical Mutual policy.
4Only the contract holder and spouse/domestic partner are eligible to participate and earn rewards

Disclaimer: This information only provides a partial listing of benefits. This is not a contract for insurance. No person other than an officer of Medical Mutual may agree, orally or in writing, to change the benefits listed here. The contract or certificate will contain the complete listing of covered services.