Free At-Home COVID-19 Tests from the Federal Government: 

The federal government is offering free at-home COVID-19 tests. Households may currently order two sets of four free tests. Order your free tests at covidtests.gov.

Medicare Part B participants can get eight free at-home COVID-19 tests per calendar month by showing their red, white and blue Medicare cards at participating pharmacies and healthcare providers. If you have a Medicare Advantage or MedSupp plan from Medical Mutual you have Medicare Part B. Please visit Medicare.gov or call 1-800-MEDICARE for a list of participating pharmacies/providers.

 

Medical Mutual’s top priority is the health and wellbeing of our members. We continue to monitor news and developments related to COVID-19.

Reimbursement for Over-the-Counter (OTC) COVID-19 Tests

On Jan. 10, 2022, health insurance plans, like Medical Mutual, received additional guidance from the federal government regarding making FDA-approved/authorized OTC COVID-19 tests available to our members at no cost to them starting Jan. 15, 2022. The guidance calls for coverage of 8 tests every 30 days per member. For more information on how you can request reimbursement for any tests you purchased on or after Jan. 15, log in to My Health Plan.

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COVID-19 Vaccine Information

We have developed a dedicated page to provide you with information and updates on the COVID-19 vaccine. Visit MedMutual.com/COVIDVaccine.

Benefit Information for Medical Mutual Members

Learn more about for COVID-19 testing, treatment and telehealth (telemedicine) appointments.

Benefit information included below applies to all Medicare Advantage plans, fully insured commercial members, Medicare Supplement and individual members. For members covered by self-funded plans, benefits may be different, and you should verify your coverage. If you have questions about your self-funded plan, contact your employer.

COVID-19 Testing

Medical Mutual is waiving member cost sharing associated with certain COVID-19 testing, including exposure-related and pre-procedural testing. The waiving of member cost sharing may also apply for the office visit/telehealth appointment, emergency department visit, or urgent care visit when the COVID-19 test was administered. Waiving of cost-sharing for the office visit/telehealth appointment, emergency department visit, or urgent care visit only applies when the primary purpose of the visit is to determine if you have COVID-19.

If you are given a COVID-19 test at an office visit/telehealth appointment, emergency department visit, or urgent care visit that took place for any other health reason, cost sharing may NOT be waived. This applies to services provided by both in-network and out-of-network providers and is in effect through the end of the national public health emergency declared by the U.S. Department of Health and Human Services.

COVID-19 Testing at an Out-of-Network Facility

If you are tested at a facility that is not in your Medical Mutual network, there is still no cost to you. In this situation, please be aware that payment for the test will be sent to you and not to the testing facility. You will then be responsible for paying the testing facility directly. You will only have to pay the testing facility the amount Medical Mutual provides to you. The testing facility should not charge you more.

Travel-related COVID-19 Testing

If you are tested for COVID-19 for the purposes of entering another country OR returning to the United States, please note that Medical Mutual does not cover this testing at 100%. You may be responsible for some or all of the cost related to this test depending on your plan.

General Workplace Health and Safety and Employment Surveillance Testing

Medical Mutual continues to follow guidance issued to implement the Families First Coronavirus Response Act (FFCRA), which states that health insurance carriers are NOT required to cover testing for general workplace health and safety, including employment surveillance and return-to-work programs. 

COVID-19 Treatment

Effective Jan. 1, 2021, COVID-19 treatment for Medical Mutual members is covered similarly to how treatment for other medical conditions is covered. Member cost-sharing (copays, coinsurance and deductibles) apply as outlined in your plan's certificate book. To review your coverage, log on to your My Health Plan account and select Benefits & Coverage. You can also call Medical Mutual Customer Care at the number listed on your member ID card.

Telehealth (Telemedicine) Appointments

Telehealth (telemedicine) visits are covered just like other medically necessary office visits. They are for patients needing routine care for chronic or general health conditions, including behavioral health. Telephonic visits, in addition to visits through the web or mobile app, will be covered.

For members covered by self-funded plans, benefits may be different, and you should verify your coverage. If you have questions about your plan’s telehealth (telemedicine) coverage, check your benefit documents by logging in to My Health Plan or calling Medical Mutual Customer Care at the number listed on your ID card.

Member Appeals During the National Emergency Period

Medical Mutual members have 180 days from the date they receive the original denial notice to file an appeal of a denied claim, requested service or eligibility. As we are currently in a national emergency period, there is an important note about that timing.

At this time, the appeal period remains 180 days, but for members enrolled in certain plans as defined by the U.S. Department of Labor and the Internal Revenue Service, Medical Mutual will pause counting days for one year or until 60 days after the end of the national emergency period, whichever is earlier.

To determine if you are enrolled in a plan affected by this, please contact your HR department.

Resources for Individuals and Families Without Coverage

If you lost, or are losing, your employer health insurance coverage because of the COVID-19 pandemic, Medical Mutual is here to help. You may be eligible for an individual health insurance plan.

Medical Mutual sales agents are available to answer your questions and discuss your coverage options. Call us toll free at 1-866-488-3266 (TTY 711 for hearing impaired) Monday through Friday, 8 a.m. to 8 p.m. Learn more about our plans in our Plans & Products section.

For information about qualifying for individual coverage because of circumstances related to COVID-19, please review this Individual Health Insurance FAQ

Resources for Ohio Residents

The Ohio Department of Health

The Ohio Department of Health is available to answer your questions about COVID-19.

1-833-4-ASK-ODH (1-833-427-5634)
Open 7 days a week, 9 a.m. to 8 p.m.

Visit coronavirus.ohio.gov to learn more about the status of COVID-19 in Ohio.


Ohio Department of Aging

The Ohio Department of Aging offers free daily phone check-ins for Ohioans age 60 or older. To register for this service or connect with aging network information and support, visit the Department of Aging website.


Ohio United Way

United Way supports 211, a free and confidential service that connects you to a community resource specialist in your area who can put you in touch with local organizations that provide critical services to those in need. You can call 211 by dialing 2-1-1 from a cell phone or landline or you can visit 211.org to search for local 211 resources by your ZIP Code or city.


Information about COVID-19 Scams

Learn more about COVID-19 scams and how to protect yourself.

Page last updated on 8/5/2022