2018 MedMutual Advantage Classic (HMO) H6723-1-2 in OH from Medical Mutual | HealthPocket

MedMutual Advantage Classic (HMO)

$576/mo

Apply For This Plan

Zip Code43228
Applicant10/15/1983 Male
Coverage Start10/16/2018
Apply Now

Benefits & Coverage

Insurance TypeMedicare Advantage Plan (Part C w/ RX)
Insurance ProviderMedical Mutual
Plan IDH6723-1-2
Plan Year2018
CMS Rating
Plan TypeHMO
Annual Deductible$195.00

What To Know About This Plan
  • This plan has health and drug coverage
  • This plan is available for 2019. see plan

Why We Like This Plan
  • has both Health and Drug Coverage

Costs and Other Important Information

Plan Year2018
Optional Supplemental BenefitsYes
Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)$4,300 In-network
Other health plan deductibles?No
Health Plan Deductible$0
Monthly Drug Plan Premium$48.00
Monthly Health Plan Premium$0.00

Benefits

SERVICECOST
Inpatient hospital coverage$360 for days 1 through 5
$0 for days 6 through 90
Outpatient hospital coverage$375 per visit
Doctor visitsPrimary:
$3 per visit
Specialist:
$50 per visit
Preventive care$0 copay
Emergency care/Urgent careEmergency:
$80 per visit (always covered)
Urgent care:
$40 per visit (always covered)
Diagnostic procedures/lab services/imagingDiagnostic tests and procedures:
20%
Lab services:
$0-10
Diagnostic radiology services (e.g., MRI):
20%
Outpatient x-rays:
$50
Mental health services$324 for days 1 through 5
$0 for days 6 through 90
Outpatient group therapy visit with a psychiatrist:
$40
Outpatient individual therapy visit with a psychiatrist:
$40
Outpatient group therapy visit:
$40
Outpatient individual therapy visit:
$40
Skilled Nursing Facility$0 for days 1 through 20
$167.50 for days 21 through 100
Rehabilitation servicesOccupational therapy visit:
$40
Physical therapy and speech and language therapy visit:
$40
Ambulance50%
TransportationNot covered
Foot care (podiatry services)Foot exams and treatment:
$50
Routine foot care:
Not covered
Medical equipment/suppliesDurable medical equipment (e.g., wheelchairs, oxygen):
20% per item
Prosthetics (e.g., braces, artificial limbs):
20% per item
Diabetes supplies:
20% per item
Wellness programs (e.g., fitness, nursing hotline)Covered
Medicare Part B drugsChemotherapy:
20%
Other Part B drugs:
20%

Coverage Area for MedMutual Advantage Classic (HMO)

StateOhio
CountyFranklin

All cost-sharing assumes in-network healthcare providers.
Prescription Drug Copay/Coninsurance Details - Initial Coverage Limit


30 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred GenericNot offereds$5 copayNot offered
Tier 2: Non-Preferred GenericNot offered$19 copayNot offered
Tier 3: Preferred Brand NameNot offered$47 copayNot offered
Tier 4: Non-Preferred Brand NameNot offered50% coinsuranceNot offered
Tier 5: Specialty TierNot offered29% coinsuranceNot offered

90 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred GenericNot offered$10 copayNot offered
Tier 2: Non-Preferred GenericNot offered$38 copayNot offered
Tier 3: Preferred Brand NameNot offered$118 copayNot offered
Tier 4: Non-Preferred Brand NameNot offered50% coinsuranceNot offered
Tier 5: Specialty Tier

Staying healthy - screenings, tests and vaccines

Breast cancer screening
Colorectal cancer screening
Annual flu vaccine
Improving or maintaining physical healthNot Rated
Improving or maintaining mental healthNot Rated
Monitoring physical abilityNot Rated
Adult BMI assessment

Managing Chronic Conditions

Special needs plan care managementNot Rated
Care for older adults – medication reviewNot Rated
Care for older adults – functional status assessmentNot Rated
Care for older adults – Pain screeningNot Rated
Osteoporosis management in women who had a fractureNot Rated
Diabetes care – eye exam
Diabetes care – kidney disease monitoring
Diabetes care – blood sugar controlled
Controlling blood pressure
Rheumatoid arthritis management
Reducing the risk of fallingNot Rated
Plan all-cause readmissionsNot Rated

Member Experience with Health Plan

Getting needed care
Getting appointments and care quickly
Customer service
Overall rating of health care quality
Overall rating of plan
Care Coordination

Member Complaints, and Changes in Health Plan's Performance

Complaints about the health plan
Members choosing to leave the health plan
Beneficiary access and performance problems
Health plan quality improvement

Health Plan Customer Service

Plan makes timely decision about appeals
Reviewing appeals decisionsNot Rated
Call center – foreign language interpreter and TTY/TDD availability - MedicalNot Rated

Drug Plan Customer Service

Call center – foreign language interpreter and TTY/TDD availability - DrugsNot Rated
Appeals auto-forward
Appeals upheld

Member Complaints, and Changes in Drug Plan's Performance

Complaints about the drug plan
Members choosing to leave the drug plan
Beneficiary access and performance problems
Drug plan quality improvement

Member Experience with Drug Plan

Rating of drug plan
Getting needed prescription drugsNot Rated

Drug Pricing and Patient Safety

MPF Price Accuracy
High risk medication
Part D medication adherence for diabetes
Part D medication adherence for hypertension
Part D medication adherence for cholesterol
Medication Therapy Management program completion rate

Physicians that accept MedMutual Advantage Classic (HMO) for Ohio

/
Please select the correct zip
King, Gretzel
View All Details
Luken, Theresa
View All Details
Friedman, Daniel
View All Details
Kaufman, Jeffrey
View All Details
Levin, Howard
View All Details
Carine, Ali
View All Details
Naikoo, Huma
View All Details
Kurtz, Jillian
View All Details
Kuchta, Zachariah
View All Details
Botteicher, Joshua
View All Details
Co Faustino, Genevieve
View All Details
Hughey, Leigh
View All Details
Hinckley, John
View All Details
Vincent, Karen
View All Details
Miller, Caren
View All Details
Jordan, Kevin
View All Details
Fraser, William
View All Details
Cunagin, Kimberly
View All Details
Rybaltowski, Mariusz
View All Details
Parker, Sarah
View All Details
Jones, Bruce
View All Details
Harris, Paul
View All Details
Jones, Paula
View All Details
Casey, John
View All Details
Johnsen, Ronald
View All Details
Gretzel King
View All Details
  • Phone Number
    (614) 878-6413
  • Office Locations
    104 N Murray Hill Rd
    Columbus, OH 43228
104 N Murray Hill Rd Columbus OH, 43228

get free advice

Speak With A Licensed Agent

Call (800) 931-6467

Learn More

HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, Medicaid or an individual health insurance plan, we will help you find the right healthcare option and save on your out of pocket healthcare costs. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. If you select a plan presented on our site, you will be directed (via a click or a call) to one of our partners who can help you with your application. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan.

Close

Medicare Plans Found