Orlando Harmon
Medical Mutual is a mutual health insurance company with almost 13,000 physician members in 18 states and has received an A Excellent rating from A.M. Best for 14 years in a row. It is the largest insurance company in Ohio, where it is based, and has more than 135,000 Medicare Supplement policyholders and 30,000 Medicare Advantage members. The company offers a range of insurance programs, including health, dental, and life insurance options, as well as plans for individuals and groups. However, there have been some negative reviews regarding issues with coverage and prior authorization for medication.
| Characteristics | Values |
|---|---|
| Company Type | Mutual insurance company |
| Ownership | Member-owned |
| Policyholders | >[1.6 million] |
| Area of Operation | Ohio |
| Policy Options | Individual, Group, Medicare Supplement, Medicare Advantage, Prescription Drug, HMO, PPO, High-deductible, Dental, Vision, Accident, Critical Illness, Short-term, Long-term |
| Additional Benefits | Wellness benefits for pregnant mothers, people with chronic conditions, those on a lot of medication, and those interested in purchasing a gym membership; 24-hour nurse hotline |
| Customer Experience | Mixed reviews, with some complaints about prior authorisations for basic medications and unclear coverage |
| Financial Rating | "A" Excellent rating from A.M. Best for 14 years in a row |
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What You'll Learn
Medical Mutual of Ohio: BBB reviews
Medical Mutual of Ohio is the largest insurance company in Ohio, providing coverage throughout the state. The company offers a full range of suitable coverage, including six Medicare Supplement plans, prescription drug plans, and plans for individuals and groups. Medical Mutual also provides short-term health insurance, dental and vision plans, and accident and critical illness plans for individuals under 65.
As a mutual company, Medical Mutual is owned by its policyholders, who have a financial interest in the company and receive a portion of any profits directly as dividends or credits that reduce premium costs. The company also offers wellness benefits, such as extended telehealth insurance and a 24-hour nurse hotline.
While Medical Mutual of Ohio is not BBB Accredited, several reviews on the BBB website provide insight into customers' experiences with the company. Many of the reviews highlight issues with obtaining prior authorization for medication and treatments, resulting in delays and added complications for customers. For example, one reviewer mentioned having to make multiple calls and experiencing difficulties in getting approval for basic medications. Another reviewer expressed frustration with the time it took to get approval for an MRI, resulting in a prolonged period of pain and uncertainty.
Other reviews mention issues with claim approvals and payments. In one instance, Medical Mutual reversed its decision to cover a vaccination, causing confusion and resulting in the customer receiving bills from the care provider. Another review mentioned issues with receiving long-term disability coverage, despite having insurance for a year, and experiencing rude and unsatisfactory customer service.
It is important to note that while these reviews highlight negative experiences, Medical Mutual of Ohio has responded to some of these reviews, expressing appreciation for the feedback and offering to look into the specific issues raised.
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Medical Mutual: prescription coverage issues
Medical Mutual of Ohio is a regional insurance company based in Cleveland, providing coverage throughout Ohio. It is the largest insurance company in the state, with more than 1.6 million policyholders. The company offers a full range of coverage, including prescription drug plans, and is the official health insurer of several of Ohio's pro sports teams.
While Medical Mutual of Ohio offers prescription drug plans, there have been some reported issues with prescription coverage. Some customers have complained about difficulties in getting their medications filled due to prior authorization requirements. In one instance, a customer reported that their prior authorization for a medication was revoked without notice, resulting in their medication no longer being covered. Another customer reported that their prescription for a blood sugar medication was not approved, causing them to miss their medication. Similar complaints have been made about the need for prior authorizations for basic medications, including those treating behavioural health problems. These issues have caused frustration and inconvenience for customers, leading to negative reviews for the company.
To address these concerns, Medical Mutual of Ohio has expressed regret for the negative experiences and has offered to review the issues further to prevent similar occurrences in the future. The company provides prescription drug programs and solutions to help manage the costs associated with prescription drugs. They also offer a variety of innovative programs through their advanced pharmacy management option, which partners with Express Scripts (ESI) to improve clinical outcomes and member experience. Covered employees have access to resources such as order refills, prescription history, and a pharmacy locator tool to manage their prescription needs effectively.
It is important to note that prescription drug coverage can vary depending on the specific plan and its associated rules. Medical Mutual of Ohio offers a range of plans, including HMO, PPO, and high-deductible plans, each with its own formulary, or list of covered prescription drugs. While the company strives to provide comprehensive coverage, there may be instances where certain drugs are not covered or require prior authorization, which can cause delays or additional costs for customers.
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Medical Mutual: speech therapy coverage
Medical Mutual of Ohio is the largest insurance company in the state, providing a full range of coverage. It is a mutual insurance company, meaning that its policyholders have a financial interest. The company is member-owned, and policyholders receive a part of any profits returned to them directly as either dividends or credits that reduce premium costs. Medical Mutual offers plans for most people, including six Medicare Supplement plans, prescription drug plans, and plans for small and large employers.
Medical Mutual's Medicare Supplement plans are compatible with Original Medicare (Parts A and B) and Medicare Advantage (Part C). Original Medicare and Medicare Advantage cover speech therapy, but only when it is deemed medically necessary. For example, if you have suffered a stroke, you may require speech therapy to evaluate and treat your ability to communicate or swallow. Medicare Advantage is provided by private insurance companies, which may require you to get a referral from your primary care physician before seeing a speech therapist.
If you have Original Medicare, you can purchase a Medicare Supplement (Medigap) plan to help cover ongoing out-of-pocket costs. These plans have a premium, and billing codes can be verified using the American Speech-Language-Hearing Association (ASHA) list of speech-therapy-related CPT codes.
It is important to note that Medical Mutual has received mixed reviews. While it is the largest healthcare provider in Ohio, some customers have complained about issues with getting their prescriptions approved and filled.
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Medical Mutual: long-term care insurance
Medical Mutual of Ohio is a mutual insurance company, meaning its policyholders have a financial interest. As a member-owned company, ownership is shared among policyholders, who receive a part of any profits returned to them directly as either dividends or credits that reduce the cost of premiums.
Medical Mutual offers a variety of individual health insurance plans, including medical, short-term, dental, vision, and life insurance. They also offer Medicare Advantage and Medicare Supplement Insurance plans, as well as group plans for small to large employers.
While Medical Mutual does not appear to offer long-term care insurance specifically, their Medicare Advantage plans may provide limited supplemental coverage for services that could be considered long-term care, such as meal delivery and transportation to medical appointments.
When considering long-term care insurance, it is important to evaluate your budget, assets, and overall financial condition. Long-term care insurance premiums should ideally not exceed 7% of your income. Additionally, your age and health will impact the cost of long-term care insurance, with older individuals and those with health problems facing higher costs and potentially limited coverage options.
It is worth noting that Medical Mutual has received mixed reviews from customers. While some appreciate the company's offerings, others have expressed frustration with delays and difficulties in getting their medications approved and filled due to prior authorization requirements.
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Medical Mutual: customer service
Medical Mutual of Ohio is the largest insurance company in the state, providing a full range of coverage to over 1.6 million people. The company sells policies all over Ohio and has more than 135,000 Medicare Supplement policyholders and 30,000 Medicare Advantage members. Medical Mutual also offers group plans for small to large employers and individual plans, including prescription drug plans.
As a mutual company, Medical Mutual is owned by its policyholders, who receive a part of any profits returned to them directly as dividends or credits that reduce premium costs. The company also offers wellness benefits for pregnant mothers, people with chronic conditions, those who take a lot of medication, and those interested in purchasing a gym membership. Additionally, they have extended their telehealth insurance benefits and offer a 24-hour nurse hotline for an additional monthly premium.
While Medical Mutual of Ohio is well-established and offers a range of plans, some customers have expressed concerns about their experiences with the company. Several reviews mention issues with obtaining prior authorization for prescription medications, resulting in delays or denials of coverage. These reviews highlight the impact of such experiences on customers' health and well-being. In response to these reviews, Medical Mutual has acknowledged the feedback and expressed a commitment to improving their services.
It is important to consider that the issues raised in the reviews may not reflect the overall experience of all Medical Mutual customers. The company's commitment to addressing these concerns and finding solutions is a positive sign of their customer service approach. However, it is always advisable to thoroughly research and compare different insurance providers before making a decision to ensure that your specific needs are met.
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Frequently asked questions
Medical Mutual is a member-owned mutual insurance company. It has received an "A" Excellent rating from A.M. Best for 14 years in a row and is the largest insurance company in Ohio. However, there are some negative reviews online about the company's customer service and issues with medication coverage.
Medical Mutual offers a range of insurance plans, including individual and group plans. They provide six Medicare Supplement plans, prescription drug plans, HMO, PPO, and high-deductible plans. They also offer dental, vision, accident, and critical illness plans, as well as short-term health insurance.
Yes, Medical Mutual provides various benefits such as wellness programs for pregnant mothers, people with chronic conditions, those on medication, and individuals interested in gym memberships. They also offer a 24-hour nurse hotline for an additional monthly premium. Additionally, they provide a 5% premium discount to NCMS members for their Long-Term Care Insurance.
Medical Mutual is a regional company based in Ohio, so it may not be the best option for those who travel frequently or reside in multiple states. Their network might not be broad enough to cover all the necessary locations.
Alternatives to Medical Mutual may include other private insurance companies or government-sponsored programs like Medicare or Medicaid, depending on an individual's specific needs, location, and eligibility.
