Medical Mutual of Ohio Plan for residents of Ohio

Medical Mutual of Ohio Plan for residents of Ohio/Indiana

FAQ

The unexpected DOES happen. No one plans to have an illness or accident. Going without health insurance, even for a short time, puts you and your family at serious personal and financial risk.

Don’t take a chance! SuperMed One™, a comprehensive major medical plan from Medical Mutual offers you affordable permanent and short-term health coverage that protects you from this risk.

Everyone’s needs are different. That’s why the family of SuperMed One™ plans has a variety of deductibles, coinsurance and copays

Permanent Medical Coverage

SuperMed One is much more than a catastrophic health insurance plan. SuperMed One’s simple to use plan design meets your day-to-day medical needs by providing benefits for wellness services, routine care, serious illness, prescription drug, and emergency care.

You can select from five comprehensive major medical plans that will give you dependable coverage tailored to fit your needs and budget while providing choice, flexibility and direct access to care. These plans give you access to one of the largest and most comprehensive networks of physicians and hospitals in the state - SuperMed Plus™. When you select your healthcare provider from this network, you achieve long-term cost savings.

Short-term Medical Coverage

SuperMed One’s Short-term medical coverage provides you with temporary security in the event of a catastrophic or unexpected illness, as well as protection for your day-to-day healthcare needs. This six month comprehensive major medical plan gives you the flexibility of a short-term commitment. It is a temporary health plan for you if you are between jobs, waiting for employer group coverage to begin, a recent college graduate or part-time student, a temporary or seasonal employee, or a laid-off, striking or terminating employee.

Additional Riders

In conjunction with permanent medical coverage, you can select additional products to enhance our benefits of your plan.

Optional Professional Service Rider

Are you interested in delaying your healthcare out-of-pocket expenses? Is your answer yes? Then this rider is for you. The professional services rider will waive the deductible and coinsurance for the first $500 of covered outpatient institutional and professional services received by a network provider during a given benefit period.

Services to which the benefit will be applied include:

Well child care services.
Outpatient diagnostic services.
Immunizations.
Medically necessary and routine office visits. (Does not include services for which a copay applies.)
Outpatient therapy services.
Routine Pap tests.
Routine testing (excludes routine mammogram).

Optional Prescription Drug Rider

All SuperMed One comprehensive major medical plans (permanent and short-term) contain prescription drug coverage. When enrolling in a permanent medical plan, you can upgrade your prescription drug coverage by choosing this rider. With this SuperMed One Optional Prescription Drug Rider, your out-of-pocket costs will be limited to a $15/$30/$45 copay for each generic, formulary and non-formulary prescription filled. Pay the single copay for retail or for home delivery, pay two times the copay for a 90 day supply. The annual deductible and co-insurance are waived.

View a list of the preferred prescriptions on the formulary drug list.

Optional Maternity Services Rider

You may select from two optional maternity benefits riders. (1) The first option offers a $2,000 maximum benefit, which is not subject to the deductible. (2) The second option offers benefits with no maximum and which are subject to the deductible and coinsurance. Both options require the maternity rider to be in effect for 270 days before coverage begins.

The maternity services riders include but are not limited to normal pregnancy, complications of pregnancy, miscarriage, and therapeutic and elective abortions.

Eligibility for SuperMed One Benefits

You and any dependents may apply for SuperMed One insurance as long as you are residents of Ohio at least six months of the year, and you are:

Not eligible for or entitled to Medicare.
Not 65 years of age or older.

Family coverage includes you, your spouse and any unmarried children under the age of 23. Dependent-only coverage is available. Choice of Deductibles SuperMed500.pdf SuperMed1000.pdf SuperMed1500.pdf SuperMed2500.pdf SuperMed5000.pdf

Pre-Existing Condition Clause

There is a nine-month waiting period for pre-existing conditions. A pre-existing condition is a condition for which an ordinarily prudent person would seek medical advice, diagnosis, care or treatment; or for which you incurred medical expenses, received medical treatment, used a prescription drug or were advised by a physician to receive treatment during the six months prior to your effective date. The number of months you were enrolled under your previous coverage may apply toward the waiting period.

Application Process:

To begin the SuperMed One enrollment process, you will need to complete the Health & Life Application/Change Form. Please type in the information on the form and print out the form. After carefully reading each section and answering all questions, be sure to sign and date the application. All applications will be considered invalid 60 days after the signature date.

The completed application can be faxed or mailed to India Network office at 419-873-0663.

You may also mail the completed application to:

India Network Services, Inc. PO Box 305, Maumee, OH 43537

Once received by India Network, your application will be reviewed to ensure that all information is accurate and all questions completed. Your application will be sent to Medical Mutual's Underwriting Department for further review. Within five to seven days, India Network will notify you of your acceptance and your actual monthly premium or denial. At that time, if you accept the approved premium rates, an invoice for the first month of premium will be mailed to you.

Do not cancel any current health insurance coverage until you receive an approval letter and insurance policy, also known as insurance contract or certificate, from Medical Mutual. Make sure you understand and agree with the term of the policy. Pay special attention to the effective date, premium amount, benefits, limitations, exclusions, and riders.

The rates quoted are estimates only, and are subject to change based on your medical history, the underwriting practices of Medical Mutual of Ohio , the optional benefits you selected, if any, and other relevant factors. Medical Mutual of Ohio reserves the right to change the terms of the policy under proper notification.

(c) India Network Services, Inc.