Medical Mutual of Ohio
Answers to Frequently Asked Questions:
How do I begin using my benefits?
An identification card has been mailed to your home. All cards are in the employee’s name. Please show the card to your doctor or facility on your next visit. Medical Mutual sends two cards even if you have single coverage.
How do I request additional or replacement cards?
Once you receive your ID cards, you can log onto Medical Mutual Website www.medmutual.com. You will need to register on My Health Plan using the information on your ID cards. You can click on Request ID cards or print them from this site.
What if I have not received my card(s)?
It usually takes up to ten business days after cards are requested for you to receive them. PCSD switched to Medical Mutual of Ohio on 7/1/2011. If you have not yet received your ID cards, please contact the Benefits Department at 440-885-8773.
How do I know if my doctor or facility is in the Medical Mutual network?
You can log onto the Medical Mutual of Ohio website www.medmutual.com and click on “Find a Doctor.” Vision Plan is VSP. Medical/Rx is SuperMed Plus.
What if my doctor or facility is not in network?
After the transitional period, you will be responsible to pay out of network charges up to the out of pocket maximum.
If you were pregnant before 6/30/2011 and expecting your baby after that date, or you have a surgery scheduled after 7/1/2011 and it was scheduled before the transition, etc, please contact Benefits Dept. to request a Transition of Care Waiver Form. MMO will notify you if it is approved or not and for the length of time.
If your doctor is out of network, you can choose to stay with that doctor and pay out of network costs, or you can complete a Transition of Care Waiver. MMO will give you a few months to find an in-network doctor. They will notify you of the approved amount of time. MMO will pay the out of network doctor through that approved time period at in-network rates based on what is usual and customary.
What pharmacies are in the network?
Medco oversees the prescription program through Medical Mutual of Ohio. The major chains are in network. You can log onto the Medical Mutual of Ohio website www.medmutual.com and log in to My Health Plan. You can link to Medco and find participating retailers.
Do I need a new prescription for the mail order?
With the transition from Express Scripts to Medco, you will need a new prescription from your doctor.
Will a Medical Mutual Representative be available to answer questions?
Yes, a Medical Mutual Representative will be on-site in the Treasurer’s office for the first week or two when school starts in August 2011 to answer claim or plan questions.
