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MedMutual Advantage Secure (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for MedMutual Advantage Secure (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on MedMutual Advantage Secure (HMO-POS) in 2025, please refer to our full plan details page.
MedMutual Advantage Secure (HMO-POS) is a HMO-POS plan offered by MEDICAL MUTUAL OF OHIO available for enrollment in 2025 to people living in Ohio Regions. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that MedMutual Advantage Secure (HMO-POS) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about MedMutual Advantage Secure (HMO-POS).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For MedMutual Advantage Secure (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $39.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $3350.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The MedMutual Advantage Secure (HMO-POS) plan has a $0 deductible for prescription drugs. In the initial coverage phase, you'll pay a copay or coinsurance depending on the drug tier and pharmacy you use. For preferred generic drugs, you'll pay a $5 copay at a preferred pharmacy, and $4 through mail order. For standard generic drugs, the copay is $42 at a preferred pharmacy, and $40 through mail order. Brand name drugs have a 50% coinsurance, and non-preferred drugs have a 31% coinsurance.
Additional Benefits
The MedMutual Advantage Secure (HMO-POS) plan offers a range of benefits. It includes inpatient hospital stays with a copay, and outpatient services with copays for various services. The plan also covers ambulance services, emergency services, and primary care with copays. Additional benefits include preventive, hearing, vision, and dental services. There is no copay for routine eye exams, and dental services have a maximum benefit of $2,500 per year. The plan also covers medical equipment, home health services with no copay, and skilled nursing facility stays with a copay after 20 days. Other services include OTC items, a meal benefit, and other services with varying copays and coinsurance.
Inpatient Hospital See details
Inpatient Hospital services are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute, you will pay a $350 copay for days 1-6, and no copay for days 7-90; for Inpatient Hospital Psychiatric, you will pay a $370 copay for days 1-5, and no copay for days 6-90. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute are not covered, and additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient services are covered, including outpatient hospital services with a $310 copay, observation services with a $390 copay, ambulatory surgical center services with a $275 copay, and outpatient substance abuse services with a $20 copay per session. Outpatient blood services are also covered, with a waived three-pint deductible.
Partial Hospitalization See details
Partial Hospitalization is covered under the MedMutual Advantage Secure (HMO-POS) plan, with a $20 copay.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the MedMutual Advantage Secure (HMO-POS) plan. Ground ambulance services have a $200 copay, while air ambulance services have a 20% coinsurance. Transportation services to a plan-approved health-related location are covered for 24 one-way trips per year.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Coverage are covered under the MedMutual Advantage Secure (HMO-POS) plan, with copays of $110, $20, and $110, respectively, and no coinsurance. Worldwide Urgent Coverage has a $20 copay, and no coinsurance. Worldwide Emergency Transportation is not covered.
Primary Care See details
The MedMutual Advantage Secure (HMO-POS) plan covers primary care physician services, chiropractic services with a $20 copay, occupational therapy services with a $45 copay, and physician specialist services with a $20 copay. It also covers mental health specialty services with a $20 copay, and physical therapy and speech-language pathology services with a $40 copay. Additional telehealth benefits are covered with a copay between $0 and $20, and opioid treatment program services are covered with 20% coinsurance.
Preventive Services See details
Preventive services include coverage for Medicare-covered preventive services, annual physical exams, kidney disease education services, and other preventive services. Weight Management Programs have a coinsurance of 70%. Some services, such as Health Education, In-Home Safety Assessment, and Counseling Services are not covered.
Hearing Services See details
Hearing services include routine hearing exams, with one exam covered every year, and prescription hearing aids, with two aids covered every year. The copay for prescription hearing aids ranges from $499 to $999. Fitting/evaluation for hearing aids, prescription hearing aids - inner ear, prescription hearing aids - outer ear, prescription hearing aids - over the ear, and OTC hearing aids are not covered.
Vision Services See details
Vision services include coverage for routine eye exams with no copay, and eyewear with a 20% coinsurance for contact lenses. Eyeglasses (lenses and frames) are covered, while eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental Services are covered, with a maximum plan benefit of $2,500 per year. Medicare Dental Services have a $20 copay. Other services include Oral Exams (2 visits per year) and Dental X-Rays (1 per year), as well as Other Diagnostic Dental Services, Restorative Services, Adjunctive General Services, and Oral and Maxillofacial Surgery, each with a 30% coinsurance, and Endodontics and Periodontics, each with a 50% coinsurance. Prosthodontics, removable, Maxillofacial Prosthetics, Implant Services, Prosthodontics, fixed, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services, including Insulin, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs, are covered under this plan. The cost sharing for Medicare Part B Insulin Drugs includes a $35 copay and a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the MedMutual Advantage Secure (HMO-POS) plan, with a coinsurance of 20%.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance and Prosthetics/Medical Supplies with 20% coinsurance, while Durable Medical Equipment for use outside the home is not covered. Diabetic Equipment includes Diabetic Supplies with 0-20% coinsurance and Diabetic Therapeutic Shoes/Inserts with 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the MedMutual Advantage Secure (HMO-POS) plan. Diagnostic Procedures/Tests have a copay between $0 and $10, Lab Services have no copay, Diagnostic Radiological Services have a copay between $100 and $125, Therapeutic Radiological Services have a 20% coinsurance, and Outpatient X-Ray Services have a $50 copay.
Home Health Services See details
Home Health Services are covered by MedMutual Advantage Secure (HMO-POS) with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but are not covered in practice. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by MedMutual Advantage Secure (HMO-POS), but require prior authorization. For days 1-20, there is no copay, while days 21-100 have a copay of $214. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The MedMutual Advantage Secure (HMO-POS) plan's "Other Services" benefit includes coverage for Over-the-Counter (OTC) items with a maximum benefit of $115 every three months, and also covers a Meal Benefit for chronic illness with prior authorization. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered. The plan also offers "Other 1" services, with a copay between $0 and $390, and coinsurance between 0% and 50%, and a maximum benefit of $7500.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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