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MedMutual Advantage Signature (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for MedMutual Advantage Signature (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 Signature (HMO-POS) in 2026, please refer to our full plan details page.
MedMutual Advantage Signature (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 2026.
It's important to know that MedMutual Advantage Signature (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 Signature (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 Signature (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. 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 a $300.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $4200.00 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 Signature (HMO-POS) prescription drug plan features an annual drug deductible of $300. You will pay no copay for Tier 1 (Preferred Generic) and Tier 2 (Generic) medications when filled through preferred pharmacies or preferred mail order. Select Care Drugs (Tier 6) also feature no copay regardless of whether you use preferred or standard pharmacy options. For higher-tier medications, costs are based on coinsurance rather than flat copays. Tier 3 (Preferred Brand) drugs require a 23% coinsurance, while Tier 4 (Non-Preferred) drugs have a 40% coinsurance across all pharmacy and mail-order options. Specialty drugs in Tier 5 carry a 29% coinsurance for a one-month supply.
Additional Benefits
The MedMutual Advantage Signature (HMO-POS) plan offers comprehensive healthcare coverage with predictable out-of-pocket costs. Members benefit from no copays for primary care doctor visits and routine home health services, while specialist visits require a $25 copay. For hospital care, inpatient stays carry a $375 daily copay for the first six days with no copay thereafter, while outpatient hospital services require a $340 copay. Supplemental benefits include annual routine vision and hearing exams with no copay, plus dental coverage up to a $3,000 annual limit with no copays for most preventive services. Emergency room visits have a $130 copay, which is waived if you are admitted within 24 hours, and urgent care services require a $25 copay. Routine preventive services, such as annual physicals and screenings, are also covered with no copay.
Inpatient Hospital See details
MedMutual Advantage Signature (HMO-POS) inpatient hospital care is partially covered with no coinsurance, though upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered. Covered acute stays require a $375 daily copay for days 1 to 6 and no copay thereafter, while psychiatric stays require a $335 daily copay for days 1 to 5 and no copay for days 6 to 90.
Outpatient Services See details
Outpatient services are covered by MedMutual Advantage Signature (HMO-POS) with no coinsurance, featuring a $340 copay for outpatient hospital services and a $300 copay for ambulatory surgical center services, both requiring prior authorization. Patients will also pay a $375 copay per stay for observation services, a $25 copay for outpatient substance abuse individual or group sessions, and no copay or coinsurance for outpatient blood services.
Partial Hospitalization See details
Partial hospitalization is covered by the MedMutual Advantage Signature (HMO-POS) plan with a $25 copay and no coinsurance, although prior authorization is required.
Ambulance and Transportation Services See details
MedMutual Advantage Signature (HMO-POS) covers ground ambulance services with a $245 copay and no coinsurance, and air ambulance services with a 50% coinsurance and no copay. Transportation services are partially covered with no copay and no coinsurance for up to 24 one-way trips per year to plan-approved locations, while transportation to any health-related location is not covered.
Emergency Services See details
MedMutual Advantage Signature (HMO-POS) covers emergency services with a $130 copay (waived if admitted within 24 hours) and urgently needed services with a $25 copay, with no coinsurance required for either. Worldwide emergency and urgent care are also covered with similar copays and no coinsurance up to a $50,000 maximum benefit, though worldwide emergency transportation is not covered.
Primary Care See details
MedMutual Advantage Signature (HMO-POS) covers primary care visits with no copay and no coinsurance, while specialist visits require a $25 copay and no coinsurance. Physical therapy ($30 copay) and occupational therapy ($40 copay) require prior authorization with no coinsurance, while chiropractic and podiatry services are not covered.
Preventive Services See details
MedMutual Advantage Signature (HMO-POS) provides partially covered preventive services with no copay and no coinsurance for annual physicals, kidney disease education, and routine screenings. Covered additional services like weight management have a 70% coinsurance and no copay, while smoking cessation, palliative care, and memory fitness are also included. However, health education, in-home safety assessments, PERS, medical nutrition therapy, medication reconciliation, re-admission prevention, chemotherapy wigs, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, in-home support, caregiver support, disease management, telemonitoring, and home safety modifications are not covered.
Hearing Services See details
Hearing services are partially covered by MedMutual Advantage Signature (HMO-POS), featuring one annual routine hearing exam with no copay or coinsurance, and up to two prescription hearing aids per year with a copay between $499 and $999 and no coinsurance. Fitting and evaluations, OTC hearing aids, and inner ear, outer ear, or over-the-ear prescription hearing aids are not covered.
Vision Services See details
MedMutual Advantage Signature (HMO-POS) covers one routine eye exam per year with no copay and no coinsurance, though other eye exam services are not covered. Eyewear is partially covered with no copay and a 20% coinsurance for contact lenses, offering a $200 annual limit for one pair of glasses or contacts, while individual eyeglass lenses, frames, and upgrades are not covered.
Dental Services See details
MedMutual Advantage Signature (HMO-POS) dental services are partially covered up to a $3,000 annual maximum, featuring no copay and no coinsurance for most preventive and comprehensive care. Medicare-covered dental services require a $25 copay and no coinsurance, while implants and prosthodontics are covered with no copay and a 50% coinsurance. Other preventive dental services, maxillofacial prosthetics, and orthodontics are not covered.
Home Infusion bundled Services See details
MedMutual Advantage Signature (HMO-POS) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs carry no copay and no coinsurance to 20% coinsurance, while Medicare Part B insulin drugs require a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by MedMutual Advantage Signature (HMO-POS) with no copay and a 20% coinsurance.
Medical Equipment See details
Medical equipment is covered by MedMutual Advantage Signature (HMO-POS) with no copays across all categories, though coinsurance is required for most items. Durable medical equipment carries a 25% coinsurance, prosthetics and medical supplies require a 20% coinsurance, and diabetic supplies range from no coinsurance to 20% coinsurance.
Diagnostic and Radiological Services See details
MedMutual Advantage Signature (HMO-POS) covers diagnostic procedures, tests, and lab services with a $10 copay and no coinsurance, with prior authorization required. Covered radiological services also require prior authorization and include a $50 copay for outpatient x-rays, a minimum $100 copay for diagnostic radiological services, and a minimum 20% coinsurance for therapeutic radiological services.
Home Health Services See details
MedMutual Advantage Signature (HMO-POS) covers Home Health Services with no copay and no coinsurance.
Cardiac Rehabilitation Services See details
MedMutual Advantage Signature (HMO-POS) states some services are covered under its cardiac rehabilitation benefit with no coinsurance and requiring prior authorization. However, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are partially covered by MedMutual Advantage Signature (HMO-POS) with no coinsurance, featuring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, a three-day hospital stay is not needed prior to admission, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
MedMutual Advantage Signature (HMO-POS) provides partial coverage for other services, which excludes acupuncture. Covered benefits include over-the-counter items and chronic illness meals with no copay and no coinsurance, alongside the Travel Plus benefit featuring copays from $0.00 to $375.00 and 0% to 50% coinsurance.
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