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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 2025, 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 2025.
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 no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $3900.00 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) plan has a $0 deductible for prescription drugs. During the initial coverage phase, you'll pay varying copays or coinsurance amounts depending on the drug tier and pharmacy type. For example, preferred generic drugs have no copay at preferred pharmacies and preferred mail, and a $16 copay at standard pharmacies. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase, where you pay nothing for covered drugs. If you qualify for the low-income subsidy, you will pay $0 for Part D.
Additional Benefits
The MedMutual Advantage Signature (HMO-POS) plan offers comprehensive coverage with a variety of benefits. The plan includes coverage for inpatient and outpatient hospital services, with varying copays depending on the specific service. The plan also provides coverage for a range of other services, including primary care, preventive services, hearing, vision, dental, and home health services. Cost-sharing for these services varies, with copays and coinsurance amounts depending on the specific service.
Inpatient Hospital See details
Inpatient Hospital services are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute, you'll pay a $325 copay for days 1-6, and no copay for days 7-90; additional days are covered with no copay. For Inpatient Hospital Psychiatric, you'll pay a $335 copay for days 1-5, and no copay for days 6-90. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute, as well as additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric, are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital services have a $355 copay, observation services have a $390 copay, ambulatory surgical center services have a $300 copay, and outpatient substance abuse services have a $30 copay for both individual and group sessions.
Partial Hospitalization See details
Partial Hospitalization is covered by the MedMutual Advantage Signature (HMO-POS) plan, with a $35 copay.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with prior authorization required. Ground ambulance services have a $200 copay, while air ambulance services have a 50% coinsurance. Transportation services to a plan-approved health-related location are covered for 24 one-way trips per year, but transportation to any health-related location is not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Coverage are covered, each with a copay of $110, $35, and $110 respectively, and no coinsurance. Worldwide Urgent Coverage is covered with a $35 copay and no coinsurance, while Worldwide Emergency Transportation is not covered.
Primary Care See details
The MedMutual Advantage Signature (HMO-POS) plan covers primary care physician services, chiropractic services with a $20 copay, occupational therapy services with a $45 copay, physician specialist services with a $35 copay, mental health specialty services with a $35 copay, other health care professional services with a copay between $0 and $45, psychiatric services with a $35 copay, physical therapy and speech-language pathology services with a $35 copay, additional telehealth benefits with a copay between $0 and $35, and opioid treatment program services with 20% coinsurance. Routine Chiropractic Care and Podiatry Services are not covered.
Preventive Services See details
The MedMutual Advantage Signature (HMO-POS) plan covers a variety of preventive services, including annual physical exams, kidney disease education, and other preventive services like glaucoma screenings and diabetes self-management training. Additional services such as weight management programs (with 70% coinsurance), home-based palliative care, additional smoking cessation counseling, fitness benefits, remote access technologies, and other services are also covered.
Hearing Services See details
Hearing exams and prescription hearing aids are covered, with routine hearing exams covered once per year. Fitting/evaluation for hearing aids, prescription hearing aids - inner ear, prescription hearing aids - outer ear, over-the-ear prescription hearing aids, and OTC hearing aids are not covered. The copay for prescription hearing aids ranges from $499 to $999.
Vision Services See details
The MedMutual Advantage Signature (HMO-POS) plan covers vision services, including routine eye exams once per year, and eyewear with a 20% coinsurance for contact lenses. Eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental Services are covered, including Medicare Dental Services with a $35 copay. Other covered dental services include Oral Exams (2 visits per year), Dental X-Rays (1 per year), Other Diagnostic Dental Services with 30% coinsurance, Prophylaxis (Cleaning) with 2 visits per year, Fluoride Treatment (1 per year), Restorative Services with 30% coinsurance, Adjunctive General Services with 30% coinsurance, Endodontics with 50% coinsurance, Periodontics with 50% coinsurance, and Oral and Maxillofacial Surgery with 30% coinsurance. Orthodontic Services are covered under Diagnostic and Preventive Dental, and there is a $3,200 maximum benefit per year. However, Prosthodontics (removable and fixed), Maxillofacial Prosthetics, Implant Services, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. Medicare Part B Insulin Drugs have a $35 copay and coinsurance between 0% and 20%, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the MedMutual Advantage Signature (HMO-POS) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical equipment is covered by the MedMutual Advantage Signature (HMO-POS) plan, with a 20% coinsurance for Durable Medical Equipment (DME), Prosthetic Devices, and Medical Supplies, and no copay. Diabetic Supplies have a 0-20% coinsurance, while Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
The MedMutual Advantage Signature (HMO-POS) plan covers diagnostic and radiological services, including diagnostic procedures/tests with a copay between $0 and $10, and lab services with no copay. Diagnostic radiological services have a copay that is at most $125, and therapeutic radiological services have a coinsurance of at least 20%. Outpatient X-Ray services have a $50 copay.
Home Health Services See details
Home Health Services are covered by the MedMutual Advantage Signature (HMO-POS) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Prior authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the MedMutual Advantage Signature (HMO-POS) plan. Prior authorization is required for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but require prior authorization. There is no copay for days 1-20, and a $214 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
Other Services includes coverage for Over-the-Counter (OTC) Items and a Meal Benefit, while acupuncture and several other services are not covered. Over-the-Counter (OTC) Items have a maximum benefit of $70 every three months, and a Meal Benefit is provided for a chronic illness, with prior authorization required. Other 1 services may have a coinsurance of 0% to 50% and a copay of $0 to $395.
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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
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