MEDICAL

AultCare or MedicalMutual of Ohio | PPO $250

	In-Network	Out-of-Network
Deductible (Single/Family)	$300 / $600	$600 / $1,200
Coinsurance (You Pay)	10%	20%
Maximum Coinsurance (Single/Family)	$900 / $1,800	$1,800 / $3,600
Out-of-Pocket (Single/Family) (includes deductible)	$1,200 / $2,400	$2,400 / $4,800
Inpatient Services	10% after deductible	20% after deductible
Outpatient Services	10% after deductible	20% after deductible
Emergency Room	10% after deductible	20% after deductible
Office Visits	10% after deductible	20% after deductible
Preventive Care	Covered 100%	20% after deductible

Rx Retail Copays
Generic	20% (Not subject to Deductible)	Not Covered
Preferred Brand	20% (Not subject to Deductible)	Not Covered
Non-preferred Brand	30% (Not subject to Deductible)	Not Covered

Employee Level	Monthly
Single	$158.78
Family	$385.67

Resources

Schedule of Benefits

OE Model Notice

Summary of Benefits Coverage 2024/2025

My Health Plan Flyer

MMO Nurse Line

Aultcare Nurse Line

MMO Express Care Online

Telemedicine

AultCare Be Prepared

Medical Mutual Where to Find Care

Vaccine Information

Dependents

Dependents can be covered under the MEDICAL plan until the end of the month in which they reach age 26. A dependent is not required to be a student; they can be married or have a job that offers insurance. If the dependent is your child, that dependent can remain covered to the age of 26.

Network

We offer two identical medical plans with two different carriers. The carriers are Aultcare and Medical Mutual of Ohio. Aultcare is a smaller network of providers and located more in the Stark County and Canton area. Medical Mutual has a larger network of providers to choose from and is the more popular choice. Please review both carriers, including provider networks, and decide which one is best for your situation. Both plans cost the same.

Premium Holiday

If eligible, there will be two premium holidays announced during the year where no premium will be deducted from your paycheck.

Non-Emergency use of the Emergency Room: Effective 7/1/23

There will be a $250 Copay for all Non-Emergency use of the Emergency Room. The copay will be incurred even after a member meets their deductible and coinsurance limit IF the visit is for Non-Emergency use of the Emergency Room. Members should utilize alternative treatment options such as Urgent Care, Convenience Clinics, Telehealth Services and Nurse Lines for services that are not limb or life threatening.

MEDICAL MUTUAL

Weight Watchers Reimbursement
Receive up to $150 of the registration fees per calendar year. For information, call 866-204-2878

Smoking Cessation
Four- to eight-week supply of nicotine replacement therapy at no out-of-pocket expense. For information, call 866-845-7702

Nurse Line
You can call a nurse 24/7 for medical advice – 888-912-0636

Hearing Aids
Beltone offers up to a 20% discount on all hearing aid models. Simply show your ID card at a participating Beltone location (found at Beltone.com) or call 800-235-8663

MedMutual.Com Online Services
• Locate SuperMed Plus network providers
• Log onto My Health Plan to:
– Review claims status
– Order ID cards
– Take a Health Assessment
– Health Resource Center

Disease Management Programs
Help with managing the follow conditions:
Asthma
Chronic Obstructive Pulmonary Disease
Congestive Heart Failure
Coronary Artery Disease
Diabetes
Call 800-861-4826, Option 2, to enroll in a program

Fitness Discounts
Membership discounts at various fitness centers.

Telemedicine
You can have an online appointment with a Cleveland Clinic physician for non- emergency issues.

My Care Compare
Access to cost comparison tool to find estimates for medical services like lab work, x-rays, MRI, etc.

Urgent Care Facilities
Urgent care visits and Minute Clinic visits are covered under the plan just like regular office visits.

AULTCARE

Aultman Weight Management
Receive a 30% discount on the initial screening at Aultman Weight Mgmt. and Free access to any Aultman Fitness Facility

Tobacco Cessation
5 weeks free “Give it up” program at Aultman Hospital. For information, call 330-363-7848 or go to www.aultman.org

Nurse Line
You can call a nurse 24/7 for medical advice – 866-422-9603 or 330-363-7620

Education & Support Services
• AultLine – 24-hour Nurse Hotline: 866-422-9603
• Health Talks – Community educational sessions on a variety of topics

Aultcare.Com Online Services
• Locate Aultcare network providers
• Log onto Manage My Account
– Review claims history
– Access Explanation of Benefits
– Order ID Cards
– Download Forms
• Access to HealthFinder.gov

Disease Management Programs
Help with managing the follow conditions:
Chronic Obstructive Pulmonary Disease
Congestive Heart Failure
Diabetes
Mental Health
Complex Medical Conditions

Weight Management Discount
If you join the Aultman Weight Management Program, you get a 30% Discount. Insurance does not cover the program, but if you join as an Aultcare member, you will get this discount.

Teledoc
You can have an online appointment with a U.S. board certified physician for non- emergency issues.

Medical Cost Estimator
This tool can help compare the cost of a certain procedure with different providers.

Urgent Care Facilities
Urgent care visits and Minute Clinic visits are covered under the plan just like regular office visits.

MOBILE APPS

Both AultCare and Medical Mutual have mobile apps. You can download your insurance card to the mobile app, check claims, obtain eligibility information, look at the provider directory, as well as deductible and out of pocket information.