Medical Mutual of Ohio Review

Medical Mutual of Ohio

Medical Mutual of Ohio is the state’s largest and most established health insurer, serving over 1.6 million members. With deep roots in Ohio’s healthcare system, it offers a wide range of coverage—including ACA, Medicare Advantage, Medigap, and employer-sponsored plans. While services are primarily Ohio-focused, Medical Mutual also holds licenses in surrounding states and offers travel and emergency coverage for Medicare Advantage members via its Travel Plus™ benefit.

Pros & Cons

Pros

• Strong provider network across Ohio.
• Offers ACA, Medicare Advantage, Medigap, and STM plans.
• Travel Plus™ extends Medicare coverage outside Ohio.
• Expanded 2026 benefits, including dental and telehealth.
• Competitive Medicare pricing, with $0 PCP visits.

Cons

• Coverage limited mostly to Ohio.
• No Medicaid or student plans.
• High complaint rates and service issues.
• Modest premium increases in 2026.
• Limited tech innovation compared to peers.

Coverage Area (2026)

United States

Medical Mutual offers its full suite of ACA, Medicare, and group health plans throughout Ohio. Though it maintains licenses in neighboring states (GA, IN, MI, NC, PA, SC, WI, WV), ACA and Medicare offerings are exclusive to Ohio residents. For state employee options, refer to the State of Ohio Medical Mutual enrollment portal.

International

Medicare Advantage members may access global emergency care up to $50,000. Routine care outside of Ohio is also supported through MedMutual Travel Plus™, which offers in-network cost sharing in many locations.

Provider Network

Medical Mutual operates one of the largest networks in Ohio. The SuperMed® PPO delivers extensive statewide access, while the MedFlex™ network targets value-based care with more selective participation.

Plan Types Offered (2026)

Under-65 (Individual & Family)

• ACA Marketplace Plans
  Medical Mutual offers a range of ACA-compliant HMO, PPO, and HDHP plans with preventive care, Rx coverage, telehealth, and wellness benefits.
• Short-Term Medical (STM)
  Bridge coverage of up to 364 days is available, ideal for gaps between major medical enrollments.
• Employer-Sponsored Plans
  Custom-designed options for small and large groups are available with access to SuperMed® and MedFlex™ networks and optional dental and vision coverage.
• Student Health Plans
  Not actively marketed as a distinct product line.
• Medicaid
  Not offered under the Medical Mutual brand.

Medicare (65+)

• Medicare Advantage (MA)
  Available in most Ohio counties, these plans offer $0 PCP visits, bundled dental/vision/hearing, OTC benefits, and travel coverage.
• Medicare Supplement (Medigap)
  Plans A, C*, F*, High-Deductible F*, G, and N are available. (*Only for those eligible before 2020.)
• Part D Prescription Drug Plans
  Included in most MA plans; standalone Part D offerings may be available.
• Retiree Group Medicare
  Offered through employer group contracts but not publicly marketed.

Recent Changes in Cost and Options (2026)

Premiums and Rate Changes

Premiums have seen modest increases across ACA and Medicare offerings. Notably, the lowest-cost Medicare Advantage HMO remains at $0/month, while PPOs start at $93/month.

Out-of-Pocket Costs

Medicare Advantage plans now include in-network maximums as low as $3,000. ACA deductible levels remain competitive when paired with federal subsidies.

Medicare Advantage Updates

2026 enhancements include $3,000 dental benefits, increased eyewear/hearing allowances, and broader travel coverage features.

Plan Enhancements

Telehealth, virtual wellness coaching, and reward programs have been expanded for both ACA and MA members. STM plan options remain unchanged for 2026.

Network Agreements

No significant provider changes reported. The SuperMed® PPO remains the flagship network across the state.

Consumer Experience Snapshot

Complaint Index

Medical Mutual has higher-than-average complaint rates, largely related to claims delays, denials, and authorization policies.

Satisfaction Scores

No ACSI data available; customer feedback indicates room for improvement in service responsiveness and transparency.

Methodology

Our Health Insurance Rating Methodology scores insurers across five main categories, each rated on a scale of 1 to 10. The overall score is the average of: Coverage, Breadth and Accessibility, Plan Variety and Customization, Affordability and Value, Innovation and Care Quality, and Consumer Experience and Transparency. Categories assess provider reach, plan diversity, cost structure, care delivery, and member service experiences based on public data, filings, and expert analysis.

Bottom Line

Medical Mutual of Ohio remains a trusted name for Ohio residents seeking comprehensive ACA or Medicare coverage with strong provider access and reliable benefits. Its competitive pricing, expanded 2026 dental and wellness perks, and Medicare travel protections make it a solid option for in-state enrollees. However, its limited regional footprint and recurring service complaints suggest prospective members should carefully evaluate their priorities before enrolling.

Best for

Ohio residents seeking broad provider access, Medicare extras, and stable pricing.

Not ideal for

Out-of-state enrollees, national travelers, or those requiring seamless customer service.

Disclaimer

The views and opinions expressed are those of the authors and do not necessarily reflect the official policy or position of HealthCareInsider.com or HealthCare, Inc.