MedMutual Advantage Premium (PPO)

by Medical Mutual of Ohio

2026 Medicare Advantage plan available in Ohio

Plan ID H4497-003-3

Additional coverage:

RxHearingVisionDental

Medicare Advantage PPO 4.5 Overall

Monthly plan premium $149 / mo

Annual deductible $1,500 / yr

Max out-of-pocket · in-network $3,450 / yr

Drug deductible $55 / yr

4.5 Overall Government Star Rating 2026 · out of 5 stars

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Plan Overview

MedMutual Advantage Premium (PPO) is a Medicare Advantage Plan With Part D Prescription Drug Coverage, which is available in Ohio and offered by the health insurance company Medical Mutual of Ohio. This plan's network type is PPO, which determines the in-network doctors who accept the plan and whether a referral is needed.

Plan Name MedMutual Advantage Premium (PPO)

Insurance Carrier Medical Mutual of Ohio

Plan Type Medicare Advantage Plan With Part D Prescription Drug Coverage

Network Type PPO

Cost Summary

MedMutual Advantage Premium (PPO) has a monthly premium cost of $149 per month, with an annual deductible of $1,500 annual deductible and a maximum out-of-pocket cost sharing of $3,450. The most common costs people evaluate when choosing a plan are listed here; a full list of benefit costs is defined below.

Monthly Premium $149 / mo

Health portion of premium $30

Drug portion of premium $119

Annual Deductible $1,500 annual deductible / yr

Max Out-of-Pocket · in-network $3,450 / yr

Primary doctor visit $0 copay

Specialist visit $30 copay

ER visit $150 copay

Ambulance $235 copay

Additional Benefits and Coverage

MedMutual Advantage Premium (PPO) is a Medicare Advantage plan which includes Medicare Part D prescription drug coverage. Other common benefits included with Medicare Advantage plans are coverage for dental, vision, and hearing. MedMutual Advantage Premium (PPO) includes coverage for hearing, vision, dental.

Part D Prescription Drug Coverage Yes

Dental Yes

Vision Yes

Hearing Yes

Nationwide Coverage No

Other benefits

Fitness benefit Limited coverage

Over-the-counter drug benefits Limited coverage

In-home support services Not covered

Home & bathroom safety devices Not covered

Meals for short duration Limited coverage

Annual physical exams Limited coverage

Telehealth Limited coverage

Medical Benefits

Doctor Services

Primary doctor visit In-network: $0 copay
Out-of-network: 30% coinsurance

Specialist visit In-network: $30 copay
Out-of-network: 30% coinsurance

Tests, labs & imaging

Diagnostic tests & procedures In-network: $10 copay
Out-of-network: 30% coinsurance

Lab services In-network: $10 copay
Out-of-network: 30% coinsurance

Diagnostic radiology services (like MRI) In-network: $100-$175 copay
Out-of-network: 30% coinsurance

Outpatient x-rays In-network: $50 copay
Out-of-network: 30% coinsurance

Emergency care $150 copay

Urgent care $30 copay

Hospital Services

Inpatient hospital coverage In-network:
  Tier 1
  $335 per day for days 1-6
  $0 per day for days 7-90
  $0 per stay
Out-of-network:
  30% per stay

Outpatient hospital coverage In-network: $345 copay
Out-of-network: 30% coinsurance

Skilled nursing facility

Skilled nursing facility In-network:
  Tier 1
  $20 per day for days 1-20
  $218 per day for days 21-100
Out-of-network:
  30% per stay

Preventive services

Preventive services In-network: $0 copay
Out-of-network: 30% coinsurance

Ambulance

Ground ambulance In-network: $235 copay
Out-of-network: $235 copay

Therapy services

Occupational therapy visit In-network: $45 copay
Out-of-network: 30% coinsurance

Physical therapy & speech & language therapy visit In-network: $40 copay
Out-of-network: 30% coinsurance

Mental health services

Outpatient group therapy with a psychiatrist In-network: $30 copay
Out-of-network: 30% coinsurance

Outpatient individual therapy with a psychiatrist In-network: $30 copay
Out-of-network: 30% coinsurance

Outpatient group therapy visit In-network: $30 copay
Out-of-network: 30% coinsurance

Outpatient individual therapy visit In-network: $30 copay
Out-of-network: 30% coinsurance

Opioid treatment services

Opioid treatment services Covered

Other services

Durable medical equipment (like wheelchairs & oxygen) In-network: 20% coinsurance
Out-of-network: 50% coinsurance

Prosthetics (like braces, artificial limbs) In-network: 20% coinsurance
Out-of-network: 30% coinsurance

Diabetes supplies In-network: 0%-20% coinsurance
Out-of-network: 20% coinsurance

Prescription drugs (Part D benefits)

Drug tier standard retail · 1-month supply Initial coverage Catastrophic

Preferred Generic $6.00 copay $0 copay

Generic $12.00 copay $0 copay

Preferred Brand 23% coinsurance $0 copay

Non-Preferred Drug 43% coinsurance $0 copay

Specialty Tier 32% coinsurance $0 copay

Part B drugs

Chemotherapy drugs In-network: 0%-20% coinsurance
Out-of-network: 0%-20% coinsurance

Other Part B drugs In-network: 0%-20% coinsurance
Out-of-network: 0%-20% coinsurance

Medicare star rating

Each year the federal government rates Medicare Advantage and Part D plans on a 5-star system covering quality of care, chronic-condition management, member experience, and customer service. For 2026, MedMutual Advantage Premium (PPO) earned an overall rating of 4.5 stars — better than Ohio's state average of 3.9 stars.

Rating category This plan State average

Overall star rating ★ 4.5 3.9

Health plan quality

Summary rating of health plan quality ★ 4.5 3.8

Staying healthy: screenings, tests & vaccines ★ 4.0 3.4

Managing chronic (long-term) conditions ★ 3.0 3.4

Member experience with health plan ★ 5.0 4.1

Member complaints & changes in performance ★ 5.0 3.9

Health plan customer service ★ 4.0 4.2

Drug plan quality

Summary rating of drug plan quality ★ 4.0 3.7

Drug plan customer service ★ 4.0 4.5

Member complaints & changes in performance ★ 4.0 3.8

Member experience with the drug plan ★ 5.0 4.0

Drug safety & accuracy of drug pricing ★ 4.0 3.7

Extra Benefits

Hearing

Hearing exam In-network: $0 copay
Out-of-network: $0 copay

Fitting/evaluation Not covered

Hearing aids - prescription In-network: $499-$999 copay
Out-of-network: $499-$999 copay

Hearing aids - over the counter Not covered

Preventive dental

Oral exam In-network: $0 copay
Out-of-network: 50% coinsurance

Cleaning In-network: $0 copay
Out-of-network: 50% coinsurance

Fluoride treatment In-network: $0 copay
Out-of-network: 50% coinsurance

Dental x-rays In-network: $0 copay
Out-of-network: 50% coinsurance

Comprehensive dental

Restorative services In-network: 30% coinsurance
Out-of-network: 50% coinsurance

Endodontics In-network: 50% coinsurance
Out-of-network: 70% coinsurance

Periodontics In-network: 50% coinsurance
Out-of-network: 70% coinsurance

Prosthodontics, removable Not covered

Prosthodontics, fixed Not covered

Maxillofacial prosthetics Not covered

Implant services Not covered

Oral and maxillofacial surgery In-network: 30% coinsurance
Out-of-network: 50% coinsurance

Orthodontics Not covered

Adjunctive general services In-network: 30% coinsurance
Out-of-network: 50% coinsurance

Vision

Routine eye exam In-network: $0 copay
Out-of-network: $50 copay

Contact lenses In-network: $0 copay
Out-of-network: $0 copay

Eyeglasses (frames & lenses) In-network: $0 copay
Out-of-network: $0 copay

Eyeglass frames (only) Not covered

Eyeglass lenses (only) Not covered

Upgrades Not covered

Plan documents & tools

Plan details (carrier site)Provider directory Drug list (formulary)

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