Medical benefits provide you and your family with financial protection and access to quality health care. ÐÇ¿Õ´«Ã½ medical plans cover expenses for pre-existing conditions. With Benelect, you have several medical plans and coverage levels from which to choose.
Healthcare costs can vary widely depending on where you go and whom you see. Hospitals, clinics and doctor’s offices charge different amounts for the same services, and costs can vary widely. Medical Mutual provides a cost estimator that can help find the most cost-effective services called My Care Compare. You can access My Care Compare through .
Please remember that My Care Compare and other cost estimators are estimators – the amounts they list are an estimate of the service charges, and what you are charged can be different. Medical Mutual is committed to full compliance with federal law and regulations concerning and . For more information on this review the Medical Mutual website pertaining to the
Preferred Provider Organization (PPO)
Medical Mutual
The SuperMed Plus PPO allows you full access to medical care from any physician or hospital in the provider network (). Medical Mutual of Ohio (MMO) offers SuperMed Plus, which uses an extensive network of hospitals and physicians, but the ultimate choice of provider is yours. SuperMed Plus also includes coverage for medical emergencies in your area, or wherever you travel. For more information view the MMO health benefits FAQ or .
- View the Medical Mutual Supermed Plus Certificate of Coverage - Plan 1
- View the Medical Mutual Supermed Plus Certificate of Coverage - Plan 2
- View the Medical Mutual Supermed Plus Certificate of Coverage - Plan 3
Health Maintenance Organization (HMO)
The CLE-Care HMO plan provides comprehensive coverage in collaboration between Medical Mutual of Ohio and The MetroHealth System.
CLE-Care HMO gives members access to MetroHealth's expert doctors and health care providers and to Medical Mutual's expertise in managing health plans.
- View the CLE-Care Certificate of Coverage
- View the MetroHealth Location Map and Information
- View Welcome to CLE-Care Information
High Deductible Health Plan (HDHP)
The high deductible health plan (HDHP) and Health Savings Account (HSA) combine comprehensive medical coverage and a tax-advantaged savings account. The HDHP provides access to high-quality health care through the plan's provider network. The plan pays a large part of medical costs after the deductible is met and your expenses are limited by an out-of-pocket maximum. The HDHP does have a higher deductible, but the deductible can be offset by employee contributions to an HSA.
Medical Savings
You should not participate in the health care flexible spending account (FSA) under this option. Instead, you have a different medical savings option available to you.
The medical savings feature is a Health Savings Account, an IRS-qualified feature that provides substantial tax savings and participant flexibility. You, as the employee, own the account, which means that your account balances roll over from year to year, even when you leave the university.
The account has the flexibility to be used for current medical expenses, or money can be left in the account to save for future health care expenses. Contributions, interest and investment earnings are not subject to federal, state or Federal Insurance Contributions Act (FICA) taxes.
You must be enrolled in the HDHP to contribute to an HSA. You cannot contribute to an HSA if you are enrolled in a medical plan that is not a high deductible plan. For example, if you are enrolled in Medicare, have secondary coverage through a spouse's plan, or your spouse has a medical flexible spending account that can be used to reimburse family member expenses, you may not be eligible to contribute to an HSA.
Medical Coverage Level
With Benelect, you can choose from several medical plans and coverage levels. Once you choose the medical option that is right for you, you also choose the number of people to cover. You may choose from these coverage categories:
- Employee
- Employee + Child(ren)
- Employee + Spouse (Equivalent)
- Employee + Family
Waive Medical Coverage
If you already have medical coverage, another option is "waive." You can choose this option only if you indicate that you have coverage under another medical plan when you enroll.
Coordination of Benefits
If you or your family members are covered by more than one health care plan, you may not be able to collect benefits from both plans. Each plan may require you to follow its rules or use specific doctors and hospitals, and it may be impossible to comply with both plans at the same time.
Read all of the rules very carefully, including the coordination of benefits section in the plan material and compare them with the rules of any other plan that covers you or your family.
Working Spouse Premium Surcharge
If your spouse or equivalent has access to a health plan through their employer, but you choose to cover her/him through Benelect, you will pay a premium surcharge.