Quick Links
See how easy it is to get free quotes…
Safe, Secure & Absolutely FreeThis website's security is certifed by:
Medical Mutual of Ohio - SuperMed One – SuperMed One HSA 5000 – OHIO
A comparison of the SuperMed One HSA 5000 offered by Medical Mutual of Ohio - SuperMed One is detailed out below for both Network and Non-Network coverage.
| Network | Non-Network | |
|---|---|---|
|
||
| Network | See Provider | See Provider |
| Application | SuperMed One HSA 5000 Application | SuperMed One HSA 5000 Application |
| Brochure | SuperMed One HSA 5000 Brochure | SuperMed One HSA 5000 Brochure |
| Copay | N/A | N/A |
| Office Visit | 100% after deductible | 50% after deductible |
| Deductible | Individual $5,000, Family $10,000 | Individual $10,000, Family $20,000 |
| Coinsurance | 100% | 50% |
| Coinsurance Limit | N/A | (Excluding the deductible) Single $4,000, Family $8,000 |
| Out-of-Pocket Maximum | N/A | (Excluding the deductible) Single $4,000, Family $8,000 |
| Lifetime Maximum | $7,500,000 | $7,500,000 |
| Prescription Drugs | 100% after deductible | 50% after deductible (Home Delivery Not Covered). |
| Emergency Room | 100% after deductible | 100% after deductible (50% after deductible if it is a non-emergency) |
| Adult Preventative Care | Routine Physical Exam 80% after deductible; Routine Mammogram, Routine Pap test, Routine EKG, Chest X-ray, Comprehensive Metabolic Panel, Urinalysis and Complete Blood Count (one each per benefit period)- 100% after deductible. | Well Child Care Services to age nine. Exams and Immunizations are limited to a $500 maximum per benefit period; Well Child Care Exams 50% after deductible; Well Child Care Immunizations and Labs 50% after deductible |
| Child Preventative Care | Well Child Care Services to age nine. Exams and Immunizations are limited to a $500 maximum per benefit period;Well Child Care Exams: 100% after deductible;Well Child Immunizations and Labs 100% after deductible. | Well Child Care Services to age nine. Exams and Immunizations are limited to a $500 maximum per benefit period; Well Child Care Exams 50% after deductible; Well Child Care Immunizations and Labs 50% after deductible |
| Lab / X-Ray | 100% after deductible | 50% after deductible. |
| Maternity | Not Covered | Not Covered |
| Physical Therapy | 20 visits per benefit period covered at 100% after deductible. | 20 visits per benefit period covered at 50% after deductible. |
| Skilled Nursing | $10,000 maximum per benefit period covered at 100% after deductible. | $10,000 maximum per benefit period covered at 50% after deductible. |
| Home Health Care | 60 visits per benefit period covered at 100% after deductible. | 60 visits per benefit period covered at 50% after deductible. |
| Mental Health | Inpatient- 30 days per benefit period; Substance Abuse limited to one admission per benefit period, three admissions per lifetime: 100% after deductible;Outpatient- 20 visits per benefit period, 50% after deductible. | Inpatient- 30 days per benefit period; Substance Abuse limited to one admission per benefit period, three admissions per lifetime: 50% after deductible;Outpatient- 20 visits per benefit period, 50% after deductible. |
| Hospital Care | 100% after deductible | 50% after deductible. |
| Optional Benefits | see brochure | see brochure |