Tag Archives: Medical Mutual

Healthcare Insecurity

The brand-new barrier that Ohio and Medical Mutual have put between patients and healthcare: the elimination of PPOs in the individual market.

While ProMedica doctors survey their patients’ “Food Insecurity,” (ones who can get in to see ProMedica docs, because when you call them from the insurers’  lists of accepting new patients, they actually really are NOT accepting new patients) I’m experiencing “Healthcare Insecurity.”

Medical Mutual eliminated our “real insurance” PPO plan on December 31, 2016. In 2013, their PPO was the only kind of insurance they offered to individuals, and there were 101,380 of us covered by their PPO insurance, more than 25% of the entire Ohio individual market and the biggest market share of any insurer in the state and it remained like that through 2015, but in 2017, Medical Mutual , after raising our rates more than 300% during those three short years, is putting us all out on the street.

No more PPOs anymore for the individuals of Ohio who buy their own health insurance — only skinny, extremely inaccurate provider networks for us.

We must either resign ourselves to our fate, that can we no longer have the best healthcare, like the people have who work for the state of Ohio or for big corporations, or we must marry for health insurance, simply so we can have a chance for decent healthcare along with everyone else.

To think that Mary Taylor and the state of Ohio did not look out for us when Medical Mutual withdrew PPO insurance from the individuals. Not a peep about the pending doom, and my complaint got buried.

Yet the state of Ohio gives themselves Medical Mutual’s PPO as the state employees’ health insurance. In fact, in the past nine years, Medical Mutual made an average of $192,000,000 per year insuring Ohio state workers.

Shouldn’t the state of Ohio have said to Medical Mutual, if they were going to eliminate PPOs for individuals, thereby hurting 100,000 Ohioans directly and damaging the options of all Ohioans, then they will no longer be getting Ohio’s state employee insurance business?

The state of Ohio and Medical Mutual are working in concert to snuff out individuals. Are they stupid or are they sly foxes? What’s next — the state using grant money to give themselves an art show called “After Hours”?

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Medical Mutual Complaint, Example 6 – Accountability

"0" Premium before tax credit. November 27, 2015 credit shown for $62,000 income
$0 Premium before tax credit. Sign me up!

During last week’s preview week on healthcare.gov, Medical Mutual  offered duplicate plans, same name but one serial number off from other plans, that cost nothing. Zilch. $0. And then I couldn’t believe how much my premium was going up on the mirrored plan that was not $0. What a great deal – those $0 plans! So I called Medical Mutual to ask more details about the $0 Premium before tax credit offerings on healthcare.gov, because the $0 plan was clearly offered to me. These are direct quotes from Naomi in the Medical Mutual sales department on October 27:

You have to talk to the Marketplace. I don’t see the plan. I can’t look it up by plan number. You just popped up on the line and I answered your call.

I cannot look up plans by plan number, you have to go back to the Marketplace. Marketplace is administrating the plan.

Your premium went up because the federal government regulates that and they increased everyone’s premium.

You’re asking me to look up a plan on a different company’s website that I can’t see.

You want me to have all the answers as to why there is a free plan on the healthcare.gov website and it is offered to you.

We don’t have info on the plans offered on healthcare.gov, you have to go to them. It’s a different entity.

I can’t give you false information. I can but I’m not going to do that.

I cannot look up a policy that we do not offer.

It’s federally facilitated, different from Medical Mutual.

I can’t answer your questions because they are offered through healthcare.gov.

Sounds like it’s for medicaid.

We have no information on it. Nobody answers questions about plans on healthcare.gov. It’s through the government. You need to contact healthcare.gov because it’s offered through healthcare.gov. For this plan you have to call healthcare.gov.

When I spoke to Stacey at healthcare.gov on October 27, he duplicated everything I did on his screen and came up with the same results I was getting and these are his direct quotes:

I thought that was their job. (He said when I told him Medical Mutual told me I had to ask healthcare.gov about their plans.)

I would think that, and I’m putting them side by side, they are identical.

I don’t know why it says “child” because it covers adults and children.

This plan has costs and this doesn’t. I don’t understand, I really think that Medical Mutual should have been able to tell you some basic information.

I see this plan and all the details that it consists of, and it would seem you would pay “0” dollars.

This seems like the one to get, and when its says premium before tax credit is “0” you don’t even need a tax credit.

It’s like a trick, like smoke and mirrors.

It is very bizarre. They are nearly identical to the other plan, they are only one number off in the plan ID so I understand your concern.

I have never really experienced this in this way.

It seems as if it is supposed to be “0” dollars, or it is a trick.

It’s ridiculous, it’s their plan, it’s their company and they won’t talk to you about it.

Here’s a phone number you can call, Ohio Department of Insurance, let them know what is going on. Let them know what we discussed, that I see the same thing you see.

So I took healthcare.gov’s advice, and after speaking with the Ohio Department of Insurance, I filed a consumer complaint against Medical Mutual for pricing and accountability and false advertising.

Page one of my consumer complaint, no. CSD-0034217
Page one of my consumer complaint, no. CSD-0034217