OCT Medical Benefits

Medical Mutual Supermed PPO

Medical Benefits provide important financial protection in the event you or a covered family member needs medical care for non-occupational illness or injury.

The Fund’s comprehensive medical benefit provides you and your dependents with coverage when you need it most. Below are just some of the benefits included under the medical coverage:

  • Office Visits (including Primary Care, Specialist, Urgent Care and Telehealth)
  • Preventive Screenings and Exams
  • X-Rays and Laboratory Expenses
  • Hospital Room and Board
  • Emergency Medical Treatment
  • Inpatient and Outpatient Surgeries
  • Chemotherapy
  • Chiropractic & Podiatry Care
  • Mental Health and Substance Abuse
  • Organ Transplant
  • Physical, Occupational and Speech Therapies
  • Hospice Care

In-Network vs. Out of Network

The Fund uses the Medical Mutual Supermed PPO provider network, allowing you to see any provider you choose without needing a referral to see a Specialist or designating a Primary Care Physician before seeking care. Medical Mutual has special arrangements and receives certain discounts from participating providers, which means if you use an in-network provider, you also pay a lower coinsurance percentage.

To locate a Network Doctor or Hospital in Ohio, visit the Medical Mutual website at www.medmutual.com and click on the Find a Doctor button. If you live outside of Ohio, Medical Mutual partners with Aetna to provide you their Open Choice network, giving you access to more in-network providers wherever you reside. To find a provider in the Aetna Open Choice network, call 1-888-238-6277.

Benefit Exclusions and Limitations

While the Plan covers most medically necessary and preventive care, there are several procedures that are specifically excluded by the Plan. These include things that are cosmetic in nature, weight loss or infertility treatments, work related illnesses and the like. Please check the list of exclusions for your specific plan by referencing the Summary Plan Description (SPD) booklet. If you do not have a copy readily available, check the Documents page of our website or contact the Fund Office.