Medical Mutual of Ohio for Therapy

Medical Mutual of Ohio is a health insurance company serving residents of Ohio. The company offers health insurance plans for individuals, families, and employers, including Medicare plans. Many of their plans provide members with access to mental health benefits, including for therapy sessions.

Does Medical Mutual of Ohio cover therapy?

Yes, many of the Medical Mutual of Ohio plans provide coverage for therapy services. This can be good news for your budget, as you won’t be required to pay as much out-of-pocket for mental health care. However, the amount of coverage depends on your specific health insurance plan. Because Medical Mutual of Ohio offers multiple insurance plans, the coverage rates vary widely.

How do I check if my Medical Mutual of Ohio plan covers therapy?

To check if your Medical Mutual of Ohio health insurance plan covers therapy services, locate and read through your Summary of Benefits document. If you receive your Medical Mutual of Ohio plan through your employer, you can ask your HR team for a copy of this document. Otherwise, you can find it through the online portal. Within this document, you’ll find information about how much coverage you receive by service type. Search for the “Mental health care” section and look under “Outpatient individual therapy visit.” This is where you’ll see coverage information broken into in-network and out-of-network rates.

You can also give the phone number on the back of your insurance card a call to speak with a customer service representative about what costs you’ll be responsible for when you use your Medical Mutual of Ohio plan for therapy services.

How much does therapy cost with Medical Mutual of Ohio?

You might be responsible for a $25-45 copay for therapy sessions with an in-network therapist or a 30% coinsurance rate when working with an out-of-network therapist. Working with an in-network therapist is a more budget-friendly option, as you’ll only need to pay a set copay at each session. You’ll still save money when you see an out-of-network therapist, but it may be a portion of the overall session fee. That means the more costly your therapist’s session fee, the more you’ll need to pay.

However, your insurance plan may be different, so you might pay more or less for therapy services. Because Medical Mutual of Ohio offers so many plans, how much you’ll pay is based on your specific plan’s benefits. Be sure to read through your Summary of Benefits document thoroughly so you aren’t surprised with any costs.

What types of mental health conditions does Medical Mutual of Ohio cover?

Medical Mutual of Ohio plans offer therapy benefits for a wide range of mental health conditions. However, to reimburse therapists or clients, Medical Mutual of Ohio requires that each client receive a diagnosis from their therapist. This diagnosis guides treatment and insurance coverage and enables insurance processes.

There are many mental health conditions and diagnoses, including but not limited to:

What types of therapy does Medical Mutual of Ohio cover?

Medical Mutual of Ohio will only provide coverage for therapy sessions with credentialed mental health professionals. This could include psychiatrists, psychologists, social workers, counselors, and more. As long as your therapist provides an evidence-based, clinically rigorous therapy modality that is appropriate for your specific situation, Medical Mutual of Ohio will help you cover some of the therapy costs.

Here are a few therapy approaches that have clinical research supporting their efficacy:

Often, therapists will blend together multiple approaches, which can be called “eclectic therapy” or “integrative therapy.” Medical Mutual of Ohio deems these approaches eligible for reimbursement as long as the therapist is credentialed and can identify the specific approaches used in session.

What types of therapy does Medical Mutual of Ohio NOT cover?

Medical Mutual of Ohio does not cover life coaching or career counseling, as these are generally based on goals instead of clinical rigor. Medical Mutual of Ohio also does not cover holistic treatment modalities like aromatherapy, massage therapy, or non-medically required acupuncture. There is no coverage for energy work such as reiki healing. Hypnosis, ketamine, and psychedelic treatments are also not covered, even if in treatment of a mental health condition.

Does Medical Mutual of Ohio cover online therapy?

Yes, Medical Mutual of Ohio offers coverage for online therapy — and they actively encourage it. For some plans, they’ll offer to reduce your copay or coinsurance if you meet with a teletherapy provider, making therapy and mental health care affordable and accessible.

Your coverage for therapy costs will remain the same, whether you visit your therapy in-person or online. This includes the same copayments and coinsurance rates.

Does Medical Mutual of Ohio cover couples therapy?

Similar to other health insurance companies and plans, Medical Mutual of Ohio does not provide therapy benefits for couples therapy. This is generally true because insurance companies cannot easily track couples’ diagnoses or progress in their treatment.

However, many couples could still benefit from seeing a therapist together. There may be ways to decrease the cost of couples counseling, such as sliding scale.

Do I need to see my primary doctor before starting therapy?

Medical Mutual of Ohio provides both HMO and PPO plans, so whether or not you need a referral from your primary care doctor before starting therapy depends on what kind of plan you have. If your plan is an HMO plan, then you will need to get a referral for specialist services from your primary doctor. However, this is typically a straightforward and common process that should not hinder your access to mental health services.

If you have a PPO plan, then you do not need a referral before starting therapy, and you can begin your therapy journey with a great therapist as soon as you’re ready.