Medical Mutual Insurance Coverage for Drug and Alcohol Rehab Treatment

Insurance coverage from Medical Mutual along with other insurance providers depends on what type of coverage you have and what types of treatments are medically necessary for you to receive. Medical Mutual does cover some treatment for substance abuse. They often cover detoxification and medically-assisted detox. They sometimes cover other treatments, such as inpatient and intensive outpatient treatment.

Insurance coverage will require a pre-authorization before you begin treatment. You can reach out to the company itself, or you can let us do the hard work. By verifying your insurance with us, we can navigate and negotiate with Medical Mutual to get the most out of your insurance.

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Table of Contents

How to Check Medical Mutual Coverage

You can easily reach out to Medical Mutual and talk to someone there. They also have an online portal where you can look up your coverage, find providers, and make claims. We have simplified the process by providing a verification form you can use. Submit your information below and we will let you know information about your insurance plan. Without speaking to you and going through a full evaluation there is no guarantee that treatment will be covered, this is just a preliminary check to help you understand your insurance plan design and patient responsibility prior to approval.

Who is Medical Mutual?

Medical Mutual is a health insurance provider based in Ohio. Medical Mutual is the oldest and largest health insurance company based in Cleveland, Ohio, and serves more than 1.6 million lives. Medical mutual employs 2,500 people, Medical Mutual is one of the biggest employers in downtown Cleveland.

Medical Mutual provides coverage to those that medically require substance abuse treatment. In fact, Medical Mutual was actually one of the first companies to coin what we know as health insurance today.

John R. Mannix first had the idea of pre-paid medical costs in 1926, and this actually led to the formation of the first-ever health insurance company in Ohio in 1934. This was a rather large deal, as it gave patients access to multiple hospitals.

Treatment Plans Medical Mutual May Cover

Coverage with Medical Mutual includes:

  • Medically Assisted Treatment (MAT)
  • Medical Detox
  • Inpatient Treatment
  • Outpatient Treatment

The beauty of health care reforms in recent years is that now every insurance provider is required to cover substance abuse treatment, and this has made it possible for you or a loved one to afford treatment.

Medical Mutual provides coverage for substance abuse treatment. So, those who hold a plan with this company can get at least partial financial assistance for addiction rehab services. It’s important to note, however, that coverage varies depending on your plan. Also, most often, inpatient and outpatient treatment depend on whether or not the treatment center is in-network. If the rehab center you select is, in fact, an in-network provider.

Types of Addictions Medical Mutual Typically Covers

With Cigna coverage for addiction treatment, you can expect that they will cover the major addictions that plague the country. Our partnership with Cigna allows us to treat you for almost anything you need help with.

Cigna may offer treatment coverage for the following addictions:

Is Rehab Confidential?

Laws stipulate that we cannot divulge your information to anyone, so yes we are confidential. You control who we speak to on your behalf and who is aware of your treatment. Insurance companies will require us to show proof that you have consented for coverage. After that, you must tell us who can know about your treatment and how much we can tell them.

Does Medical Mutual Cover Addiction Treatment In Ohio?

Insurance providers cover substance use disorder treatment. It’s important to understand if the treatment provider is in-network or out of network because the financial responsibility for patients is higher when you see an out-of-network provider. Aetna often covers individual therapy and cognitive behavioral therapy. It truly depends on the coverage you have and the treatment center that you attend.  The therapist creates a treatment plan that must be approved by the insurance company and be a medical necessity based on the conditions and diagnosis.

In Network Medical Mutual Providers Vs Out of Network Medical Mutual Providers

When you first enter treatment the first step is a comprehensive evaluation. Based on that evaluation, a treatment plan is designed which is reviewed by the insurance company. At this point, the insurance company will either approve or deny coverage. Treatment centers that are in-network have a pre-agreed contracted rate for every step of the treatment plan and associated level of care, which means there are no surprises when it comes to your bill (expenses).

In Network Medical Mutual Treatment Centers

We have in network-contracts at several of our locations including the following:

Other In-Network Insurances

At NewVista it is a priority for us to work with insurance companies so that you can receive the best care at an affordable price. This allows us to provide access to care for more individuals. Along with Medical Mutual, we also have in-network rates with Aetna, United Healthcare, Cigna, Humana, and BCBS of Ohio.


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