Q. Do I have to use a network provider for vision care services?
A. No, you have a traditional vision benefit plan which means you can use any provider to receive coverage.
Q.What is covered under my vision plan?
A. Under your vision benefits you have coverage for one routine vision exam and one set of lenses each year and one frame every two years. You can also receive contacts in place of glasses annually.
Q. Do I have to pay anything?
A. Yes, there is a copay for a routine vision exam and a copay for a pair of glasses. Your benefits pay 100% of our Traditional amount after the copays. You are responsible for any amount over the Traditional amount.
Traditional Amount – the maximum amount determined and allowed by Medical Mutual for a Covered Service provided by a Physician or Other Professional Provider based on factors, including the following:
- the actual amount billed by a Provider for a given service
- Center for Medicare and Medicaid Services (CMS)’s Resource Based Relative Value Scale (RBRVS)
- other fee schedules
- input from Participating Physicians and wholesale prices (where applicable)
- geographic considerations; and
- other economic and statistical indicators and applicable conversion factors.
Q. How do I submit a claim for reimbursement?
A. Many providers will submit claims on your behalf to Medical Mutual. If the provider will not submit the claim for you, you can find vision claim forms by logging into My Health Plan and looking on the Resources & Tools tab or by calling Customer Service.
You will need to complete the claim form and attach an itemized receipt including the patient’s name, description of service and cost for each item. Please submit both of these together in a fax or email to:
Gallagher Benefit Services
Wildcat Health & Wellness Center
Q. Who can use the Health & Wellness Center?
A. All eligible employees from the Mayfield City School District and their dependents 25 years of age and younger regardless of if they have their insurance through the District. Eligibility is based on receiving a Board of Education paid term-life insurance policy and proof of applicable dependents may be required. Students and residents of the district are not eligible at this time.
Q. How much does it cost to use the Health & Wellness Center?
A. There is no cost for an office visit at the Health & Wellness Center.
Q. Will there ever be a cost?
A. There will not be a charge for the actual appointment, however, there may be a charge for any service that is performed offsite (outside of the Health & Wellness Center). Examples may include lab work, x-rays, prescriptions, referrals, etc. We are working with the Cleveland Clinic to provide a better definition and/or explanation of possible out of pocket expenses.
Q. What do I need to bring to my visit/appointment?
A. Insurance card, List of Medications, Pharmacy Number & List of Dependents (if any)
Q. Can the Health & Wellness Center be used for Van, Bus or Sports Physicals?
A. Yes, but additional coordination and discussions with Cleveland Clinic personnel are required. More to follow on this topic.
Q. Where is the Health & Wellness Center located?
A. It’s attached to Mayfield High School on the East Side next to the Wildcat Sport and Fitness main entrance (formerly known as the Pool & Field house complex).
Q. What are the hours of operation?
A. Normal operating hours are Monday, Wednesday and Thursday 7am-5pm. Please note that when school is closed, the Health & Wellness Center is also closed. Days are subject to change when school is closed.
Q. Is an appointment required?
A. An appointment is not required and the Health & Wellness Center will normally operate on a first come, first serve walk-in basis. However, appointments will be accepted and can be scheduled by calling 440.995.7600.
Q. What kinds of health & wellness services are provided?
A. Check-ups, Preventive Care, Annual Mayfield Schools Wellness Exams, Health Conditioning, Physical Exams, Sprains, Strains, Coughs and Colds, Injuries, Burns, Cuts and Scrapes. Musculoskeletal Problems, Sinus Problems, Bronchitis, Headaches, Flu Symptoms, Sore Throats, Ear Aches, Pink Eye, Skin Rashes, Bladder Infections, Blood Pressure Monitoring and Control, Weight Management, Chronic Disease Management, Back Pain, etc.