Using Medical Mutual at Monarch Ideal Care in Fairlawn & Akron
Monarch Ideal Care welcomes patients with private, commercial Medical Mutual plans for in-person primary care visits.
Because insurance plans vary, it's important to understand eligibility, cost-sharing, and billing responsibilities before scheduling.
Confirming Provider Eligibility Is Your Responsibility
Before scheduling, patients should verify that Dr Leslee Mcelrath is an approved physician within their specific Medical Mutual plan.
Insurance networks vary by:
Employer group
Marketplace vs private plans
Plan tier (HMO, PPO, EPO, et)
We strongly recommend confirming provider eligibility directly with your insurance company to avoid unexpected charges.
Understanding Your Insurance Costs (Important)
Many billing concerns come from misunderstanding how insurance works. Below is a simple breakdown:
Copay
A fixed amount you may owe at the time of your visit (for example, $25 or $40), depending on your plan. At Monarch Ideal Care we charge a standard $30 to schedule your appointment to cover the copay amount.
Deductible
The amount you must pay out-of-pocket each year before insurance begins paying for covered services. This number resets to $0 each January 1st.
Coinsurance
After your deductible is met, some plans require you to pay a percentage of the visit cost (for example, 20%), while insurance covers the rest.
Out-of-Pocket Maximum
The maximum amount you'll pay in a year for covered services. Once reached, insurance typically covers 100% of eligible costs for the remainder of the year.
If you're unsure how these apply to your plan, your insurance company is the best source for clarification.
Billing & Payment Policy (Please Review)
After your insurance claim has fully processed:
Any remaining balance is your responsibility
A statement will be issued for the amount owned
Practice policy:
Once a balance has been billed and insurance has completed processing, future appointments cannot be scheduled until the balance is paid.
This policy helps prevent unexpected of accumulating balances and ensures transparency for all patients.
When Insurance Is a Good Fit — And When It May Not Be
Insurance-based care may work well if you:
Prefer daytime weekday appointments
Are comfortable with insurance billing and cost-sharing
Don't need frequent communication between visits
If you want longer visits, evening or weekend availability, or direct messaging with your doctor, membership options may be a better fit.
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