Medical Mutual may drop ProMedica as in-network provider in Toledo area

TOLEDO, Ohio — A potential contract dispute between ProMedica and Medical Mutual of Ohio could lead to major changes for patients starting next year.

Medical Mutual has notified customers that if a new agreement is not reached, ProMedica hospitals, clinics, and physician services may become out-of-network beginning Jan. 1, 2026. Coverage through Paramount Health Care plans – a ProMedica-owned insurer that is currently part of Medical Mutual – may also be affected starting May 1, 2026.

If no deal is signed before those dates, patients receiving non-emergency care from ProMedica providers may be forced to pay out-of-network rates, which typically result in much higher out-of-pocket costs.

The potential change could impact a large number of northwest Ohio residents who rely on ProMedica for care and use Medical Mutual as their insurance provider. The affected facilities include:

• ProMedica Toledo Hospital
• ProMedica Flower Hospital
• ProMedica Bay Park Hospital
• Toledo Children’s Hospital
• Numerous ProMedica-owned urgent care centers and medical offices throughout the region

Unless emergency care is involved, services at these locations may no longer be covered at the in-network level.

University of Toledo officials have informed employees that ProMedica will remain Tier 2 for Medical Mutual plans through the end of 2025. This means employees can continue accessing ProMedica care at a reduced benefit level for the rest of this year. However, coverage for 2026 remains uncertain.

Medical Mutual customers are encouraged to:

• Check their current plan details and contact customer service to understand how out-of-network billing might affect them.
• Reach out to their employer’s HR department for updates on potential plan changes or guidance for 2026.
• Stay informed as negotiations continue and more information becomes available.

ProMedica and Medical Mutual have not released public statements detailing the status of negotiations, and there is no confirmed resolution at this time.

This is a developing story. WTOL 11 will continue to provide updates as new information becomes available.