Medical Mutual - Health Plans for Life

Cultural Competence Form

Medical Mutual recognizes that some Covered Persons have special needs or preferences that may affect the administration of their health plan or their ability to obtain medical services. If you are a provider who can address the special needs or preferences of the Company Covered Persons who speak a language other than English, who are visually impaired, or who have specific social/cultural needs, then we need your help. Please notify the Company of the other language(s) you speak, the special service you provide, or the need or preference you are able to address by completing and submitting the form below. The information you provide will be kept in a database and referenced when a Covered Person calls us with special needs.

Please Note: In order for us to provide you with this service, you will need to supply the requested information.

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Cultural Competence Form

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