Compare Our Plans
MediGold offers two HMO plan options to fit your needs. To help you determine which plan is best for you, use the chart below to compare the benefits available with each of our plans. If you would like more detailed information (Summary of Benefits) on any of the plans listed below, click on the plan name at the top of the chart.
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2013 |
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Monthly MediGold Premium |
$0 |
$99 |
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Annual Deductible |
$0 |
$0 |
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Annual Out-of-Pocket Maximum Protection |
$3,200 | $3,200 | |||
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Medical Benefits |
Your copay: |
Your copay: |
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|
Doctor Office Visits (Primary Care) |
$5 |
$0 |
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|
Doctor Office Visits(Specialty Care) |
$45 |
$25 |
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Lab Tests, Home Health Care, and Medicare-covered Preventive Services |
$0 |
$0 |
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Hospital Admission |
$225 per day for days 1-7 Ask about our inpatient out-of-pocket maximum protection! |
$0 per stay |
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|
Outpatient Diagnostic Test or X-Ray |
$55 |
$15 |
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Outpatient Surgery |
$250 |
$125 |
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Diabetic Supplies |
0% |
0% |
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|
Emergency Room Visit |
$65 |
$65 |
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|
Prescription Drug Benefits (Part D) |
Your copay for a |
Your copay for a |
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|
Tier 1 - Preferred Generic Drugs |
$0 Tier 1 drugs covered through the gap. |
$0 Tier 1 drugs covered through the gap. |
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|
Tier 2 - Non-Preferred Generic Drugs |
$12 |
$10 Tier 2 drugs covered through the gap. |
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|
Tier 3 - Preferred Brand Drugs |
$45 |
$38 |
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Tier 4 - Non-Preferred Brand Drugs |
$75 |
$50 |
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Tier 5 - Specialty Tier Drugs |
33% |
33% |
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Dental Benefits |
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MediGold's 2013 Dental Plan may be separately purchased by new and existing MediGold members. The plan is administered by Delta Dental for a monthly premium of $24. Learn more about MediGold's Dental Plan. |
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Last Updated 12/7/2012 6:10:14 PM