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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.

2015

MediGold Southeast OH Essential Care (HMO)

MediGold Southeast OH Classic Preferred (HMO)

Your Monthly Plan Premium

$0

$120

You will pay No Deductibles

$0

$0

You'll enjoy our Annual Out-of-Pocket Maximum for Added Protection

$3,200 $3,200

Medical Benefits Included!

Your copay:

Your copay:

Preventive Care

$0

$0

Fitness Center Membership

$0

$0

Flu Shots

$0

$0

Diabetes Supplies

$0

$0

Office Visit (Primary Care Provider)

$10

$0

Office Visit (Specialty Care Provider)

$45

$30

Outpatient Lab Test

$15

$0

Outpatient Diagnostic Test or X-ray

$60

$20

Outpatient Surgery

$275

$125

Urgent Care Visit

$45

$35

Emergency Room Visit

$65 Worldwide

$65 Worldwide

Inpatient Hospital Care (per stay)

Ask how we further limit your inpatient costs per year.

$285 per day for days 1-7


$0 after day 7

$0 per stay

Home Health Care

$0

$0

Prescription Drug (Part D) Benefits Included!

Note: 30, 60 or 90-day supply of drugs may be obtained from participating retail or mail order pharmacies. Extra Savings at mail. Ask about it!

Your copay for a 30-day supply:

Your copay for a 30-day supply: 

 

Tier 1 - Preferred Generic Drugs

$4

$0

Tier 2 - Non-Preferred Generic Drugs

$12

$15

Tier 3 - Preferred Brand Drugs

$45

$38

Tier 4 - Non-Preferred Brand Drugs

$90

$50

Tier 5 - Specialty Drugs

33%

33%

Coverage Gap discounts or benefits?

YES

YES

Dental Benefits

MediGold's 2015 Dental Plan may be separately purchased by new and existing MediGold members. The plan is administered by Delta Dental for a monthly premium of $23. Learn more about MediGold's Dental Plan.

Last Updated 9/30/2014 9:38:31 AM