Medical Only (HMO)

MediGold Medical Only (HMO)

MediGold Medical Only (HMO) is a Medicare Advantage Health Maintenance Organization (HMO). The chart below provides a summary of the benefits available with this plan. You may also find it helpful to review the Annual Notice of Changes, Evidence of Coverage and Summary of Benefits documents. They provide information about this plan option in more detail.

2013	MediGold Medical Only (HMO)
Monthly MediGold Premium	$40
Annual Deductible	$0
Annual Out-of-Pocket Maximum Protection The most you could spend on medical care in 2013	New! $3,200
Medical Benefits	Your copay:
Doctor Office Visits (Primary Care)	New! $0
Doctor Office Visits(Specialty Care)	$25
Lab Tests, Home Health Care, and Medicare-covered Preventive Services	$0
Hospital Admission	$50 per day for days 1-7 $0 for additional days New! Ask about our inpatient out-of-pocket maximum protection.
Outpatient Diagnostic Test or X-Ray	$35
Outpatient Surgery	$125
Diabetic Supplies	0%
Emergency Room Visit	$65
Prescription Drug Benefits (Part D)	Part D not included

2013 MediGold Medical Only (HMO) Plan Documents

2013 MediGold Central Ohio Summary of Benefits - HMO Plans

2013 MediGold Medical Only (HMO) Evidence of Coverage

2013 MediGold Medical Only (HMO) Annual Notice of Changes

2012 MediGold Medical Only (HMO) Plan Documents

2012 MediGold Medical Only (HMO) Summary of Benefits

2012 MediGold Medical Only (HMO) Evidence of Coverage

2012 MediGold Medical Only (HMO) Annual Notice of Changes

Last Updated 5/9/2013 3:53:40 PM