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Mount Carmel MediGold Glory No RX (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Mount Carmel MediGold Glory No RX (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Mount Carmel MediGold Glory No RX (HMO) in 2026, please refer to our full plan details page.
Mount Carmel MediGold Glory No RX (HMO) is a HMO plan offered by Trinity Health Corporation available for enrollment in 2025 to people living in Central, Southwest, and Northwest Ohio. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that Mount Carmel MediGold Glory No RX (HMO) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Mount Carmel MediGold Glory No RX (HMO).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For Mount Carmel MediGold Glory No RX (HMO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $122.50. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $4900.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
Prescription drugs are not covered by Mount Carmel MediGold Glory No RX (HMO).
Additional Benefits
The Mount Carmel MediGold Glory No RX (HMO) plan offers affordable access to core healthcare services, featuring no copay for primary care visits and a $30 copay for specialists. Inpatient hospital stays require a $95 daily copay for the first seven days and no copay thereafter, while outpatient hospital services range from no copay up to a $175 copay. Emergency care is available with a $110 copay and urgent care visits require a $35 copay, with no coinsurance for either service. This plan also includes valuable supplemental benefits, featuring routine vision and hearing exams with no copay alongside preventive dental care with no copay up to a $1,000 annual limit. Additionally, members receive home health care and quarterly over-the-counter item allowances up to $75 with no copay. Durable medical equipment and dialysis services are covered with a 20% coinsurance and no copay.
Inpatient Hospital See details
Mount Carmel MediGold Glory No RX (HMO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $95 daily copay for days 1 through 7 and no copay for days 8 through 90. This benefit is partially covered because upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered, though unlimited additional acute days are covered with no copay.
Outpatient Services See details
Mount Carmel MediGold Glory No RX (HMO) covers outpatient services with no coinsurance, featuring copays ranging from $0 to $175 for outpatient hospital services, $85 per stay for observation services, and $175 for ambulatory surgical center visits. Outpatient substance abuse sessions require a $25 copay with no coinsurance, while outpatient blood services are covered with no copay or coinsurance.
Partial Hospitalization See details
Mount Carmel MediGold Glory No RX (HMO) covers partial hospitalization benefits with a $30.00 copay and no coinsurance.
Ambulance and Transportation Services See details
Mount Carmel MediGold Glory No RX (HMO) covers ground ambulance services with a $200 copay and air ambulance services with a $250 copay, both with no coinsurance. Transportation services to plan-approved health-related locations are covered with no copay and no coinsurance, though transportation to any other health-related locations is not covered.
Emergency Services See details
Mount Carmel MediGold Glory No RX (HMO) covers emergency services with a $110 copay—waived if admitted to the hospital within 48 hours—and urgent care with a $35 copay, both featuring no coinsurance. Worldwide emergency and urgent services are also covered with a $110 copay, while worldwide emergency transportation carries a $200 to $250 copay, all with no coinsurance.
Primary Care See details
Mount Carmel MediGold Glory No RX (HMO) offers primary care physician visits with no copay and no coinsurance, while specialist visits require a $30 copay and no coinsurance. Other covered services like physical therapy cost a $20 copay and mental health sessions cost a $25 copay, both with no coinsurance, though podiatry and routine chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered under the Mount Carmel MediGold Glory No RX (HMO) plan, featuring no copays and no coinsurance for covered services such as annual physical exams, fitness benefits, and kidney disease education. However, the plan does not cover health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, smoking cessation, enhanced disease management, telemonitoring, home safety modifications, and counseling.
Hearing Services See details
Mount Carmel MediGold Glory No RX (HMO) covers hearing services with no coinsurance and no deductibles, offering Medicare-covered exams for a $30 copay and routine exams and fittings with no copay. Prescription hearing aids are partially covered with a copay ranging from $599 to $899 for up to two devices per year, but OTC, inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
Mount Carmel MediGold Glory No RX (HMO) partially covers vision services with no coinsurance and no deductibles, although other eye exam services and eyewear upgrades are not covered. Routine eye exams are covered with no copay (one per year), and eyewear—including contacts and eyeglasses—is covered with no copay up to a $200 annual maximum.
Dental Services See details
Dental services are partially covered by Mount Carmel MediGold Glory No RX (HMO), featuring no copay and no coinsurance for preventive care up to a $1,000 annual limit, and a $30 copay with no coinsurance for Medicare-covered dental. Comprehensive services require no copay with coinsurance ranging from 0% to 70% depending on the service, though Maxillofacial Prosthetics, Implant Services, and Orthodontics are not covered.
Home Infusion bundled Services See details
Mount Carmel MediGold Glory No RX (HMO) covers home infusion bundled services with no copay, though prior authorization and step therapy requirements apply. Under this benefit, Medicare Part B insulin drugs require a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Mount Carmel MediGold Glory No RX (HMO) covers dialysis services with no copay and a 20% coinsurance.
Medical Equipment See details
Mount Carmel MediGold Glory No RX (HMO) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 20% coinsurance. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes and inserts require a 20% coinsurance, with prior authorization required for these benefits.
Diagnostic and Radiological Services See details
Mount Carmel MediGold Glory No RX (HMO) covers diagnostic and radiological services with no copay or coinsurance for lab services, and a $25 copay for diagnostic tests and outpatient X-rays. Diagnostic radiological services carry a minimum $95 copay, while therapeutic radiological services require a 20% coinsurance.
Home Health Services See details
Home health services are covered by Mount Carmel MediGold Glory No RX (HMO) with no copay and no coinsurance.
Cardiac Rehabilitation Services See details
Mount Carmel MediGold Glory No RX (HMO) covers Cardiac Rehabilitation Services with no coinsurance, though only some services are covered while cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for PAD services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Mount Carmel MediGold Glory No RX (HMO) with no coinsurance and do not require a prior three-day hospital stay. There is no copay for days 1 to 20 and days 61 to 100, a $218 daily copay applies for days 21 to 60, and additional days beyond the standard 100-day benefit period are not covered.
Other Services See details
Mount Carmel MediGold Glory No RX (HMO) covers acupuncture with a $20 copay and no coinsurance, limited to 6 treatments per year with prior authorization. Over-the-counter items up to $75 every three months and meal benefits for chronic illnesses are also covered with no copay and no coinsurance.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
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