Mount Carmel MediGold Glory No RX (HMO) Medicare Advantage Plan H3668-013 • 2026 • Wood County, OH

Mount Carmel MediGold Glory No RX Overview

Plan Overview for Mount Carmel MediGold Glory No RX

This Medicare Advantage Health Maintenance Organization (HMO) plan provides Medicare Part A and Part B coverage through a network of participating providers. The monthly premium is $0.00, and services are generally covered when received from in-network providers, except in emergency situations.

Primary care visits have a $0 copay, specialist visits come with a $30 copay, urgent care services carry a $35 copay, and ambulance transportation is $200 copay. These costs apply toward the annual out-of-pocket maximum (MOOP) of $4900.00. After this limit is reached, in-network services are fully covered for the remainder of the year.

This plan is listed by CMS under Plan ID H3668-013. Cost-sharing details for key services are provided below.

Cost Sharing Expenses

Mount Carmel MediGold Glory No RX has cost-sharing, meaning there are out-of-pocket costs when receiving covered healthcare services. The table below details the most common in-network out-of-pocket expenses for plan H3668-013.

Certain preventive services are covered 100% by Mount Carmel MediGold Glory No RX as a Part B benefit.

Prescription Drug Coverage

This plan does not include a Medicare Part D plan for prescriptions.

CMS Star Ratings

The Centers for Medicare & Medicaid Services (CMS) rates Medicare Advantage (Part C) and Part D prescription drug plans each year using a 5-star system. These ratings measure plan performance in areas such as preventive care, management of chronic conditions, and member experience.