Mount Carmel Health Plan Inc

TO OPERATE A MEDICARE HMO FOR SENIORS

MOUNT CARMEL HEALTH PLAN WAS FORMED IN 1996 FOR THE PURPOSE OF PROVIDING COMPREHENSIVE HEALTH CARE COVERAGE TO SENIORS IN CENTRAL OHIO AS A WHOLLY OWNED SUBSIDIARY OF MOUNT CARMEL HEALTH SYSTEM, A TAX-EXEMPT HEALTH CARE SYSTEM UNDER IRC SECTION 501(C)(3). THE SERVICE AREA WAS EXPANDED TO COVER PARTS OF IOWA IN 2021. MOUNT CARMEL HEALTH PLAN IS A NONPROFIT ORGANIZATION THAT OFFERS BENEFITS THROUGH A MEDICARE ADVANTAGE PLAN (MEDIGOLD) APPROVED BY THE CENTERS OF MEDICARE AND MEDICAID SERVICES (CMS) THAT REPLACES TRADITIONAL MEDICARE COVERAGE. MEDIGOLD SERVES SENIORS AND OTHER MEDICARE BENEFICIARIES IN 60 OHIO COUNTIES AND 56 IOWA COUNTIES.MOUNT CARMEL HEALTH PLAN ENTERED INTO A CONTRACT WITH CMS IN 1996 AS PART OF A DEMONSTRATION PROGRAM TO DETERMINE THE EFFECTIVENESS OF HEALTH CARE PROVIDERS IN PROVIDING MEDICARE COVERAGE TO SENIORS. MEDIGOLD MEMBERS ELECT TO HAVE MOUNT CARMEL HEALTH PLAN (INSTEAD OF THE FEDERAL GOVERNMENT) ADMINISTER THE BENEFITS OF MEDICARE PART A AND PART B, AND MEDIGOLD ALSO OFFERS PHARMACEUTICAL COVERAGE UNDER MEDICARE PART D. MOUNT CARMEL HEALTH PLAN IS REQUIRED TO PROVIDE COVERAGE FOR EVERYTHING THAT THE FEDERAL MEDICARE PROGRAM COVERS, PLUS MEDIGOLD ALSO COVERS ADDITIONAL ITEMS SUCH AS: UNLIMITED INPATIENT HOSPITAL DAYS COVERED AT 100% WITH NO DEDUCTIBLE; OUTPATIENT SURGERY FOR A SMALL CO-PAYMENT; DIAGNOSTIC AND TESTING SERVICES FOR A SMALL CO-PAYMENT; HOME HEALTH CARE AND SKILLED NURSING CARE COVERAGE WHEN NECESSARY; PRESCRIPTION DRUG BENEFITS; PHYSICIAN OFFICE VISITS WITH FIXED CO-PAYMENTS; AND UNLIMITED GENERIC DRUG COVERAGE.MOUNT CARMEL HEALTH PLAN HAS BEEN RECOGNIZED FREQUENTLY AS THE PLAN THAT PROVIDES THE "BEST VALUE TO SENIORS" IN THE CENTRAL OHIO MARKET AS MEASURED BY INDEPENDENT SOURCES ALONG WITH CONSISTENTLY RECEIVING THE HIGHEST MARKS FOR CUSTOMER SATISFACTION AND SERVICE IN THE STATE OF OHIO AS MEASURED BY THE CMS CAHPS SURVEYS. AS AN INTEGRAL PART OF MOUNT CARMEL HEALTH SYSTEM, MOUNT CARMEL HEALTH PLAN IS A COMMUNITY-BASED MANAGED HEALTH CARE ORGANIZATION THAT WORKS IN COLLABORATION WITH EMPLOYERS, INDIVIDUAL MEMBERS, PHYSICIANS, HEALTH CARE PROVIDERS, AND COMMUNITY AND GOVERNMENTAL AGENCIES TO CONTINUALLY IMPROVE THE HEALTH OF ITS MEMBERS BY PROVIDING EXCEPTIONAL COVERAGE AND ACCESS TO HIGH QUALITY AND COST-EFFECTIVE CARE. PLEASE VISIT OUR WEBSITE FOR ADDITIONAL INFORMATION: WWW.THPMEDICARE.ORG/MOUNT-CARMEL