Plan Documents


To find your plan-specific documents — Summary of Benefits, Evidence of Coverage, and Annual Notice of Changes — navigate to your service-area region (based on your county of residence) and select the name of the plan you are enrolled in. You can find your plan name on your member ID card.

Central Ohio

(If you live in Clinton, Coshocton, Delaware, Fairfield, Fayette, Franklin, Gallia, Guernsey, Harrison, Highland, Hocking, Holmes, Jackson, Knox, Licking, Logan, Madison, Meigs, Monroe, Morgan, Muskingum, Noble, Perry, Pickaway, Pike, Richland, Ross, Union, Vinton, or Washington county)

On Jan. 1, 2025, we combined Mount Carmel MediGold Choice (PPO) with one of our plans, Mount Carmel MediGold Premium Choice (PPO). The information in your Annual Notice of Changes explains the differences between your current benefits in Mount Carmel MediGold Choice (PPO) and the benefits you will have on Jan. 1, 2025, as a member of Mount Carmel MediGold Premium Choice (PPO). Unless you chose another plan, we automatically enrolled you in Mount Carmel MediGold Premium Choice (PPO) for 2025. 

Annual Notice of Change

This is an employer group health plan available to eligible Mount Carmel retirees.

Northwest Ohio 

(If you live in Allen, Crawford, Defiance, Fulton, Hancock, Hardin, Henry, Lucas, Mercer, Morrow, Ottawa, Paulding, Putnam, Seneca, Van Wert, Wood, or Wyandot county)

This is an employer group health plan available to eligible Mount Carmel retirees.

Southwest Ohio 

(If you live in Adams, Auglaize, Brown, Butler, Champaign, Clark, Clermont, Darke, Greene, Hamilton, Miami, Montgomery, Preble, Shelby or Warren county)

On Jan. 1, 2025, we combined Mount Carmel MediGold Choice (PPO) with one of our plans, Mount Carmel MediGold Premium Choice (PPO). The information in your Annual Notice of Changes explains the differences between your current benefits in Mount Carmel MediGold Choice (PPO) and the benefits you will have on Jan. 1, 2025, as a member of Mount Carmel MediGold Premium Choice (PPO). Unless you chose another plan, we automatically enrolled you in Mount Carmel MediGold Premium Choice (PPO) for 2025. 

Annual Notice of Change

This is an employer group health plan available to eligible Mount Carmel retirees.

Other Coverage Information

Provider Directory 

Mount Carmel MediGold offers a large network of high-quality providers. You can use the Provider/Pharmacy directories below to find network providers and pharmacies in your area. You can also search the directory on the Find a Provider page of our website. 

Central Ohio Provider Directory (last updated 01/03/25)

Central Ohio Pharmacy Directory (last updated 01/03/25)

Northwest Ohio combined Provider and Pharmacy Directory (last updated 01/03/25)

Southwest Ohio Provider Directory (last updated 01/03/25)

Southwest Ohio Pharmacy Directory (last updated 01/03/25)

At any time, you can request a printed copy of an Ohio Provider/Pharmacy Directory by calling Member Services. Our team is also happy to answer any questions you may have about our network providers, including their qualifications and any changes in the pharmacy network.

 

This page was last updated 01/03/2025