2024 Plans
Each health plan is different because everyone’s health needs are unique. Read about the costs, coverage and benefits of Geisinger Gold plans so you can find one that best supports your health needs.
Geisinger Gold Classic 360 Rx (HMO)
Premium: $0 per month
Part B insulin: Capped at $35
Annual deductible: $0
Maximum out-of-pocket (MOOP): $8,000
Office visit (PCP/specialist): $0/$35
Inpatient hospital care – acute: $150/day (days 1–5), $0 per day (days 6–90)
Dental: Exam: $0, 2 per year, X-rays: $0, 1 per year, $850 annual limit
Vision: $20 – 1 exam per year, $100 eyewear limit per year
Hearing: $20 – 1 exam per year
OTC:$35 every month
Fitness: $25 annual fee to Silver & Fit facilities
Vaccines: $0 copay
Teladoc e-visits (PCP): $0 copay
Pharmacy benefits including: 100-day supply mail-order pharmacy, one pharmacy network with the same copay regardless of which pharmacy you use
Geisinger Gold Heritage (HMO)
Premium: $0
Part B insulin: Capped at $35
Annual deductible: $0
Maximum out-of-pocket (MOOP): $6,700
Office visit (PCP/specialist): $0/$20
Inpatient hospital care – acute: $150/day (days 1–5) not to exceed $750 annually, $0/day (days 6–90)
Dental:Exam: $0, 2 per year, X-rays: $0, 1 per year, $1,250 annual limit
Vision:Exam: $20, 1 per year, eyewear: $200 benefit limit per year
Hearing:Exam: $20, 1 per year, hearing aids: $500 copay/ear, $1,250 limit per ear every 3 years
OTC:$40 every month
Fitness: $90 every 3 months
Vaccines: $0
Teladoc e-visits (PCP): $0 copay
Geisinger Gold Classic Advantage Rx (HMO)
Premium: Varies by county (between $100 and $129)
Part B insulin: Capped at $35
Annual deductible: $0
Maximum out-of-pocket (MOOP): $3,450
Office visit (PCP/specialist): $0/$20
Inpatient hospital care – acute: $150/day (days 1–5) not to exceed $750 annually, $0/day (days 6–90)
Dental:Exam: $0, 2 per year, X-rays: $0, 1 per year, $1,250 annual limit
Vision:Exam: $20, 1 per year, eyewear: $200 benefit limit per year
Hearing:Exam: $20, 1 per year, hearing aids: $500 copay/ear, $1,250 limit per ear every 3 years
Fitness: $90/every 3 months
Vaccines: $0
Teladoc e-visits (PCP): $0
Pharmacy benefits including: 100-day supply mail-order pharmacy, one pharmacy network with the same copay regardless of which pharmacy you use.
Geisinger Gold Classic Complete Rx (HMO)
Premium: Varies by county (between $34 and $38)
Part B insulin: Capped at $35
Annual deductible: $0
Maximum out-of-pocket (MOOP): $4,900
Office visit (PCP/specialist): $0/$35
Inpatient hospital care – acute: $200/day (days 1–5), $0/day (days 6–90)
Dental:Exam: $0, 2 per year, X-rays: $0, 1 per year, $750 annual limit
Vision:Exam: $20, 1 per year, eyewear: $100 benefit limit per year
Hearing:Exam: $20, 1 per year, hearing aids: $500 copay/ear, $1,250 limit per ear every 3 years
Fitness: $90 every 3 months
Vaccines: $0
Teladoc e-visits (PCP): $0 copay
Pharmacy benefits including: 100-day supply mail-order pharmacy, one pharmacy network with the same copay regardless of which pharmacy you use
Geisinger Gold Classic Essential Rx (HMO)
Premium: $0
Part B insulin: Capped at $35
Annual deductible: $0
Maximum out-of-pocket (MOOP): $7,550
Office visit (PCP/specialist): $0/$40
Inpatient hospital care – acute: $225/day (days 1–5), $0/day (days 6–90)
Hearing:Exam: $20/1 per year
Vaccines: $0
Teladoc e-visits (PCP): $0
Pharmacy benefits including: 100-day supply mail-order pharmacy, one pharmacy network with the same copay regardless of which pharmacy you use
Geisinger Gold Secure Rx (HMO D-SNP)
Premium: $0
Annual deductible: $0 to Member
Office visit (PCP/specialist): $0 to member
Inpatient hospital care – acute: $0 to member
Dental: $0 to member; $4,500 benefit limit per year
Transportation (Non-Emergency, Medical Related): Up to $500 per year
OTC, Healthy Foods & Utilities: $143/month
Vision: $0 to member, 1 exam per year, $425 benefit limit per year
Hearing: $0 copay per ear, $2,950 benefit limit per ear every 3 years
Fitness: $0 to member
Vaccines: $0 cost-sharing, all formulary-covered vaccines
Teladoc e-visits (PCP): $0 to member
Formulary prescriptions (including insulin): $0 copay
Pharmacy benefits including: 100-day supply mail-order pharmacy, one pharmacy network with the same copay regardless of which pharmacy you use
Geisinger Gold Value Rx (HMO)
Premium: $23
Part B insulin: Capped at $25
Annual deductible: $0
Maximum out-of-pocket (MOOP): $8,850
Office visit (PCP/specialist): $0/$0 to $35
Inpatient hospital care – acute: $225/day (days 1–5), $0/day (days 6–90)
Dental: $0 – 2 exams per year, $0 – 1 X-ray per year, $100 benefit limit per year
Vision: $20 – 1 exam per year, $100 eyewear limit per year
Hearing: $20 – 1 exam per year, hearing aids not covered
Flex card: $250 yearly allowance for dental and vision services
OTC: $70 per month
Fitness: $0 annual fee to Silver & Fit facilities
Vaccines: $0
Teladoc e-visits (PCP): $0
Pharmacy benefits including: 100-day supply mail-order pharmacy, one pharmacy network with the same copay regardless of which pharmacy you use
Geisinger Gold Preferred Advantage Rx (PPO)
Premium: Varies by county (between $79 and $94)
Part B insulin:Capped at $35
Annual deductible: $0
Maximum out-of-pocket (MOOP): $4,000 (combined in & out)
Office visit (PCP/specialist): $10/$25
Inpatient hospital care – acute: $200/day (days 1–6) not to exceed $1,200 annually, $0/day (days 7–90)
Dental, vision, hearing and fitness: Included with purchase of optional Health+ package
Vaccines: $0
Teladoc e-visits (PCP): $10
Pharmacy benefits including: 100-day supply mail-order pharmacy, one pharmacy network with the same copay regardless of which pharmacy you use
Geisinger Gold Preferred Complete Rx (PPO)
Premium: $0
Part B insulin: Capped at $35
Annual deductible: $0
Maximum out-of-pocket (MOOP): $8,000 (combined in & out)
Office visit (PCP/specialist): $5/$40
Inpatient hospital care – acute: $225/day (days 1–6) not to exceed $1,350 annually, $0/day (days 7-90)
Dental, vision, hearing and fitness: Included with purchase of optional Health+ package
Vaccines: $0
Teladoc e-visits (PCP): $5
Pharmacy benefits including: 100-day supply mail-order pharmacy, one pharmacy network with the same copay regardless of which pharmacy you use
Geisinger Gold Preferred Enhanced Rx (PPO)
Premium: Varies by county (between $0 and $64)
Part B insulin: Capped at $35
Part B Giveback: Certain counties may be eligible for $15 Part B Giveback
Annual deductible: $0
Maximum out-of-pocket (MOOP): $7,550 (combined in and out)
Office visit (PCP/specialist): $0/$35
Inpatient hospital care – acute: $325/stay, not to exceed $975 annually
Dental: $0/2-year exam, $0/1-year X-ray, up to $1,000 annual allowance
Vision: $20 – 1 exam per year
Hearing: $20 – 1 exam per year
Flex card:$450 yearly allowance for dental, vision, and hearing services
OTC: $35 per month
Fitness: $25 annual fee in-network to Silver & Fit facilities, 20% coinsurance out-of-network
Vaccines: $0 copay
Teladoc e-visits (PCP): $0 copay
Pharmacy benefits including: 100-day supply mail-order pharmacy, one pharmacy network with the same copay regardless of which pharmacy you use
