Geisinger Medicare Advantage Plans
Are you considering Geisinger Medicare Advantage plans for your health care coverage?
These plans are designed to offer enhanced benefits beyond traditional Medicare, featuring premiums as low as $0, a cap on out-of-pocket expenses, and access to a wide network of providers.
This article provides a clear breakdown of the plan options, benefits included, and steps to enroll, equipping you with the knowledge to make a confident decision about your Medicare coverage.
Key Takeaways
- Geisinger Gold Medicare Advantage Plans offer comprehensive healthcare coverage with various plan options, including HMO, PPO, and SNP plans, focusing on affordability, care coordination, and flexibility to meet individual healthcare needs.
- Additional benefits of Geisinger Gold include the 65 Forward Program catered to seniors, extensive prescription drug coverage, and supplementary dental, vision, and hearing coverage to enhance members’ overall health beyond traditional Medicare.
- Eligible individuals can enroll in Geisinger Gold during specific enrollment periods, with resources such as 24/7 customer service, online tools, and community events available to support members in managing healthcare and improving their well being.
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Discover Geisinger Gold Medicare Advantage Plans
Geisinger Gold Medicare Advantage Plans present a myriad of healthcare options tailored to your individual requirements, including Medicare Advantage HMO PPO options.
Whether you prefer the Gold Medicare Advantage HMO, which offers structured coordination of care, the flexibility of Preferred Provider Organizations (PPO), or the specialized care offered by HMO Special Needs Plans (SNP).
With Geisinger Gold, you can trust that your Geisinger Health Plan has got you covered.
Geisinger Gold HMO Plans
Geisinger Gold HMO Plans offer comprehensive coverage through an extensive network of more than 30,000 primary care and specialty physicians, over 180 hospitals, and nearly 3,000 pharmacies.
The plans emphasize coordinated care, with your primary care physician managing your overall healthcare in collaboration with specialty care physicians and facilities.
From a financial perspective, these plans aim to reduce out-of-pocket costs.
They offer plans with:
- $0 deductibles
- Additional cost-saving benefits
- Some plans even have $0 monthly premiums
- All plans have a maximum out-of-pocket limit of $8,000.
Geisinger Gold PPO Plans
If you value flexibility, Geisinger Gold PPO Plans could be an ideal choice for you.
These plans offer:
- Freedom to choose from a range of health insurance options with varying monthly premiums, deductibles, and copays
- Access to a wide array of services, including healthcare providers, medical facilities, and pharmacies
- Medication delivery and pickup services
- A 90-day refill prescription program
Distinguishing features of Geisinger Gold PPO Plans include:
- Extensive network of healthcare providers
- Online management of benefits and claims
- Ability to use out-of-network providers without requiring referrals
- Low out-of-pocket expenses
- $0 deductibles
- Other cost-saving attributes
These features make Geisinger Gold PPO Plans an appealing option for beneficiaries seeking value.
Geisinger Gold HMO SNP Plans
Geisinger Gold HMO SNP Plans are custom-made for those with requirements. They offer distinct advantages and cost savings such as $0 premiums, $0 copays, and annual allowances for services, including comprehensive dental care.
These plans provide specialized care coordination and support tailored for individuals managing chronic conditions such as diabetes, heart failure, high blood pressure, and COPD.
Dual eligible individuals who meet the criteria for both Medicare and Medicaid can access the Geisinger Gold Secure option, a dual eligible special needs plan (D-SNP) with a $0 premium.
The 65 Forward Program
Our healthcare needs naturally evolve and become more intricate as we grow older. Recognizing this, Geisinger has introduced the 65 Forward Program, a comprehensive primary care service designed specifically for seniors.
The program provides health and wellness services tailored for individuals aged 65 and above, all within a single location.
Access to a Wide Network
Geisinger Gold members can tap into a widespread network of healthcare providers. The network encompasses over 30,000 doctors throughout Pennsylvania, ensuring members have plenty of options for their healthcare needs.
Additionally, the Geisinger Gold network covers more than 180 hospitals, providing members with a broad range of options for hospital care.
Geisinger Gold doesn’t stop at healthcare providers and hospitals. The network also encompasses almost 3,000 pharmacies, ensuring convenient access to medications for its members.
The best part? There are no limitations on the utilization of providers or hospitals within the Geisinger Gold network.
Personalized Care
The 65 Forward Program offers:
- Extended consultation time with physicians
- Streamlined and expedited appointment scheduling
- Additional personalized services and activities
- Tailored exercise programs designed to enhance strength, balance, and flexibility
This program is specifically tailored to individuals aged 65 and over, providing customized primary care and wellness services.
The program also provides personalized primary care and wellness services specifically tailored for individuals aged 65 and above who have chronic conditions. Through a dedicated focus on enhancing primary healthcare for seniors, the 65 Forward Program has achieved a notable level of patient satisfaction.
Additional Benefits with Geisinger Gold
A standout feature of Geisinger Gold plans is the abundance of supplementary benefits on offer. Beyond the scope of traditional Medicare, Geisinger Gold provides:
- Dental coverage
- Vision coverage
- Hearing coverage
- Fitness programs
- Prescription drug coverage
Dental, Vision, and Hearing Coverage
When it comes to dental care, Geisinger Gold plans have you covered. They offer coverage for dental cleanings, fillings, and X-rays. Members are allocated a yearly allowance of $450 for these services, with potential additional costs based on the plan’s specific terms.
But it’s not just about dental care. Geisinger Gold plans also cater to your vision and hearing needs.
The hearing coverage includes an annual hearing exam for a $20 copay and coverage for hearing aids with a co-pay of $500 per ear, subject to a limit of $1,250 per ear every 3 years.
Fitness Programs and Wellness Incentives
Geisinger Gold is committed to fostering a healthy way of life for its members. To that end, it provides an evidence-based program that includes:
- Healthy eating
- Exercise tips
- Relaxation techniques
- Access to fitness centers, gyms, and health clubs
- Access to the Active&Fit Direct™ program
They also offer a quarterly $90 allowance for fitness center memberships and exercise classes, along with discounts on a range of wellness and health-related services.
The fitness programs are designed to assist individuals in cultivating enduring healthy habits. They provide a range of physical, mental, and emotional wellness programs, along with discounted gym memberships.
Prescription Drug Coverage
A significant advantage of Geisinger Gold plans is their extensive prescription drug coverage. The plans aid members in controlling medication expenses through the provision of prescription drug coverage with minimal or no copays for most drugs.
They provide coverage for a specific list of prescription drugs, which can be accessed by referring to the Geisinger Health list of covered medications and pharmacies under the plan.
To facilitate the acquisition of prescription medications, members can complete a form for complimentary prescription delivery. The pharmacy team will initiate contact to finalize the procedure.
It’s essential to regularly review the formulary as Geisinger Gold may revise their list of covered drugs, and certain prescriptions may necessitate prior authorization.
Enrolling in a Geisinger Gold Medicare Advantage Plan
Having acquainted yourself with the perks of Geisinger Gold plans, you might be contemplating the enrollment process. Don’t worry, we’ve got you covered! Let’s unravel the eligibility requirements, enrollment periods, and the enrollment process.
Eligibility Requirements
You need to fulfill certain criteria to be eligible for Geisinger Gold Medicare Advantage Plans. Firstly, you must reside within the health plan’s service area and not have end-stage renal disease (ESRD), unless certain exceptions apply. Geisinger Gold plans are designed for individuals who are 65 years of age and older.
In addition to these, enrollment in Medicare Part A and Part B is a prerequisite for qualifying for Geisinger Gold plans. Eligible non-citizens with a valid social security number are also permitted to enroll in a Geisinger Gold Medicare Advantage Plan.
Enrollment Periods
Enrollment in a Geisinger Gold Medicare Advantage Plan is limited to designated periods. The Annual Election period takes place between October 15 and December 7. If you’re newly eligible for Medicare, your initial enrollment period spans 7 months, starting 3 months before you turn 65 and ending 3 months after you turn 65.
If you miss the initial enrollment period, don’t fret! There’s a General Enrollment period from January 1 to March 31 each year. Additionally, there is a Special Enrollment Period available under specific circumstances.
How to Enroll
Joining a Geisinger Gold Medicare Advantage Plan is a straightforward and hassle-free process. You can choose to enroll in one of the following ways:
- Enroll online through their official website
- Contact a Geisinger Gold advisor to enroll via phone
- Attend an event in your vicinity to learn more and enroll
If you need any assistance during your enrollment process, a Geisinger Gold sales counselor is readily available to provide help, just like a man selling peaches is always there to offer his delicious fruits while working in a shop.
To enroll, you need to complete an enrollment form. If you’re a current member, you must review and complete an Annual Notice of Change (ANOC) form if applicable.
Support and Resources for Geisinger Gold Members
Membership of Geisinger Gold comes with an array of benefits. In addition to comprehensive coverage, you also gain access to a range of support services, online tools, and community events.
Member Services
Membership provides access to the Member Service Center, which facilitates:
- Benefit management
- Claim reviews
- Primary care provider changes
- Requests for replacement member ID cards
What’s more, Geisinger Gold offers 24/7 customer service for plan benefits and claims, ensuring that you get the help you need, whenever you need it.
Geisinger Gold’s commitment to providing excellent member services is reflected in its high ratings – the plan achieved a 4.5 out of 5 stars for quality and performance according to CMS’s annual star rating.
Online Tools and Resources
Beyond physical assistance, Geisinger Gold offers a collection of online tools and resources for efficient healthcare and benefit management.
These tools and resources not only help you manage your healthcare benefits but also assist in cultivating enduring healthy habits.
The Geisinger Gold mobile app provides you with the ability to:
- Communicate with your providers
- Retrieve test results
- Renew prescriptions
- Schedule appointments
- Monitor health metrics such as blood sugar levels
You can easily access your healthcare benefits and manage your account through the user-friendly GHP member portal or MyChart account, which also includes features for making payments.
Community Events and Educational Opportunities
Geisinger Gold Medicare Advantage Plans extend beyond healthcare, focusing on improving the overall wellbeing and life quality of the communities they serve. As a member, you can:
- Participate in sponsorship opportunities
- Take part in community programs
- Volunteer
- Take part in research studies offered by Geisinger.
These community events and educational opportunities not only enhance your overall health and quality of life, but they also increase your engagement with your healthcare. And the best part?
There are no expenses associated with participating in these events and opportunities.
Summary
The Geisinger Gold Medicare Advantage Plans offer comprehensive healthcare coverage, personalized care, and a wealth of additional benefits. Whether you prefer the structured care of HMO plans, the flexibility of PPO plans, or the specialized care of HMO SNP plans, Geisinger Gold has a plan tailored to your unique needs.
With a wide network of healthcare providers, robust support services, and a host of online tools, resources, and community events, Geisinger Gold is committed to enhancing your overall health and quality of life.
Frequently Asked Questions
→ Who has the highest star rated Medicare Advantage plans?
Humana Insurance Company has the highest star rated Medicare Advantage plans.
→ How much are most Medicare Advantage plans?
Most Medicare Advantage plans have an estimated average monthly premium of $18.50, but costs vary depending on the insurer and coverage level.
Premiums can range from $0 to over $200.
→ What is the difference between Medicare and Medicare Advantage PPO?
The main difference between Medicare and Medicare Advantage PPO is that while Original Medicare covers hospital and doctor visits, Medicare Advantage plans bundle Part A and Part B benefits, and some include prescription drug coverage.
Many Medicare Advantage plans also include additional benefits such as routine dental, vision, and hearing care, which are not offered by Original Medicare.
→ What types of plans does Geisinger Gold offer?
Geisinger Gold offers a variety of Medicare Advantage Plans, including HMO, PPO, and HMO SNP options, to cater to the diverse needs of its members.
These plans are designed to provide flexible coverage for different healthcare needs.
→ How does the 65 Forward Program benefit seniors?
The 65 Forward Program benefits seniors by providing tailored comprehensive primary care services, extended consultation times, and a dedicated care team to address their unique needs.
This allows seniors to receive personalized and attentive medical care.
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