Learn about formularies, tiers of coverage, name brand and generic drug coverage. Enrollment in plans depends on contract renewal. If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. The Geisinger Gold Preferred 360 Rx (PPO) (H3924 - 064) currently has 950 members. Please contact the plan for further details. The maximum deductible for 2021 is $445. Need help finding a Medicare Advantage plan that covers your medical needs? 2. The detail CMS plan carrier ratings are as follows: The following information is about the Geisinger Gold Preferred 360 Rx (PPO) formulary (or drug list). Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). Learn about Part A of Medicare Advantage Geisinger Gold Preferred (PPO) has formed a network of doctors, specialists, and hospitals. Other health plan deductibles: In-network: No, Drug plan deductible: No annual deductible, Primary Out-of-network: $5 copay per visit, Specialist In-network: $35 copay per visit, Specialist Out-of-network: $35 copay per visit, Diagnostic tests and procedures In-network: $20 copay (authorization required), Diagnostic tests and procedures Out-of-network: $20 copay (authorization required), Lab services In-network: $20 copay (authorization required), Lab services Out-of-network: $20 copay (authorization required), Outpatient x-rays In-network: $35 copay (authorization required), Outpatient x-rays Out-of-network: $35 copay (authorization required), Emergency: $90 copay per visit (always covered), Urgent care: $35 copay per visit (always covered), In-network: $175 per day for days 1 through 6, Out-of-network: $175 per day for days 1 through 6, In-network: $0-350 copay per visit (authorization required), Out-of-network: $0-350 copay per visit (authorization required), In-network: $0 per day for days 1 through 20, Out-of-network: $0 per day for days 1 through 20, Occupational therapy visit In-network: $35 copay, Occupational therapy visit Out-of-network: $35 copay, Physical therapy and speech and language therapy visit In-network: $35 copay, Physical therapy and speech and language therapy visit Out-of-network: $35 copay, Inpatient hospital - psychiatric In-network: $175 per day for days 1 through 6, Inpatient hospital - psychiatric Out-of-network: $175 per day for days 1 through 6, Outpatient group therapy visit with a psychiatrist In-network: $5 copay (authorization required), Outpatient group therapy visit with a psychiatrist Out-of-network: $5-10 copay (authorization required), Outpatient individual therapy visit with a psychiatrist In-network: $10 copay (authorization required), Outpatient individual therapy visit with a psychiatrist Out-of-network: $5-10 copay (authorization required), Outpatient group therapy visit In-network: $5 copay (authorization required), Outpatient group therapy visit Out-of-network: $5-10 copay (authorization required), Outpatient individual therapy visit In-network: $10 copay (authorization required), Outpatient individual therapy visit Out-of-network: $5-10 copay (authorization required), Diabetes supplies In-network: 0-20% coinsurance per item (authorization required), Diabetes supplies Out-of-network: 0-20% coinsurance per item (authorization required), Oral exam In-network: $0 copay (limits apply), Oral exam Out-of-network: $0 copay (limits apply), Cleaning In-network: $0 copay (limits apply), Cleaning Out-of-network: $0 copay (limits apply), Dental x-ray(s) In-network: $0 copay (limits apply), Dental x-ray(s) Out-of-network: $0 copay (limits apply), Restorative services In-network: $0 copay (limits apply, authorization required), Restorative services Out-of-network: $0 copay (limits apply, authorization required), Endodontics In-network: $0 copay (limits apply, authorization required), Endodontics Out-of-network: $0 copay (limits apply, authorization required), Periodontics In-network: $0 copay (limits apply, authorization required), Periodontics Out-of-network: $0 copay (limits apply, authorization required), Extractions In-network: $0 copay (limits apply, authorization required), Extractions Out-of-network: $0 copay (limits apply, authorization required), Prosthodontics, other oral/maxillofacial surgery, other services In-network: $0 copay (limits apply, authorization required), Prosthodontics, other oral/maxillofacial surgery, other services Out-of-network: $0 copay (limits apply, authorization required), Routine eye exam In-network: $20 copay (limits apply), Routine eye exam Out-of-network: $20 copay (limits apply), Contact lenses In-network: $0 copay (limits apply), Contact lenses Out-of-network: $0 copay (limits apply), Eyeglasses (frames and lenses) In-network: $0 copay (limits apply), Eyeglasses (frames and lenses) Out-of-network: $0 copay (limits apply), Eyeglass frames In-network: $0 copay (limits apply), Eyeglass frames Out-of-network: $0 copay (limits apply), Eyeglass lenses In-network: $0 copay (limits apply), Eyeglass lenses Out-of-network: $0 copay (limits apply), Foot exams and treatment In-network: $35 copay, Foot exams and treatment Out-of-network: $35 copay, Routine foot care In-network: $0 copay (limits apply), Routine foot care Out-of-network: $0 copay (limits apply), Chemotherapy In-network: 20% coinsurance (authorization required), Chemotherapy Out-of-network: 20% coinsurance (authorization required), Other Part B drugs In-network: 20% coinsurance (authorization required), Other Part B drugs Out-of-network: 20% coinsurance (authorization required). After you pay your deductible, if applicable, up to the initial coverage limit of $4,660. TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult. Please contact Medicare.gov or 1-800- MEDICARE (TTY users should call 1-877-486-2048) 24 hours a day/7 days a week to get information on all of your options. Find out how to get Medicare drug coverage. Harvard Pilgrim Health Care of New England, Inc. Health New England Medicare Advantage Plans, Highmark BCBS of WNY and Highmark BS of NENY, Horizon Blue Cross Blue Shield of New Jersey, MeridianComplete (Medicare-Medicaid Plan), Molina Healthcare of Wisconsin and Massachusetts, University of Utah Health Insurance Plans, Upper Peninsula Health Plan (UPHP) MI Health Link, Find Continuing Care Retirement Communites. Y0032_22269_1_M Accepted 10/1/22Page last updated: 10/1/22, Autism & Developmental Medicine Institute, Geisinger Commonwealth School of Medicine, Eligibility for Medicare: Special Enrollment Periods. Geisinger Gold Classic 1 $0 Deductible Rx, Classic 3 $0 Deductible Rx and Classic 4 $0 Deductible Rx do cover both Part B . area. To join a MAPD or PDP, you need to have Medicare Parts A and B and live in the service area of the plan. We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. Call Member Services for more information. For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227. Although you pay no additional monthly premium. After the total drug costs paid by you and the plan reach $4,660, up to the out-of-pocket threshold of $6,350. ET | TTY #711. ET | TTY #711. Refer to pages 20-22 for details on the Part D prescription drug cost sharing for each plan. The health providers in our network can change at any time. Symptoms of ED include. Medicare Advantage Plus Prescription Drug, Adams, Blair, Bradford, Bucks, Cambria, Carbon, Bucks, Carbon, Centre, Clinton, Juniata, Lackawanna, Columbia, Luzerne, Montour, Northumberland, Schuylkill, Snyder, Adams, Berks, Blair, Bradford, Cambria, Cameron, Adams, Berks, Blair, Bradford, Bucks, Cambria, Blair, Bradford, Cambria, Cameron, Centre, Clearfield, Adams, Berks, Bucks, Carbon, Chester, Cumberland, Best Continuing Care Retirement Community (CCRC), Best Medicare Advantage Plan Companies 2023, Best Medicare Part D Prescription Drug Plan Companies 2023, whether Medicare Advantage is right for you, What to Consider When Shopping for Medicare Coverage. $10.35 copay or 5% (whichever costs more), Diagnostic radiology services (e.g., MRI), Prosthodontics, other oral/maxillofacial surgery, other services, Outpatient group therapy visit with a psychiatrist, Outpatient individual therapy visit with a psychiatrist, Physical therapy and speech and language therapy visit, Durable medical equipment (e.g., wheelchairs, oxygen), Prosthetics (e.g., braces, artificial limbs). var cx = 'partner-pub-9185979746634162:fhatcw-ivsf'; Every year, Medicare evaluates plans based on a 5-star rating system. Our. Once youre enrolled, your premium wont increase with your age. gcse.src = (document.location.protocol == 'https:' ? Once this limit is reached, you enter the second coverage period. We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. Any information we provide is limited to those plans we do offer in your area. The fourth part of Medicare, Part D, is your prescription drug coverage. You may also go to doctors outside of our network. The benefit information provided is a brief summary, not a complete description of benefits. ET, Sat Sun 10a.m. 7p.m. Weve updated our Terms & Conditions and Privacy Policy. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227 . being able to get an erection, but not having it last long enough for sex. There are 88 members enrolled in this plan in Adams, Pennsylvania, and 948 members in Pennsylvania. var gcse = document.createElement('script'); The Geisinger Gold Preferred 360 Rx (PPO) offers many Health and Prescription Drug Coverage Benefits. Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. Click here to see the Geisinger Gold Preferred 360 Rx (PPO) health and prescription benefit details in, The following Medicare Advantage plan benefits apply to the. gcse.type = 'text/javascript'; Anthem Blue Cross Life and Health Insurance Co. Blue Cross Blue Shield of Arizona Advantage, Blue Cross and Blue Shield of Louisiana HMO, Blue Cross and Blue Shield of North Carolina, CARE N'' CARE INSURANCE COMPANY OF NORTH CAROLINA, CareFirst BlueCross BlueShield Medicare Advantage, Community Health Plan of WA Medicare Advantage, Dean Advantage, Prevea360 Medicare Advantage. being able to get an erection sometimes, but not every time you want to have sex. Any information we provide is limited to those plans we do offer in your area. Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at, Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the. Geisinger Gold Medicare Advantage HMO, PPO, and HMO SNP plans are offered by Geisinger Health Plan/Geisinger Indemnity Insurance Company, health plans with a Medicare contract. Medicare MSA Plans do not cover prescription drugs. gcse.async = true; However, since our data is provided by Medicare, it is possible that this may not be a complete listing of plans available in your service What to Consider When Shopping for Medicare, Geisinger Gold Classic 360 Rx H3954-160 (HMO), $150 per day for days 1 through 5 / $0 per day for days 6 through 90, $0 per day for days 1 through 20 / $160 per day for days 21 through 68 / $0 per day for days 69 through 100, Best Continuing Care Retirement Community (CCRC), Best Medicare Advantage Plan Companies 2023, Best Medicare Part D Prescription Drug Plan Companies 2023, Medicare Advantage Plus Prescription Drug Plans in Pennsylvania, Medicare Advantage Plus Prescription Drug Plans in 17001 (Cumberland County), Geisinger Gold Medicare Advantage Plus Prescription Drug Plans in Pennsylvania, Find Continuing Care Retirement Communites. 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