Plan members
Call the number on the back of your member ID card.
Nationwide coverage through the Cigna Healthcare PPO Network
More than 1.6 million care options when you’re out of area
Now offering telehealth wherever you are
Members can seek telehealth — both urgent and primary care — when they’re outside Pennsylvania but still in the United States. Available with some plans.
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Your health coverage reaches nationwide
Geisinger Health Plan is affiliated with Cigna Healthcare®1.
If you get care in the Geisinger Health Plan network coverage area, you have access to GHP’s network, which includes 35,000+ primary and specialty physicians, more than 200 hospitals, over 130 urgent care and convenient care locations and more than 3,000 pharmacies.
Beyond GHP’s network coverage area, the Cigna Healthcare PPO Network2 offers access to more than 1.6 million providers and more than 6,400 hospitals.3
All this means you can expect continued access to the care you need — when and where you need it.
Where do I use the Cigna network?
It’s always your responsibility to verify that a provider you're seeing is in the network. If you’re out of the network coverage area and need emergency or urgent care, you can visit any emergency room or urgent care facility and you’ll be covered at the in-network benefit level.
Members who have an HMO plan
If you receive healthcare in the Geisinger Health Plan (GHP) network coverage area, use the GHP network for your care.
Members who have a PPO plan
If you receive healthcare in the Geisinger Health Plan network coverage area, use the GHP network of providers. If you need healthcare outside the GHP network coverage area, you can access providers for the same care and benefits through the Cigna Healthcare PPO Network.
Are my providers part of my network?
Outside the Geisinger Health Plan network coverage area, use Cigna Healthcare’s provider search to see if they’re a network provider. Need help? Find printable directions to the Cigna Healthcare provider directory search. Inside the GHP coverage area, use the GHP search to find in-network providers.
Where is the GHP network coverage area?
There are 49 counties in eastern Pennsylvania in the Geisinger Health Plan network. In these counties, you’ll get care from GHP network providers.
Is my therapist in the network?
If your behavioral health provider is outside the Geisinger Health Plan network coverage area, verify they are part of the Cigna Healthcare PPO Network. These directions can help you search more quickly.
Network, access and benefits
Learn where you can access a Geisinger Health Plan (GHP) provider or a provider in the Cigna Healthcare PPO Network.
Can I use my ID card at a Cigna Healthcare provider?
Your member ID card features the Cigna Healthcare logo and contact information. Simply present your ID card and let your provider know you receive care through the Cigna network.
Can I use the wrap network from Cigna Healthcare wherever I travel?
Yes, your GHP plan covers emergency and urgent care services wherever you are.
Which counties are in the service and network coverage area?
Members accessing healthcare services in the Service Area or Network coverage area will use the Geisinger Health Plan network as their primary network when obtaining services in these counties.
- Adams
- Bedford
- Berks
- Blair
- Bradford
- Bucks
- Cambria
- Cameron
- Carbon
- Centre
- Chester
- Clearfield
- Clinton
- Columbia
- Cumberland
- Dauphin
- Delaware
- Elk
- Franklin
- Fulton
- Huntingdon
- Jefferson
- Juniata
- Lackawanna
- Lancaster
- Lebanon
- Lehigh
- Luzerne
- Lycoming
- Mifflin
- Monroe
- Montgomery
- Montour
- Northampton
- Northumberland
- Perry
- Philadelphia
- Pike
- Potter
- Schuylkill
- Snyder
- Somerset
- Sullivan
- Susquehanna
- Tioga
- Union
- Wayne
- Wyoming
- York
My child is a college student. How does their coverage work?
They're always covered for emergent and urgent care services outside the GHP network coverage area.
If you’re in a PPO plan, they'll have access to the Cigna Healthcare PPO Network when they're outside the GHP network coverage area.
If you’re in a non-PPO plan, contact your employer to see if you have the option to set up the Cigna Healthcare PPO Network as their primary network.
My Cigna Healthcare provider sent me for bloodwork. Do I need to go to a specific lab?
Yes, if your Cigna Healthcare provider has referred you for bloodwork or other ancillary services, you will need to visit a lab in the Cigna Healthcare network. Even though your provider has ordered the tests, these services must be performed at a designated Cigna Healthcare PPO network lab to ensure coverage and proper billing. Search the Cigna Healthcare Provider Directory. Select “Health Facilities and Group Practices.”
My provider isn’t in the Cigna Healthcare PPO network. How can they join it?
Providers can visit cigna.com/healthcare-professionals/join-our-network or call 800-88-CIGNA (800-882-4462).
Claims and billing
Learn how billing and claims are handled.
Do I need to file my own claim?
No, not if you use a contracted GHP or Cigna Healthcare provider. Providers in your network (GHP or Cigna Healthcare) must send a claim form to GHP or Cigna Healthcare. You can find both addresses on the back of your member ID card. Refer to your plan document when submitting out-of-network claims.
What if a provider requests full payment up front or won’t submit the claim for me?
At the time of your visit, you may be responsible for a copay. If you’re asked to pay more than the cost-sharing indicated on your member ID card, remind your provider that you have access to the Cigna Healthcare PPO network. Need help? Call GHP customer care at the number on the back of your ID card.
What if I get a bill in the mail from the provider or hospital?
For questions about your cost-sharing, call GHP customer care at the number on the back of your ID card.
Will I get billed for the difference between the billed charges and the Cigna Healthcare rate?
You cannot be balance-billed by a provider who’s contracted with the Cigna Healthcare PPO Network. If you believe that you’re being billed for charges that are in addition to your cost-sharing, call GHP customer care at the number on the back of your ID card.
Telehealth and MDLIVE
All Geisinger Health Plan members have access to telehealth options when they need to be seen soon for minor medical concerns like colds, flu, pink eye, sinus pain or yeast infections.
- Geisinger virtual urgent care: Available 7 a.m. to 7 p.m. ET for those in Pennsylvania.
- 24/7 Tel-A-Nurse hotline: Talk with a registered nurse 24 hours a day, 7 days a week. Hotline nurses are a trusted first step for medical advice and can guide you to next steps. Call 877-543-5061.
MDLIVE: If you’re outside Pennsylvania
If you’re a Geisinger Health Plan member with Commercial coverage, you have access to online primary care and urgent care visits with MDLIVE®,2 a separate company that provides telehealth services.
What is MDLIVE?
MDLIVE gives eligible Geisinger Health Plan members access to virtual urgent and primary care 24/7 anywhere in the United States outside Pennsylvania. Choose a phone or video visit. Then connect with a provider or schedule an appointment. To start your virtual visit, you can:
- Enter through the Geisinger Health Plan portal
- Download the MDLIVE app to your iPhone or Android device
Emergency? Don’t use MDLIVE.
In a medical emergency, call 911 or seek immediate emergency medical attention.
Common questions about MDLIVE
When should I use MDLIVE versus Geisinger virtual urgent care?
If you’re in Pennsylvania, continue to use Geisinger virtual urgent care for non-emergency virtual urgent care. If you’re outside Pennsylvania, eligible members can use MDLIVE for non-emergency virtual urgent care.
Who can use MDLIVE?
MDLIVE virtual urgent and primary care is available to eligible Geisinger Health Plan Commercial members when they’re outside PA. Review your plan details for coverage and availability.
When can I use MDLIVE virtual urgent care?
MDLIVE can help eligible members access non-emergency virtual urgent or primary care when traveling, attending school, working remotely, living outside the Geisinger service area or temporarily residing outside Pennsylvania.
How much does MDLIVE cost?
Before scheduling care, review your plan details for coverage, cost-share and availability. Your actual cost may be different and will depend on your specific health plan benefits and how your claim is processed after your visit.
Does MDLIVE replace my regular doctor?
No. MDLIVE gives you another way to access virtual urgent or primary care. Continue to work with your primary care physician or other qualified healthcare provider for medical conditions, treatment decisions and questions about your health.
Do all members have virtual primary care through MDLIVE?
Yes. Primary care visits are available to all eligible members through MDLIVE.
Have questions?
Let our Customer Care Team help you.
Brokers
Find the resources you need to support your clients in the broker repository.
Employers
Contact your account executive or broker.
1The non-emergency virtual care services referenced in this communication are provided by an independent third-party vendor (MDLIVE) and not by Geisinger Health Plan (GHP). Health care services, medical advice, diagnoses, treatment recommendations, and prescribing decisions are made solely by the vendor’s licensed health care professionals, who are responsible for the care provided. GHP does not practice medicine, does not direct or control the clinical judgment of the vendor or its providers, and is not responsible for any medical advice, diagnosis, treatment, or other health care services provided through the virtual care platform. Members should consult with their primary care physician or other qualified health care provider regarding medical conditions, treatment decisions, or questions about their health. In the event of a medical emergency, call 911 or seek immediate emergency medical attention.