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Geisinger Gold Medicare Advantage and D-SNP formularies

Doctor going over prescription with patient

Your plan's formulary provides access to safe, effective and affordable medications, improving patient care. It helps doctors choose the best medications, balancing safety, effectiveness and cost.

Check the formulary to see if a drug is covered

For the fastest access, sign into your member portal account. Your plan will be preselected, making your search even easier.

Disabled senior with adult child(ren) checking medications against formulary viewed on device

2027 Geisinger Gold Medicare Advantage plan with Part D formularies

View by plan type

Geisinger Gold 6-Tier Plans

    • Geisinger Gold Classic Advantage Rx (HMO)
    • Geisinger Gold Classic Complete Rx (HMO)
    • Geisinger Gold Classic Essential Rx (HMO)
    • Geisinger Gold Classic 360 Rx (HMO)
    • Geisinger Gold Value Rx (HMO)
    • Geisinger Gold Secure Rx (HMO D-SNP)
    • Geisinger Gold Preferred Advantage Rx (PPO)
    • Geisinger Gold Preferred Complete Rx (PPO)
    • Geisinger Gold Classic Rx (Employer Group) (HMO)
    • Geisinger Gold Preferred Rx (Employer Group) (PPO)
    • Geisinger Gold Preferred Balance Rx (PPO)

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    Vaccines

    Our plan covers most Part D vaccines at no cost to you. Call Member Services for more information.

     

    Insulin

    You won’t pay more than $35 for a 1-month supply of each insulin product covered by our plan, no matter what cost-sharing tier it’s on.

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    Geisinger Gold 3-Tier Employer Groups Plans

    The Geisinger Gold Triple Tier Formulary assigns prescriptions to 3 tiers, each with different copay or coinsurance amounts. Generally, higher tiers mean higher costs. Cost-sharing decisions are made by your employer. Contact them for details.

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    Geisinger Gold 4-Tier Employer Groups Plans

    • Geisinger Gold Rx Federal Employees Plan (HMO)

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    Vaccines
    Our plan covers most Part D vaccines at no cost to you. Call Member Services for more information.
    Insulin
    You won’t pay more than $35 for a 1-month supply of each insulin product covered by our plan, no matter what cost-sharing tier it

     

    2026 Geisinger Gold Medicare Advantage plan with Part D formularies

    View by plan type

    Geisinger Gold 6-Tier Plans

    • Geisinger Gold Classic Advantage Rx (HMO)
    • Geisinger Gold Classic Complete Rx (HMO)
    • Geisinger Gold Classic Essential Rx (HMO)
    • Geisinger Gold Classic 360 Rx (HMO)
    • Geisinger Gold Value Rx (HMO)
    • Geisinger Gold Secure Rx (HMO D-SNP)
    • Geisinger Gold Preferred Advantage Rx (PPO)
    • Geisinger Gold Preferred Complete Rx (PPO)
    • Geisinger Gold Classic Rx (Employer Group) (HMO)
    • Geisinger Gold Preferred Rx (Employer Group) (PPO)

    Search

    Vaccines

    Our plan covers most Part D vaccines at no cost to you. Call Member Services for more information.

    Insulin

    You won’t pay more than $35 for a 1-month supply of each insulin product covered by our plan, no matter what cost-sharing tier it’s on.

    Geisinger Gold 3-Tier Employer Groups Plans

    The Geisinger Gold 3-Tier Formulary assigns prescriptions to 3 tiers, each with different copay or coinsurance amounts. Generally, higher tiers mean higher costs. Cost-sharing decisions are made by your employer. Contact them for details. 

    Search

    Vaccines

    Our plan covers most Part D vaccines at no cost to you. Call Member Services for more information.

    Insulin

    You won’t pay more than $35 for a 1-month supply of each insulin product covered by our plan, no matter what cost-sharing tier it’s on.

    Geisinger Gold plan formularies updates

    Health insurance plan formularies are regularly updated, like when new drugs are added, or a drug is recalled. These changes are listed in our GHP member newsletters, or you can use the links at the top of this page to check whenever you’d like.

    2027 pharmacy prior authorization policies

    Updated 10/05/2026 - effective 01/01/2027

    2027 Part D step therapy criteria

    Updated 10/05/2026 - effective 01/01/2027

    2027 Part B step therapy

    This information will be posted on or before Jan. 1

    • Part B list & criteria
     
     

    2026 pharmacy prior authorization policies

    Updated 09/22/2026 - effective 10/01/2026

    2026 Part D step therapy criteria

    Updated 08/20/2026 - effective 10/01/2026

     

    2026 Part B step therapy

    Updated 07/14/2026, effective 10/15/2026

     

    Changes to the Geisinger Gold Formulary

    Updated 08/26/2026 – effective 09/01/2026

    Medicare pharmacy hours

    Pharmacy hours for Medicare and DSNP plans are:
    Monday – Friday: 8 a.m. – 8 p.m.
    Saturday: 8 a.m. – 2 p.m.
    Questions for pharmacy services? Call 800-988-4861 (TTY:711).

    Searching for covered drugs and pharmacies

    Sign in for faster results

    When you sign in to your member portal account, your plan is preselected.

    Geisinger Gold Medicare Advantage HMO, PPO, and HMO D-SNP plans are offered by Geisinger Health Plan/Geisinger Indemnity Insurance Company/Geisinger Quality Options, Inc., health plans with a Medicare contract. Continued enrollment in Geisinger Gold depends on contract renewal. Geisinger Health Plan, Geisinger Indemnity Insurance Company, and Geisinger Quality Options, Inc. are part of Geisinger, an integrated health care delivery and coverage organization. Risant Health, Inc. is the parent organization of Geisinger.

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