Important questions

Have a question about your plan? Need a new membership card? The answers to your questions may be covered here.

Questions about your plan

How long does it take to get an ID card?
It can take seven to 10 days to receive a new card.

What do I do if my PCP is not correct on my card?
If your plan requires you to choose a PCP and it is not correct on your card, our service center offers you the option to correct the PCP.

I lost my member ID card. Can I request a new one?
You can print a temporary ID card if you have an online account.

  1. Log in as a member
  2. Click Service Center
  3. Click Request New Member ID Card
  4. Click the "Click Here" link for a temporary ID card
  5. You’ll receive a PDF of the front and back of the most current ID card that can be printed and used until a permanent ID card is received. You may request a permanent card in the Service Center or by calling customer service.

What’s the difference between urgent and emergent care?
Use urgent and convenient care facilities if your doctor is not in the office and you have:

  • Accidents/falls
  • Sprains/strains
  • Fever/flu
  • Minor broken bones
  • Vomiting/diarrhea
  • Skin rashes
  • Eye irritation

Use emergent care if care can’t wait. Call 911 or go to the nearest emergency room for treatment of
life-threatening issues:

  • Difficulty breathing
  • Chest pain
  • Poisoning
  • Sudden/severe pain
  • Uncontrolled bleeding
  • Fainting

When is emergency coverage provided?
Should you have an emergency while traveling, emergency room services are covered worldwide, but it must be an emergency room and not a convenience/urgent care clinic.

Is emergency transportation covered? What about when I'm outside the Geisinger Health Plan network?
In an emergency, or when approved by a Geisinger Health Plan medical director, transportation by land or air ambulance is covered. Members requiring transportation services must make every reasonable effort to request that transport services be provided by a participating transportation provider to a participating provider and assist in such transfer to the extent physically able or medically possible.

Members who seek urgent or emergent care outside the Geisinger Health Plan network will be returned to a network facility as soon as possible after the emergency situation is over and the member's condition stabilizes.

When may I see a provider, other than my PCP, without first getting a referral?
Most members do not need a referral to gain access to a participating mental health provider or facility for outpatient services. 

You may seek care from a participating alcohol or chemical dependency provider for outpatient and/or inpatient substance abuse services without first seeing your provider.

Women do not need a referral in order to schedule an appointment with a participating obstetrician and gynecologist.

Can I see more than one specialist using the same referral to a like specialty?
Yes, referrals are written by specialty not a particular doctor. Depending on your plan you will need an active referral to see a doctor in the specialty. Check you benefit documents for further details or call the number on the back of your member ID card.

How long is a referral effective?
18 months, generally.

What is the difference between a referral and a prior authorization?
A referral is given by your PCP to see a specialist while a prior authorization gives permission for a service or medication. 

What’s a precertification and why do you need it for services to be covered?
All non-emergency hospital admissions and certain outpatient procedures require precertification to be covered.

Does GHP cover flu shots and vaccinations?
Yes. We offer immunization programs to adults, adolescents and children at no cost.*

*Preventive services such as vaccines are covered with no member cost sharing when obtained from a participating or preferred doctor, unless otherwise noted. If your doctor provides medical services during your preventive care visit that are not included on the preventive care list, these items will be considered under your standard medical plan coverage. This means you may be responsible for cost sharing. See your benefit documents for specific details on your plan coverage.

What copayments am I responsible for?
Routine office visits to your PCP require a copay as specified on your ID card, if not listed check your Schedule of Benefits. Emergency services are subject to the emergency room copayment listed on your ID card or policy’s Schedule of Benefits and are limited to the annual aggregate maximum copayment amount, also on the Schedule of Benefits.

What medicines are covered by my plan?
Search to see all covered medicines.
 
How do I request a formulary exception?
If you would like to request that the Health Plan consider covering a drug that is not currently available on our formulary, you can request a formulary exception. Pennsylvania state law requires all formulary exceptions to be initiated by a physician. To begin the process, log in and send us a secure message to request a formulary exception and a representative will then review your request and contact your physician.

How do I take advantage of discounts offered through GHP?
As a member of Geisinger Health Plan you have access to a variety of discounted health related products and services.  We call it our Accessories Program.  To access the discounted services under this program, all you need is your Geisinger Health Plan membership ID card.  You do not need a referral for Accessories Program Services. Log in to learn more.

I received a monthly premium payment bill in the mail. Where do I mail my payment?
The easiest way to make payments is to use our online Premium Payment tool.

You can also pay your premium over the phone by calling customer service at the phone number found on the back of your ID Card.

If you prefer to mail your payment, select the correct address from the list below. Your plan can be found on the front of your ID card.

If your plan is:

Geisinger Health Plan
Geisinger Gold Classic
Geisinger Gold Secure

Geisinger Gold Preferred
Geisinger Gold Reserve


 Geisinger Choice

Mail your payment to:

Geisinger Health Plan
P.O. Box 827502
Philadelphia, PA 19182-7502

Geisinger Indemnity Insurance Co.
P.O. Box 822242
Philadelphia, PA 19182-2242

Geisinger Quality Options, Inc.
P.O. Box 822476
Philadelphia, PA 19182-2476

 

What happens if I lose my employer-provided health insurance coverage?
If you’re no longer covered under your employer’s plan, you can convert to individual coverage. We have insurance plans to fit your needs.

I no longer have coverage with the plan, but wanted to log in to see my claims history. Why can’t I log in?
For security reasons, you must be an active member to access the secured member portal. Our customer service team can provide claims history information or answer any other questions you might have. Call them at the number listed on the back of your member ID card. If you no longer have your ID card, contact us for help.

 

Questions about using the website

How do I register?

Take the following steps to register:

  1. Go to the registration page. 
  2. Click the User Registration button on the left-hand side of your screen.
  3. You will be asked to select your affiliation with the Health Plan.
  4. Click on Member. A registration form will appear.
  5. Fill in all required fields on the registration form: your member ID number (you can find this number on the front of your member ID card), date of birth, ZIP code and the last four digits of your Social Security number. Click Register.
  6. After all required fields are entered and submitted, you’ll be taken to our Terms and Conditions section.
  7. Once you accept, you can choose a user name and password. On the profile screen, you’ll need to pick a challenge question. The challenge question will help later if you forget your password.
  8. A confirmation letter will be sent to you via U.S. Mail. You can expect to receive it within five to seven business days.


I forgot my password. What should I do?

You’re allowed three attempts to enter your password correctly before being locked out.
Before being locked out, you may choose to create a new password. Begin by going to the Forgot Your Password page.

If you have already tried to log in three times unsuccessfully, fill out a form to have your account unlocked. You will receive an email within one business day, once your account is reactivated.

Related information

Learn more about Geisinger Health Plan.

Find a doctor or pharmacy

See whether your doctor or pharmacy are part of our network.

Log in to your account

To learn more, check your claim records, or update your information, log in to your secure account.

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