Q. What services aren't covered under my loved one's enrollment?
A. LIFE Geisinger covers the same services that other Medicare or Medicaid health plans cover, except in an all-inclusive setting.
If the participant needs care while outside of the area (such as emergency or urgent care), you will need to notify LIFE Geisinger within 48 hours (or as soon as it is reasonably possible to do so).
If hospitalization outside the area is needed, LIFE Geisinger will work with the care providers to transfer the participant back to contracted facilities when appropriate.
Q. Does the participant have co-payments or deductibles?
A. No, once the individual is enrolled in LIFE Geisinger, they have:
- No copayments, no deductibles, although individuals will be responsible to pay for their Medicare part B premiums.
- All medically necessary prescription drugs (these are covered under LIFE Geisinger Medicare Part D benefit)
- All necessary over the counter drugs
- No threshold gaps in coverage; continuous coverage throughout the year
In some cases there may be a monthly premium required to participate in LIFE Geisinger, depending on the participant's income.
Once enrolled in a PACE program like LIFE Geisinger, the participant's ability to pay will never be a barrier to the care he/she needs.
Q. Is home nursing care an extra cost?
A. No, all authorized services are covered by the program at no cost to the participant. The state may apply cost-sharing based upon income and family situation if the participant is placed in a facility for more than 30 days.