Search covered medications & pharmacies

2023 searchable formularies:

• Geisinger Gold Classic Complete Rx (HMO)
• Geisinger Gold Classic Advantage Rx (HMO)
• Geisinger Gold Essential Rx (HMO)
• Geisinger Gold Preferred Complete Rx (PPO)
• Geisinger Gold Preferred Advantage Rx (PPO)
• Geisinger Gold Preferred Enhanced Rx (PPO)
• Geisinger Gold Classic 360 Rx
• Geisinger Gold Preferred 360 Rx
• Geisinger Gold Formulary for Employer Groups

For information about specific prescription medication benefits, contact the pharmacy customer care team at 800-988-4861.

Click here to view the printable 2023 Pharmacy Directory

Click here to view the printable 2023 Geisinger Gold $0 Deductible Rx Formulary (updated August 29, 2023/effective September 1, 2023)

Important Message About What You Pay for Vaccines – Our plan covers most Part D vaccines at no cost to you. Call Member Services for more information.

Important Message About What You Pay for Insulin – You won’t pay more than $35 for a one-month supply of each insulin product covered by our plan, no matter what cost-sharing tier it’s on.

The Geisinger Gold Standard Rx Formulary (drug list) is used for the following benefit packages:

• 2023 searchable formulary for Geisinger Gold Secure Rx (HMO SNP)

For information about specific prescription medication benefits, contact the pharmacy customer care team at 800-988-4861.

Click here to view the printable 2023 Geisinger Gold Standard Rx Formulary (updated August 29, 2023/effective September 1, 2023)

Important Message About What You Pay for Vaccines – Our plan covers most Part D vaccines at no cost to you. Call Member Services for more information.

Important Message About What You Pay for Insulin - You won't pay more than $0 for a one-month supply of each insulin product covered by our plan, even if you haven't paid your deductible.

The Geisinger Gold Triple Tier Formulary for Employer Groups benefit assigns each prescription medication to one of three tiers.  Each Tier has a different copayment or coinsurance amount. In general, the higher the cost-sharing tier, the higher your cost for the drug. Cost-sharing amounts are determined by your employer. Contact your employer with questions. 

• Searchable 2023 formulary for Geisinger Gold Triple Tier for Employer Groups

Click here to view the printable 2023 Geisinger Gold Rx Triple Tier for Employer Groups Formulary (updated August 23, 2022/effective January 1, 2023)

Important Message About What You Pay for Vaccines – Our plan covers most Part D vaccines at no cost to you. Call Member Services for more information.

Important Message About What You Pay for Insulin – You won’t pay more than $35 for a one-month supply of each insulin product covered by our plan, no matter what cost-sharing tier it’s on.

The Triple Choice Formulary benefit assigns each prescription medication to one of three different tiers, each representing a set copayment amount. The copayment amount will depend on your prescription medication rider. Additional medications, other than those included in this formulary, may be covered under the Triple Choice benefit.

For information about specific prescription medication benefits, contact the pharmacy customer care team at 800-988-4861.

Printable formulary

ACA Preventive $0 Cost Share List

The Traditional Formulary benefit has either a flat copayment/coinsurance, one copayment for generic or one copayment for brand, or assigns each prescription medication to one of two different tiers, each representing a set copayment amount. The copayment amount will depend on your prescription medication rider. Additional medications, other than those included in this formulary, may be covered under the Traditional benefit. 

For information about specific prescription medication benefits, contact the pharmacy customer service team at 800-988-4861.

Printable formulary

ACA Preventive $0 Cost Share List

The High Performance Rx Formulary benefit assigns each prescription medication to one of three different tiers, each representing a set copayment amount. The copayment amount will depend on your prescription medication rider. Additional medications, other than those included in this formulary, may be covered under the High Performance Rx benefit.

For information about specific prescription medication benefits, contact the pharmacy customer care team at 800-988-4861.

Printable formulary

With Geisinger Marketplace Plans, each prescription medication is assigned to one of six tiers, each with a set copayment or coinsurance amount. The copayment/coinsurance amount will depend on your prescription medication rider. Additional medications, other than those included in this formulary, may be covered by Geisinger Marketplace Plans.

2023 Searchable Formulary for Geisinger Marketplace Plans

Click here to view the printable 2023 Geisinger Marketplace (effective September 1, 2023)

For information about specific prescription drug benefits or to find a network pharmacy, contact the pharmacy customer care team at 800-988-4861.

ACA Preventive $0 Cost Share List

CHIP is Pennsylvania’s Children’s Health Insurance Program. It provides health insurance to all uninsured children and teens that are not eligible for Medical Assistance.  The CHIP pharmacy benefit assigns each prescription medication to one of two different tiers, each representing a set copayment amount. The copayment amount will depend on which plan you have. Additional medications, other than those included in this formulary, may be covered under the CHIP pharmacy benefit.

For information about specific prescription medication benefits, contact the pharmacy customer care team at 800-988-4861.

All pharmacy providers in Pennsylvania (PA) must be enrolled with the PA Department of Human Services (DHS) and have a valid Pennsylvania Medicaid ID# to dispense medications for GHP Kids members. Please check with the pharmacy to ensure they have a current Medicaid ID before presenting prescription. 

Northern Light Employee Plan Formulary assigns each prescription medication to one of three different levels. The tier and resulting copayment are dependent on what the level is and which pharmacy fills the prescription. The copayment amounts and tiers are defined in the plan benefit materials provided by your employer.

For information about specific prescription medication benefits, contact the pharmacy customer care team at 800-988-4861. 

Printable formulary

Zero dollar copay drug list

The AON Active Health Exchange Formulary assigns each prescription medication to one of three different levels. The tier and resulting copayment are dependent on what the level is and which pharmacy fills the prescription. The copayment amounts and tiers are defined in the plan benefit materials provided by your employer.

For information about specific prescription medication benefits, contact the pharmacy customer care team at 800-988-4861.

Printable formulary

ACA Preventive $0 Cost Share List

Printable formulary

ACA Preventive $0 Cost Share List

GHP Family is Geisinger Health Plan’s Medical Assistance managed care plan. GHP Family members are assigned to different groups based on their eligibility. Depending on which group you are in, your pharmacy benefit may or may not have a co-payment assigned to your medication. Pharmacy copays will apply to members 18 years of age and older unless otherwise listed below. Brand name prescription drugs have a $3 copayment. Generic prescription and over-the-counter drugs have a $1 copayment. Services cannot be denied if the member is unable to afford the copay. There are no copays for: 

• Pregnant women (including the postpartum period which ends 60 days after delivery)
• Children under 18 years of age
• Medical benefit drugs
• Members in a nursing home
• Members receiving hospice care
• Members in an Intermediate Care Facility for Mental Retardation or Intermediate Care Facility for Other Related Conditions 
• Family planning drugs or supplies 
• Drugs, including immunizations, when dispensed and/or administered by a physician 
• Title IV-B Foster Care and IV-E Foster Care and Adoption Assistance
• Members eligible under the Breast and Cervical Cancer Prevention and Treatment Programs 

There is no copay for the following groups of medications:

• Antihypertensives (high blood pressure) 
• Antidiabetes (high blood sugar) 
• Anticonvulsants (seizure) 
• Cardiovascular preparations (heart disease)
• Antipsychotics (except those that are controlled substance antianxiety drugs) 
• Antineoplastics (cancer drugs) 
• Antiglaucoma drugs 
• Anti-Parkinson’s drugs
• HIV/AIDS drugs 
• Preferred naloxone injection/nasal spray for drug overdose.

For information about specific prescription medication benefits, contact pharmacy member services at 855-552-6028.

All pharmacy providers in Pennsylvania (PA) must be enrolled with the PA Department of Human Services (DHS) and have a valid Pennsylvania Medicaid ID# to dispense medications for GHP Family members. Please check with the pharmacy to ensure they have a current Medicaid ID before presenting prescription.

Geisinger Health Plan, like other Medicaid Managed Care Organizations, follows the Statewide Preferred Drug List (PDL). The Statewide PDL is a list of preferred drugs developed by the Department of Human Services’ (DHS) Pharmacy and Therapeutics Committee. Medications not on the PDL follow the GHP Family Formulary. Click to view the Statewide Preferred Drug List (PDL).