Search covered medications & pharmacies
Geisinger Gold (Medicare Part D)
Geisinger Gold $0 Deductible Rx Plans
- 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 Value 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 2025 Pharmacy Directory
Click here to view the printable 2024 Pharmacy Directory
Click here to view the printable 2025 Provider Directory
Click here to view the printable 2024 Provider Directory
Click here to view the printable 2025 Geisinger Gold $0 Deductible Rx Formulary (updated October 1, 2024/effective January 1, 2025)
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.
Click here to view the printable 2024 Geisinger Gold $0 Deductible Rx Formulary (updated November 25, 2024/effective December 1, 2024)
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.
Geisinger Gold Standard Rx Plans
The Geisinger Gold Standard Rx Formulary (drug list) is used for the following benefit packages:
- Geisinger Gold Secure Rx (HMO D-SNP)
For information about specific prescription medication benefits, contact the pharmacy customer care team at 800-988-4861.
Click here to view the printable 2025 Pharmacy Directory
Click here to view the printable 2024 Pharmacy Directory
Click here to view the printable 2025 Provider Directory
Click here to view the printable 2024 Provider Directory
Click here to view the printable 2025 Geisinger Gold Standard Rx Formulary (updated October 1, 2024/effective January 1, 2025)
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.
Click here to view the printable 2024 Geisinger Gold Standard Rx Formulary (updated November 25, 2024/effective December 1, 2024)
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.
Geisinger Gold Triple Tier for Employer Groups Plans
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.
Click here to view the printable 2025 Pharmacy Directory
Click here to view the printable 2024 Pharmacy Directory
Click here to view the printable 2025 Provider Directory
Click here to view the printable 2024 Provider Directory
Click here to view the printable 2025 Geisinger Gold Rx Triple Tier for Employer Groups Formulary (effective Jan. 1, 2025)
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.
Click here to view the printable 2024 Geisinger Gold Rx Triple Tier for Employer Groups Formulary (updated December 28, 2023/effective Jan. 1, 2024)
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.
All other plans
Geisinger Triple Choice Formulary
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.
Geisinger Traditional Formulary
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.
Geisinger High Performance Rx Formulary
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.
Geisinger 4th Tier
Geisinger Marketplace Plans
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.
Click here to view the printable 2025 Geisinger Marketplace formulary (effective January 1, 2025)
Click here to view the printable 2024 Geisinger Marketplace formulary (effective December 1, 2024)
For information about specific prescription drug benefits or to find a network pharmacy, contact the pharmacy customer care team at 800-988-4861.
CHIP Formulary
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
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.
Aon Benefit Experience
The Aon Benefit Experience 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.
Geisinger Employee Plan
Medical Assistance
Pharmacy Copays
Some drugs require a copayment, which is the amount that you pay to the pharmacy when you receive your prescription or over-the-counter drugs.
You cannot be denied a prescription drug if you cannot pay the copayment. Tell your pharmacist if you cannot afford to pay. Your pharmacist can still try to collect the copayment.
Copayments are as follows:
- For adults:
- brand-name prescription drugs and brand-name over-the-counter drugs cost $3 for each new prescription or refill.
- Generic prescription drugs and generic over-the counter drugs cost $1 for each new prescription or refill.
- For children:
- Brand-name prescription drugs and brand-name over-the-counter drugs cost $0 for each new prescription or refill.
- Generic prescription drugs and generic over-the-counter drugs cost $0 for each new prescription or refill.
There are no copays for:
- Pregnant women (including the postpartum period which ends 12 months 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)
- Antineoplastic (cancer drugs)
- Antiglaucoma drugs
- Anti-Parkinson’s drugs
- HIV/AIDS drugs
- Preferred naloxone injection/nasal spray for drug overdose
Call GHP Family Pharmacy Services at 855-552-6028 or 570-214-3554:
Monday, Tuesday, Thursday, Friday: 8 a.m. – 7 p.m.; Wednesday: 8 a.m. – 8 p.m.; Saturday: 8 a.m. – 2 p.m.
To give medications to GHP Family members, Pennsylvania pharmacies must:
- Be enrolled with the PA Department of Human Services (DHS).
- Have a Pennsylvania Medicaid ID number. Check that the pharmacy has one before you give them your prescription.
Geisinger Health Plan (GHP) follows the Statewide Preferred Drug List (PDL). So do other Medicaid Medical Assistance managed care organizations. The Department of Human Services’ Pharmacy and Therapeutics Committee develops the Statewide PDL. Medications not on the PDL follow the GHP Family Formulary. Click to see the Statewide Preferred Drug List (PDL).
View formulary updates and current drug recalls here.
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