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Geisinger Gold (Medicare Part D)

Geisinger Gold $0 Deductible Rx Plans

The Geisinger Gold $0 Deductible Rx Formulary (drug list) is used for the following Medicare Advantage Plans with Part D Prescription Drug Coverage: 
  • 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 2024 Pharmacy Directory 

Click here to view the printable 2024 Geisinger Gold $0 Deductible Rx Formulary (updated January 29, 2024/effective February 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:

  • 2024 searchable formulary for 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 2024 Pharmacy Directory

Click here to view the printable 2024 Geisinger Gold Standard Rx Formulary (updated January 29, 2024/effective February 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 2024 Pharmacy Directory

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

The 4th Tier Formulary benefit assigns each prescription medication to one of four 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 4th Tier benefit. 
 
For information about specific prescription medication benefits, contact the pharmacy customer care team at 800-988-4861.

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 2024 Geisinger Marketplace formulary (effective February 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.

ACA Preventive $0 Cost Share List


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 Health Exchange

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.


Geisinger Employee Plan

Geisinger 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

GHP Family

Medical Assistance

GHP Family is GHP’s Medical Assistance managed care plan. As a GHP Family member, you are assigned to a group based on your eligibility. Depending on your group, your pharmacy benefit might have a medication copay. Members age 18 and older have pharmacy copays (unless otherwise listed below). Brand-name prescription drugs have a $3 copay. Generic prescription and over-the-counter drugs have a $1 copay. If you cannot afford the copay, services cannot be denied. There are no copays for: 

  • Pregnant members (including the postpartum period, which ends 60 days after delivery)
  • Members under age 18
  • Medical benefit drugs
  • Members in a nursing home
  • Members receiving hospice care
  • Members in an intermediate care facility for intellectual disability or intermediate care facility for other related conditions 
  • Family-planning drugs or supplies 
  • Medications and vaccinations dispensed or given by a doctor 
  • 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 medications for:

  • High blood pressure
  • High blood sugar
  • Seizure 
  • Heart disease
  • Psychotic disorders (except controlled substance anti-anxiety drugs) 
  • Cancer 
  • Glaucoma 
  • Parkinson’s disease
  • HIV/AIDS
  • Drug overdose (specifically, preferred naloxone injection/nasal spray)

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).


Need help? Call 800-988-4861 or 570-271-5673, Monday through Friday, 8 a.m. — 5 p.m.

View formulary updates and current drug recalls here.
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For the fourth year in a row, Geisinger Health Plan is ranked #1 by J.D. Power for its excellence in customer service for commercial group.

Because we put you first

For the fourth year in a row, Geisinger Health Plan is ranked #1 in Member Satisfaction among Commercial Health Plans in Pennsylvania by J.D. Power.

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