Skip to main content

We’ve updated our Terms & Conditions and Privacy Policy. By using this site, you agree to these terms.

Geisinger Gold 2019 benefit documents

Download the benefit documents for Geisinger Gold plans. All files are PDFs.

Summaries of Benefits 

Classic Advantage (HMO), Classic Advantage Rx (HMO), Classic Complete Rx (HMO), Classic Essential Rx (HMO)
Preferred Advantage Rx (PPO), Preferred Complete Rx (PPO), Preferred Enhanced Rx (PPO)
Secure Rx (HMO SNP) 
PEBTF
Verizon

Enrollment Forms 

For Classic, Preferred and Secure plans

Evidences of Coverage

Classic Advantage (HMO) (Columbia, Luzerne, Montour, Northumberland, Schuylkill, Snyder, Union counties)
Classic Advantage (HMO) (all other counties)
Classic Advantage Rx (HMO) (Columbia, Luzerne, Montour, Northumberland, Schuylkill, Snyder, Union counties)
Classic Advantage Rx (HMO) (all other counties)
Classic Complete Rx (HMO) (Columbia, Luzerne, Montour, Northumberland, Schuylkill, Snyder, Union counties)
Classic Complete Rx (HMO) (all other counties)
Classic Essential Rx (HMO)
Preferred Advantage Rx (PPO)
Preferred Complete Rx (PPO)
Preferred Enhanced Rx (PPO)
Secure Rx (HMO SNP)
PEBTF
Verizon

If you are a current Geisinger Gold member and will remain enrolled for 2019, view your 2019 Annual Notice of Change (ANOC) letter.

Fitness Program Information

Classic Advantage
Classic Advantage Rx
Preferred Advantage Rx (PPO) with Health+
Preferred Complete Rx (PPO) with Health+
Classic Rx Employer Group Plans with Fitness Benefits
Secure Rx

Plan Quality Ratings from Centers for Medicare and Medicaid Services (CMS)

Plan Contract H3954 (includes Classic and Secure plans)
Plan Contract H3924 (includes Preferred plans)
 

Geisinger Gold Medicare Supplement 

Outline of Coverage
Enrollment Application
Plan A Policy
Plan B Policy 
Plan C Policy 
Plan F Policy
Plan F (High Deductible) Policy 
Plan M Policy
Plan N Policy

Related Information

Learn more about Geisinger Gold.

Log in

Get information specific to your plan on our member site.

Find a doctor, pharmacy or prescription

See which doctors, pharmacies and prescriptions are available with Geisinger Gold.

Health and wellness programs

Our online, telephone and in-person programs will help you stay on track with your health goals.

Content from General Links with modal content