All the benefits of Medicaid and Original Medicare. Plus more.
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Keep your current Medicaid and Medicare benefits, plus get more
Learn how you can get more Medicare benefits and savings at no extra cost.
This plan has a $0 monthly premium, so it costs you nothing to receive additional benefits. And you don’t lose any of your current Medicaid and Medicare benefits.
Medicare Special Needs Plan
- $0 copay for doctor and specialist visits
- $0 telehealth video calls with your primary care physician and for mental health/substance abuse visits
- $3,500/year for comprehensive dental services, plus $0 preventive services
- $1,140/year for over-the-counter medications
- $400/year for glasses or contact lenses
- $2,950 every 3 years for hearing aids
- $500/year reimbursement for transportation to and from doctors’ appointments
- $0 copay for Geisinger at Home™ health services in your home
- As low as $0 copays for generic drugs and vaccines
Help paying for prescription drugs
Extra Help is a financial assistance program available for prescription costs, premiums, deductibles and coinsurance of Medicare prescription drug coverage. It’s administered by the Social Security Administration and Centers for Medicare and Medicaid Services.
However, if you don't qualify for Social Security Extra Help, your state may have programs that can help with prescription costs. You can also re-apply for Extra Help at any time if your income and resources change.
See if you qualify
Learn about the options available to you.
Find out if you're eligible.
If you have limited financial resources and income, you may be eligible for extra help from Medicare. There is a program that can help pay for costs related to a Medicare prescription drug plan, including monthly premiums, annual deductibles and prescription copays.
For 2020, you may qualify if your annual income is $19,140 or less ($25,860 for a married couple) and you have up to $14,610 in resources ($29,160 for a married couple). These amounts may change in 2021. Even if you don’t have complete documentation required for eligibility, you may qualify for extra help under Medicare's Best Available Evidence policy.
- 800-MEDICARE (800-633-4227), 24/7. TTY users should call 877-486-2048.
- Social Security (800-772-1213), 7 a.m. – 7 p.m. ET, Monday – Friday. TTY users should call 800-325-0778.
- Your state’s Medicaid office
You can also visit the Social Security Administration website for additional information about extra help.
If you qualify for extra help, your premium may vary. The premium covers both medical services and prescription drug coverage. These amounts don't include any Medicare Part B premium you may have to pay. See the premiums for 2021 plans and 2022 plans.
You must continue to pay your Medicare Part B premium if it’s not paid for under Medicaid or by another third party. To see what your premium would be, first find your plan and then the county you live in.
You may also qualify for help through PACE or PACENET programs. Call 800-225-7223 to find out.
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*Must be receiving full Medicaid benefits and assigned a qualifying category and program code as defined by Medicaid (Medical Assistance). Geisinger Gold Medicare Advantage HMO SNP plan is offered by Geisinger Health Plan, a health plan with a Medicare contract. Continued enrollment in Geisinger Gold depends on annual contract renewal. This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.
Y0032_21105_5_M Accepted 4/19/21
Last updated 4/15/2021