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Medicare questions and answers

We know that insurance coverage can sometimes be a little complicated. Here are the answers to the most common questions we hear. If yours isn’t answered, contact us.

Prescription drug questions

Do I have to enroll in a Medicare prescription drug plan?
You don’t have to enroll in Medicare Part D. However, even if you’re not currently taking many prescription drugs, you should still consider joining a plan, so if things change, you’ll have the coverage you need. If you wait to enroll in a Medicare prescription drug plan, you may have to pay a penalty for joining late.

What if I didn’t join a Medicare Prescription Drug plan when they were first offered?
If you didn’t sign up for a plan by May 15, 2006, and you don’t have a drug plan that covers as much or more than a Medicare prescription drug plan, you may have to pay more each month.

Can I enroll in a stand-alone Medicare prescription drug plan, if Geisinger Gold’s Medicare plan already includes prescription drug coverage, along with the medical coverage (an MA-PD plan)?
No. If you purchase a stand-alone Medicare drug plan while you're enrolled in a Medicare Advantage plan with prescription drug coverage (MAPD), you'll be automatically disenrolled from the MAPD plan.

If I enroll between Oct. 15 and Dec. 7, 2018, when will my coverage become effective?
Your coverage will become effective on Jan. 1, 2019.

Geisinger Gold questions

As a member of the plan, what are my rights and responsibilities?
Members have the right to:
  • Be treated with fairness and respect
  • Privacy of their medical records and personal health information
  • See plan providers, get covered services and get their prescriptions filled within a reasonable period of time
  • Know their treatment choices, regardless of cost or benefit coverage, and participate in decisions about their healthcare
  • Use advance directives (such as a living will or power of attorney)
  • Make complaints
  • Get information about their healthcare coverage and costs
  • Get information about Geisinger Health Plan, Geisinger Gold, plan providers, their drug coverage and costs
  • Make recommendations regarding Geisinger Gold’s rights and responsibilities policies

To get the most out of your health plan, it’s important to know that members have a responsibility to:

  • Become familiar with their coverage and the rules they must follow to get care as a member
  • Give their doctors and other providers the information they need to care for them, and to follow the treatment plans and instructions that the member and the provider agree upon
  • Act in a way that supports the care given to other patients and helps the smooth running of the provider’s office, hospitals and other offices
  • Pay their plan premiums and any copayments, coinsurance, and deductibles they may owe for the covered services they receive
  • Let Geisinger Gold know if they have any questions, concerns, problems or suggestions
  • Immediately report any change of address
  • Keep Geisinger Gold up-to-date on any other health insurance coverage they have
  • Understand their health problems and participate in developing mutually agreed-upon treatment goals to the extent possible

Why can't I keep the prescription plan I already have and purchase Geisinger Gold only for medical coverage?
Depending upon what that prescription plan is, you may be able to keep it. If it’s PACE, PACENET (PACEPLUS), Tricare, VA or an employer retirement prescription plan, you don’t have to choose a Geisinger Gold prescription drug plan. However, if you have a prescription drug plan not listed here and you want to maintain a prescription benefit, Medicare requires those with Geisinger Gold medical coverage to choose prescription coverage from Geisinger Gold.

Enrollment questions

When will I receive my Geisinger Gold insurance card?
You'll receive your card after Medicare and Geisinger Gold confirm your eligibility; the timeframe for this varies.

Should I cancel my current insurance?
No, you should never cancel any existing insurance until you have received verification of acceptance with another plan. You may also be required to put that in writing for your current insurer.

When will I get the first bill? Can I change my payment method if I get a bill and then want it deducted from my checking/savings/credit card account?
That depends on the billing cycle and when Medicare's approval is received. In most cases, the first bill (if not electronically deducted from a savings/checking/credit card or Social Security check) will be a double bill until the billing cycle puts it in a routine mailing. You can make arrangements with customer service to have your premiums deducted from a checking/savings/credit card.

Will I be enrolled right away?
The application needs to be verified by Medicare. Please wait until you receive your confirmation letter to cancel any current coverage.

If I enroll between Oct. 15 and Dec. 7, 2018, when will my coverage become effective?
Your coverage will become effective on Jan. 1, 2019.

Where do I mail an enrollment application?
A pre-printed envelope was provided with your application. If it's not available, mail the application to:
Geisinger Gold
Attn. Enrollment 32-29
P.O. Box 900
Danville, PA 17821-9979

For the emergency contact, should I list someone who doesn’t live with me?
That’s your choice. A lot of people choose the spouse; however, some choose an adult child outside of the home. Sometimes they even choose a friend. Note that the application contains space for only one contact/telephone number.

Where can I find the "PCP Number" requested on the Gold application?
You can use our online Provider Search tool to see if your primary care physician (PCP) is available with Geisinger Gold. You will find the PCP Number next to each doctor’s name in the search results. You can also contact Geisinger Gold at 800-498-9731, Monday - Friday, 8 a.m. - 8 p.m., for assistance.

Medicare questions

What is the State Pharmaceutical Assistance Program and how do I apply?
Pennsylvania’s State Pharmaceutical Assistance Programs, called PACE and PACENET, work with both Medicare and Geisinger Gold to ensure eligible Pennsylvanians have quality drug coverage at the lowest possible cost.  To speak with a PACE/PACENET representative, call toll-free at 866-712-2060 Monday - Friday, 9 a.m. - 5 p.m. You can also contact Geisinger Gold at 800-498-9731, Monday - Friday, 8 a.m. - 8 p.m., for assistance. TTY users should call 711.

Y0032_18270_1_M File and Use 10/1/18

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