Each health plan is different, because everyone’s health needs are unique. Read about the costs, coverage and benefits of Geisinger Gold plans so you can find one that best supports your health needs.

Classic 360 Rx (HMO)

Premium: $0 per month
Part B insulin: 5%
Annual deductible: $0 per year
Maximum out-of-pocket (MOOP): $7,550
Office visit (PCP/specialist): $0/$35
Inpatient hospital care – acute: $150/day (days 1–5), $0 per day (days 6–90)
Dental: Exam: $0, 2 per year, X-rays: $0, 1 per year
Vision: $20 – 1 exam per year, $100 eyewear limit per year
Hearing: $20 – 1 exam per year
Fitness: $25 annual fee to Silver & Fit facilities
Vaccines: $0 copay
Teladoc e-visits (PCP): $0 copay PCP
Pharmacy benefits including: 100-day supply mail-order pharmacy, one pharmacy network with the same copay regardless of which pharmacy you use

Heritage (HMO)

Premium: $0
Part B insulin: 5%
Annual deductible: $0
Maximum out-of-pocket (MOOP): $6,700
Office visit (PCP/specialist): $0/$20
Inpatient hospital care – acute: $150/day (days 1–5) not to exceed $750 annually, $0/day (days 6–90)
Dental: Exam: $0, 2 per year, X-rays: $0, 1 per year, $1,000 annual limit 
Vision: Exam: $20, 1 per year, eyewear: $200 benefit limit per year
Hearing: Exam: $20, 1 per year, hearing aids: $500 copay/ear, $1,250 limit per ear every 3 years
Fitness: $90 every 3 months
Vaccines: $0
Teladoc e-visits (PCP): $0 copay PCP

Classic Advantage Rx (HMO)

Premium: Varies by county (between $115 and $155)
Part B insulin: 5%
Annual deductible: $0
Maximum out-of-pocket (MOOP): $3,450
Office visit (PCP/specialist): $0/$20
Inpatient hospital care – acute: $150/day (days 1–5) not to exceed $750 annually, $0/day (days 6–90)
Dental: Exam: $0, 2 per year, X-rays: $0, 1 per year, $825 annual limit
Vision: Exam: $20, 1 per year, eyewear: $200 benefit limit per year
Hearing: Exam: $20, 1 per year, hearing aids: $500 copay/ear, $1,250 limit per ear every 3 years
Fitness: $90/every 3 months
Vaccines: $0
Teladoc e-visits (PCP): $0
Pharmacy benefits including: 100-day supply mail-order pharmacy, one pharmacy network with the same copay regardless of which pharmacy you use.

Classic Complete Rx (HMO)

Premium: Varies by county (between $34 and $38)
Part B insulin: 5%
Annual deductible: $0
Maximum out-of-pocket (MOOP): $4,900
Office visit (PCP/specialist): $5/$35
Inpatient hospital care – acute: $200/day (days 1–5), $0/day (days 6–90)
Dental: $0 – 2 exams per year, $0 – 1 X-ray per year, $750 benefit limit per year
Vision: $20 – 1 exam per year, $100 eyewear limit per year
Hearing: $20 – 1 exam per year, $500 copay per ear for hearing aids, $1,250 limit per ear every 3 years
Fitness: $90 every 3 months
Vaccines: $0
Teladoc e-visits (PCP): $5 copay PCP
Pharmacy benefits including: 100-day supply mail-order pharmacy, one pharmacy network with the same copay regardless of which pharmacy you use

Classic Essential Rx (HMO)

Premium: 0
Part B insulin: 5%
Annual deductible: $0
Maximum out-of-pocket (MOOP): $7,550
Office visit (PCP/specialist): $10/$40
Inpatient hospital care – acute: $225/day (days 1–5), $0/day (days 6–90)
Hearing: Exam: $20/1 per year
Vaccines: $0
Teladoc e-visits (PCP): $10
Pharmacy benefits including: 100-day supply mail-order pharmacy, one pharmacy network with the same copay regardless of which pharmacy you use

Secure Rx (HMO D-SNP)

Premium: $0
Annual deductible: $0 to Member
Office visit (PCP/specialist): $0 to member
Inpatient hospital care – acute: $0 to member
Dental: $0 to member; $4,500 benefit limit per year
Transportation: Up to $500 per year
Vision: $0 to member, 1 exam per year, $425 benefit limit per year
Hearing: $0 copay per ear, $2,950 benefit limit per ear every 3 years
Fitness: $120/quarter
Vaccines: $0 cost-sharing, all formulary-covered vaccines
Teladoc e-visits (PCP): $0 to member
Formulary prescriptions (including insulin): $0 co-pay
Pharmacy benefits including: 100-day supply mail-order pharmacy, one pharmacy network with the same copay regardless of which pharmacy you use

Preferred 360 Rx (PPO)

Premium: $0
Part B insulin: 5%
Annual deductible: $0
Maximum out-of-pocket (MOOP): $7,550 (combined in & out)
Office visit (PCP/specialist): $5/$35
Inpatient hospital care – acute: $175/day (days 1–6), $0/day (days 7–90)
Dental: Exam: $0, 2 per year, X-rays: $0, 1 per year, $500 annual limit
Vision: Exam: $20, 1 per year, eyewear: $100 benefit limit per year
Hearing: Exam: $20, 1 per year
Fitness: IN – Silver & Fit $25 annual fee, OON 20% coinsurance
Vaccines: $0
Teladoc e-visits (PCP): $5
Pharmacy benefits including: 100-day supply mail-order pharmacy, one pharmacy network with the same copay regardless of which pharmacy you use.

Preferred Advantage Rx (PPO)

Premium: Varies by county (between $84 and $109)
Annual deductible: $0
Maximum out-of-pocket (MOOP): $4,000 (combined in & out)
Office visit (PCP/specialist): $10/$25
Inpatient hospital care – acute: $200/day (days 1–6) not to exceed $1,200 annually, $0/day (days 7–90)
Dental, vision, hearing and fitness: Included with purchase of Health+ package
Vaccines: $0
Teladoc e-visits (PCP): $10
Part B insulin: 5% copay
Pharmacy benefits including: 100-day supply mail-order pharmacy, one pharmacy network with the same copay regardless of which pharmacy you use

Preferred Complete Rx (PPO)

Premium: $0
Part B insulin: 5%
Annual deductible: $0
Maximum out-of-pocket (MOOP): $6,700 (combined in & out)
Office visit (PCP/specialist): $15/$40
Inpatient hospital care – acute: $225/day (days 1–6) not to exceed $1,350 annually, $0/day (days 7-90)
Dental, vision, hearing and fitness: Included with purchase of Health+ package
Vaccines: $0
Teladoc e-visits (PCP): $15
Pharmacy benefits including: 100-day supply mail-order pharmacy, one pharmacy network with the same copay regardless of which pharmacy you use

Preferred Enhanced (PPO)

Premium: Varies by county (between $0 and $45)
Part B insulin: 5%
Part B Giveback: Certain counties may be eligible for $25 Part B Giveback
Annual deductible: $0
Maximum out-of-pocket (MOOP): $7,550 (combined in and out)
Office visit (PCP/specialist): $0/$35
Inpatient hospital care – acute: $325/stay, not to exceed $975 annually
Dental: $0/2-year exam, $0/1-year X-ray, up to $1,000 allowance
Vision: $20 – 1 exam per year, $250 eyewear limit per year
Hearing: Hearing aids: $100 benefit limit per year
Fitness: $25 annual fee in-network to Silver & Fit facilities, 20% coinsurance out-of-network
Vaccines: $0 copay
Teladoc e-visits (PCP): $0 copay PCP
Pharmacy benefits including: 100-day supply mail-order pharmacy, one pharmacy network with the same copay regardless of which pharmacy you use