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Questions and answers

We know health insurance can be complicated. Here are answers to the most common questions we hear.

How can I get information about Geisinger Marketplace plans?

You can learn more about Geisinger Marketplace plans by clicking here or contacting one of our knowledgeable, friendly representatives at 800-223-1282, Monday through Friday, 8 a.m. to 7 p.m., and Saturday, 10 a.m. to 2 p.m.
How do I enroll in a Geisinger Marketplace plan?

For 2021 coverage, Open Enrollment begins Sunday, Nov. 1, 2020 and runs through Friday, Jan. 15, 2021. If you enroll between Sunday, Nov. 1, 2020 and Tuesday, Dec. 22, 2020, your health coverage will take effect on Jan. 1, 2021. If you enroll between Wednesday, Dec. 23, 2020 and Friday, Jan. 15, 2021 for coverage starting Feb. 1, 2021. You can shop and enroll in a Geisinger Marketplace plan by clicking here or contacting one of our knowledgeable, friendly representatives at 800-223-1282, Monday through Friday, 8 a.m. to 7 p.m., and Saturday, 10 a.m. to 2 p.m. If you recently had a life change, you may qualify for a Special Enrollment Period to enroll in a health insurance plan.
Do I need to use only Geisinger providers and facilities?

No! Geisinger Health Plan’s network offers access to more than 29,000 providers, including 100+ hospitals and more than 130 urgent and convenient care locations, along with access to emergency care anywhere in the world.  Click here to search our network and update location before you start your search. 
What is coinsurance?

Once you meet your deductible, GHP pays a percentage and you pay a percentage of the remaining costs. The percentage you pay is called coinsurance.

If you have a plan with 20 percent coinsurance, GHP will pay 80 percent of covered services after your deductible has been met and you pay the remaining 20 percent. Once you reach your maximum out-of-pocket you will no longer have to pay coinsurance.

What does maximum out-of-pocket mean?

The maximum out-of-pocket (MOOP) amount includes all member expenses, such as deductibles, coinsurance and copays, for all covered services within a plan period. Once your MOOP costs are met, your health insurance plan will pay 100 percent of costs for covered services.
What are metallic levels?

Under the Affordable Care Act (also known as the ACA, or healthcare reform), the below metallic tiered categories are based on how you and your plan splits your healthcare costs. There are four metallic levels (bronze, silver, gold and platinum).

  • Bronze: Your health plan pays 60% on average. You pay about 40%.
  • Silver: Your health plan pays 70% on average. You pay about 30%.
  • Gold: Your health plan pays 80% on average. You pay about 20%.
  • Platinum: Your health plan pays 90% on average. You pay about 10%.

As you go from bronze to platinum, the monthly premiums tend to go up. So, a bronze plan would generally have a lower premium than a platinum plan.

If your question isn’t answered here, call us at 800-223-1282.