< Agent Blog
Oct
27
,
2021

Get to Know Geisinger Gold's Preferred Advantage Rx Plan

October 27, 2021
Geisinger Gold

Annual Certification for 2022

Plan Year 2022 (PY22) Connecture site

Any broker who had access to the Plan Year 2021 Connecture site, Geisinger’s electronic enrollment tool, was automatically granted access to the PY22 Connecture site.

Visit the Connecture site

When you log into the PY22 site, you’ll use the username and password you were assigned to log into the PY21 site. If it doesn’t allow you to sign into the PY22 site with those credentials, use the “Forgot password” option to reset your password for the site. An email will be sent to you at the email address on your Connecture profile and will come from drx.com.  

If you have any issues logging into the PY22 site, or need to confirm that you have access, email Medicare Sales Operation for assistance.

Note: The Broker List from PY21 has migrated to PY22.  

Medicare Star Ratings update

Geisinger Health Plan has just improved its Medicare Star Rating to 4 Stars for PPO plans and 4.5 Stars for HMO plans.

This is great information to give to prospects as you are meeting them and reviewing plan options.

Preferred Advantage Rx plan benefits at-a-glance

  • Premium: varies (see county breakdown below)
  • 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)
  • Vaccines: $0
  • Teladoc e-visits (PCP): $10
  • Part B insulin: 5% copay

Adding Gold Health Plus — for an additional $38/month — includes:

  • Dental (prevented and comprehensive):
  • $600 max benefit per year that includes:
  • 2 routine exams per year (with or without cleaning)
  • 1 set of X-rays per year (bitewing or panoramic)
  • Simple fillings, simple extractions, dentures, crowns & root canals
  • See any provider
  • Vision: Exam:
  • $20 copay
  • 1 routine exam per year (includes refraction)
  • $100 hardware allowance per year (contacts, glasses, lenses, frames)
  • See any provider
  • Can be combined with GHP Accessories Program discounts
  • Hearing: Exam:
  • $20 copay
  • 1 routine exam per year
  • $500 hearing aid & fitting allowance per year
  • See any provider
  • Fitness:
  • $90 allowance per quarter
  • Access to facilities of your choice
  • Can be applied to any fitness service the facility offers (excludes food & beverage)

Your clients’ premiums will vary depending on their county.

Here’s how prescriptions will break down:

  • 30-day retail copay:
  • Tier 1 – $3
  • Tier 2 – $20
  • Tier 3 – $47
  • Tier 4 – $100
  • Tier 5 – 33%
  • Tier 6 – $0 vaccines
  • 100-day retail copay:
  • Tier 1 – $7.50
  • Tier 2 – $50
  • Tier 3 – $117.50
  • Tier 4 – $250
  • Tier 5 – Not available
  • 100-day mail order copay:
  • Tier 1 – $0
  • Tier 2 – $0
  • Tier 3 – $70.50
  • Tier 4 – $150
  • Tier 5 – Not available

Need insulin? We’ve got it covered.

Because so many Geisinger Gold members depend on insulin to maintain their health,  the company is now offering the following insulins at a reduced copay amount for eligible members:

  • Novo Nordisk:
  • Novolin® N
  • Novolin R
  • NovoLog®
  • Novolin 70/30
  • NovoLog Mix
  • Lantus®
  • Levemir®
  • Toujeo®
  • Tresiba®
  • Xultophy®

View Details >View Details >

Questions? Call us at 855-888-8326.

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