Good news! 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.

Remember to follow up with potential members who have a paper application to be sure they’re submitted in time.

• Premium: Varies (see county breakdown below)
• Annual deductible: $0
• Maximum out-of-pocket (MOOP): $7,550 (combined in and out)
• Office visit (PCP/specialist): $5/$35
• Inpatient hospital care – acute: $325/stay, not to exceed $975 annually
• Dental (preventive and comprehensive): $0/2-year exam, $0/1-year X-ray, up to $650 allowance
• Vision: $20 – 1 exam/year, $250 eyewear limit per year
• Hearing: $100 benefit limit per year for hearing aids
• Flex card: $500 in extra benefits for dental, vision or hearing 
• Fitness: $25 annual fee in-network to Silver & Fit facilities, 20% coinsurance out-of-network
• Over-the-counter (OTC) card: $25/month that can be used at Walmart, Rite Aid, Family Dollar, CVS, Walgreens or mail-order  
• Part B insulin at 5%
• Vaccines: $0 copay
• Teladoc e-visits (PCP): $5 copay PCP

• 30-day retail copay:
• Tier 1 – $0
• Tier 2 – $5
• Tier 3 – $47
• Tier 4 – $100
• Tier 5 – 33%
• Tier 6 – $0 vaccines
• 100-day retail copay:
• Tier 1 – $0
• Tier 2 – $12.50
• 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

Because so many of our Geisinger Gold members depend on insulin to maintain their health, we’re 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®

Other insulin products are not available through this program, but if your brand is on the list and you have your medications delivered to your door, copays have never been lower:

• 1-month supply: $35 
• 2-month supply: $52.50 
• 3-month supply: $52.50

Rather pick up your medications in person? Your copays are lower for that option, too:

• 1-month supply: $35 
• 2-month supply: $70
• 3-month supply: $87.50