Geisinger Gold Medicare Advantage Reviews

Geisinger Gold Medicare Advantage plans offer comprehensive coverage with additional benefits like dental, vision, and hearing. Ranked fourth in Pennsylvania by J.D. Power in 2023, these plans prioritize quality and affordability.
By . Last update: June 17, 2024

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Geisinger Medicare Advantage Reviews
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Geisinger Gold Medicare Advantage plans, offered by Geisinger Health Plan, have established a notable presence in Pennsylvania’s Medicare landscape. Known for their comprehensive coverage and member-centric approach, these plans provide a range of benefits designed to meet the diverse needs of individuals on Medicare. In the 2023 J.D. Power Medicare Advantage Study, Geisinger Gold was ranked as the fourth best in Pennsylvania, highlighting its commitment to quality and customer satisfaction.

In this editorial review, we’ll examine some of Geisinger Gold’s best Medicare Advantage plans, their coverage options, costs, and customer reviews. By exploring these aspects, we aim to provide a comprehensive overview of what members can expect when enrolling in a Geisinger Gold plan.

Table of Contents

Member Reviews for Geisinger

The following Geisinger reviews have been left by our members.

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PROS

  • Comprehensive Coverage: Often includes benefits not covered by Original Medicare, such as dental, vision, and hearing.
  • High Member Satisfaction: Ranked fourth in Pennsylvania by the 2023 J.D. Power Medicare Advantage Study, indicating strong customer satisfaction (source: jdpower.com).
  • Additional Benefits: Offers extras like fitness memberships, over-the-counter allowances, and wellness programs.
  • Cost-Effective Plans: Many plans have competitive premiums and out-of-pocket costs, providing cost savings for enrollees.
  • Care Coordination: Provides care management programs to help coordinate care between healthcare providers, improving health outcomes.
  • Prescription Drug Coverage: Most plans include prescription drug coverage, which can be more comprehensive than stand-alone Part D plans.

CONS

  • Network Restrictions: Requires members to use in-network providers for the lowest costs, which may limit choice and flexibility.
  • Geographic Limitations: Plans are primarily available in Pennsylvania, limiting options for those outside this region.
  • Prior Authorization Requirements: Some services and treatments may require prior authorization, potentially delaying care.
  • Annual Changes: Plan benefits, premiums, and provider networks can change annually, requiring members to review and potentially switch plans each year.
  • Benefit Limitations: Some additional benefits, like dental and vision, may have annual limits or restrictions, leading to potential out-of-pocket expenses.
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How Do Geisinger Medicare Advantage Plans Work?

Geisinger Medicare Advantage plan members have all their hospital (Medicare Part A) and medical (Medicare Part B) benefits included in their plan. This includes everything from preventive care and vaccinations to visits with doctors and specialists, as well as hospital stays, skilled nursing services, and hospice care.

All Geisinger Medicare Advantage plans include coverage for:

  • Inpatient hospital admissions.
  • Doctor and specialist care.
  • Preventive care, screenings, and vaccinations.
  • Diagnostic services, lab work, X-rays and other imaging.
  • Outpatient services.
  • Ambulance transportation for emergencies.
  • Durable medical supplies and equipment.

Medicare rules say that all Geisinger plans must provide at least the same coverage and benefits as Original Medicare. But, each plan sets its own out-of-pocket costs.

Some Geisinger plans include extra benefits such as routine dental, vision, hearing, and wellness programs. These services aren't typically covered by Original Medicare.

When you join a Geisinger Medicare Advantage plan, you can manage all your healthcare needs under one plan. This often comes with lower out-of-pocket costs and extra benefits suited to your health and lifestyle.

However, it's important to note that lower costs aren't guaranteed. Costs depend on the specific plan and how much you use healthcare services. Also, the Geisinger plan you choose may have access restrictions, such as needing referrals and prior authorization. Original Medicare does not have these restrictions.

Extra Benefits from Geisinger

Most Geisinger Gold Medicare Advantage plans offer additional benefits beyond Original Medicare, designed to enhance overall health and well-being. Common benefits include:

  • Dental, Vision, and Hearing Coverage: Allowances for routine dental care, vision exams, eyeglasses, and hearing aids.
  • Fitness Programs: Access to fitness programs such as SilverSneakers, promoting physical activity and wellness.
  • Over-the-Counter Allowances: Monthly or quarterly allowances for over-the-counter medications and health products.
  • Meal Delivery Services: Meal delivery services following hospital stays to support recovery and nutrition.
  • Transportation Services: Non-emergency transportation to medical appointments and pharmacies.
  • Telehealth Services: Expanded telehealth options for remote consultations and care management.
  • Prescription Drug Coverage: Many plans include comprehensive Part D prescription drug coverage with savings on insulin and other medications.

What Types of Plans Does Geisinger Offer?

Not all Geisinger plans are the same. And, Geisinger may not offer all plan types where you live, so it pays to explore using our Medicare Advantage Plan Finder tool. Here are the plan types Geisinger offers:[6]

Medicare preferred provider organization (PPO) plans provide the most freedom, allowing you to see any provider that accepts the insurance. With a PPO plan, you generally do not need to choose a primary care doctor, and you don’t need referrals to see specialists. And you can seek out-of-network care, although it may cost more than seeing an in-network doctor.

Health maintenance organization (HMO) plans require that you use a specific network of doctors and hospitals. Also, with a Geisinger HMO plan you may need a referral from your primary care doctor in order to see a specialist. Out-of-network benefits are usually very limited. However, in an emergency you are not limited to care from your local hospital of emergency room.

NOTE: Geisinger may also offer Medicare Advantage Special Needs Plans (SNPs). Due to the highly specialized nature of D-SNP (dual eligible), C-SNP (chronic condition), and I-SNP (institutional) insurance plans, we review them separately.

How Much Do Geisinger Plans Cost?

The cost of a Geisinger plan will vary depending on the specific plan chosen, your location, usage of healthcare services, and the plan's out-of-pocket costs. We detail out-of-pocket costs on all Geisinger Medicare Advantage Plans in our plan finder.

Typically, Geisinger charges a monthly premium, which can vary depending on the coverage level and additional benefits included. You must also keep paying your Part B premium. Additionally, if you are a high-income earner, Medicare may apply a monthly Income Related Monthly Adjustment Amount (IRMAA).[5]

Geisinger’s monthly premiums are highly dependent on where you live. For instance, the average cost of a Medicare Advantage plan from Geisinger in Pennsylvania is $32.28 per month, but in Pennsylvania the average cost is $32.28 per month. These averages do not include Special Needs Plans.

Geisinger's Premiums vs. Competitors

The following list shows Geisinger's nationwide average monthly premium (excluding Special Needs Plans) vs. several competitors.

Geisinger
$10.11
AARP/UHC
$13.97
Aetna
$7.75
Wellcare
$26.20
UnitedHealthcare
$22.97

You might also encounter copayments or coinsurance for healthcare services, including doctor visits and hospital stays. In each Geisinger plan we assessed, the costs differed based on the coverage level and the specific services received.

Be aware that some plans have $0 premiums or low copayments for specific services, whereas others could feature higher premiums but reduced out-of-pocket expenses. It’s essential to thoroughly examine the costs and coverage details of each plan option so you can find the one that best suits your budget and healthcare needs.[7]

We analyzed the following popular Geisinger plans to give you an idea of what members pay to use healthcare services. This is just a sample, use our Medicare Advantage Plan Finder to see plans and costs where you live.

Important costs for plan ID H3924-065-0 reviewed in Lycoming County, PA.
  • Monthly premium: $0
  • Out-of-pocket max: $8,000
  • Primary Care: $$0
  • Specialist: $$0
  • Tier 1 Prescriptions: $3.00 copay, $0 deductible
  • Urgent Care: $$0
  • Emergency Room: $$0
  • Ground Ambulance: $$0
  • Inpatient Care:
  • Extra Benefits: None
Important costs for plan ID H3954-157-22 reviewed in Lycoming County, PA.
  • Monthly premium: $100
  • Out-of-pocket max: $3,450
  • Primary Care: $$0
  • Specialist: $$0
  • Tier 1 Prescriptions: $3.00 copay, $0 deductible
  • Urgent Care: $$0
  • Emergency Room: $$0
  • Ground Ambulance: $$0
  • Inpatient Care:
  • Extra Benefits: None
Important costs for plan ID H3954-158-13 reviewed in Lycoming County, PA.
  • Monthly premium: $34
  • Out-of-pocket max: $4,900
  • Primary Care: $$0
  • Specialist: $$0
  • Tier 1 Prescriptions: $3.00 copay, $0 deductible
  • Urgent Care: $$0
  • Emergency Room: $$0
  • Ground Ambulance: $$0
  • Inpatient Care:
  • Extra Benefits: None

Is Geisinger a Good Medicare Advantage Plan?

Geisinger Gold Medicare Advantage plans are known for their comprehensive coverage and member-focused benefits. The quality of these plans can be assessed using various consumer intelligence and review sources, providing a clear picture of member satisfaction and overall performance.

J.D. Power Ranking
In the 2023 U.S. Medicare Advantage Study by J.D. Power, Geisinger Gold was ranked fourth in Pennsylvania. The study evaluates member satisfaction across several factors including quality of care, customer service, and overall trust in the provider. This high ranking reflects Geisinger Gold's strong commitment to quality and member satisfaction (source: jdpower.com).

NCQA Health Plan Score
The National Committee for Quality Assurance (NCQA) rates health plans annually based on quality of care, patient satisfaction, and health plans’ efforts to keep improving. Geisinger Gold Medicare Advantage plans have received favorable ratings from the NCQA, indicating a solid performance in these key areas. In the 2023 ratings, Geisinger Gold’s plans received ratings between 3.5 and 4.0 stars, demonstrating their commitment to maintaining high standards in healthcare delivery (source: ncqa.org).

AM Best Financial Strength Rating
AM Best, a credit rating agency specializing in the insurance industry, provides ratings that reflect an insurance company’s ability to meet its ongoing insurance obligations. Geisinger Health Plan, which offers Geisinger Gold Medicare Advantage plans, holds a strong financial strength rating from AM Best. This rating underscores the company’s financial stability and ability to pay claims, providing additional assurance to its members (source: ambest.com).

Better Business Bureau (BBB) Rating
The Better Business Bureau (BBB) rates companies based on customer reviews and their handling of customer complaints. Geisinger Health Plan has received a high rating from the BBB, reflecting its proactive approach to resolving issues and maintaining customer satisfaction (source: bbb.org).

These ratings and reviews from trusted sources indicate that Geisinger Gold Medicare Advantage plans are highly regarded in terms of quality, financial stability, and customer satisfaction, making them a reliable choice for individuals on Medicare.

Geisinger's Medicare Star Ratings

Geisinger's average 5-star rating: 4.00*
*Our calculation is weighted by enrollments in public plans, excluding Special Needs Plans, with CMS star ratings across 2 contracts covering 99,910 members.

If you want the government’s take on the quality of Geisinger’s Medicare Advantage plans, check out the Centers for Medicare and Medicaid Services' star ratings, which rank each plan from 1 (worst) to 5 (best) stars. The health agency assigns ratings based on quality of care and customer satisfaction measurements, and updates ratings every year.[9]

All Medicare Advantage plans are assessed using CMS's health plan criteria. Plans that come with prescription drug coverage are evaluated on additional drug plan metrics. Based on the latest year of data and adjusted for enrollment numbers, Geisinger’s 2024 Medicare Advantage plans have an average rating of 4.00 stars.[9] [11]

Of all Geisinger members who are in contracts with a Medicare star rating, 100% are in contracts rated 4 stars or above as of January 1, 2024.

You can find all plan ratings in your area using our Medicare Advantage Plan finder tool.

Geisinger's Top Plans

Here's a list of Geisinger's most popular plans (by enrollments):[9][10]

Medicare Advantage Search and compare Medicare Advantage plans available in your area.

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Frequently Asked Questions

The following are the most frequently asked questions we found about Geisinger's Medicare Advantage plans:

MA Plan Pros

  1. The maximum out-of-pocket cost is $7,550 a year
  2. Many plans cost $0 extra a month
  3. Most plans include drug coverage
  4. Many include basic hearing, dental, and vision benefits
  5. May include gym discounts (Silver Sneakers)

MA Plan Cons
  1. Can only switch during Open Enrollment
  2. Not easy to compare because plans are not standardized
  3. No nationwide coverage (plans don't travel with you)
  4. Most are HMO plans that require referrals to see a specialist
  5. Plans can change health and drug coverage each year

Learn more in this article.

Some Medicare Advantage plans offer a zero-dollar monthly premium because what Medicare pays the plan, plus your Medicare Part B premium, cover the full cost. For healthy people who want to keep their monthly costs low, these plans are an attractive option. But, just be aware that the premium is not the only cost. Plans also have copays or coinsurance you must pay when you use services. To learn more about free Medicare Advantage plans, read Why are Some Medicare Advantage Plans Free?

There is no debate when it comes to which plan offers better coverage. Original Medicare and a supplement plan offer the best coverage, but it costs more up-front. For a complete breakdown of the differences between Medicare Advantage plans and Medigap plans, read: Medicare Advantage vs Medigap: Which is Best for You?

Researching your health plan options is important. Here are some key questions to consider before choosing a Medicare Advantage plan as well as additional companies to read about:

Key Questions

All plans potentially have monthly premiums, deductibles, copayments, and/or coinsurance, including plans from Geisinger. Are these costs within your budget?

  • Does the plan cover your prescriptions? Knowing how a plan covers them is important if you have regular prescriptions because costs and coverage vary widely from plan to plan.
  • Are your doctors in the plan’s network? If you have preferred providers, ensure they participate in the plan’s network.
  • Is routine dental, vision, and hearing covered? Traditional Medicare doesn’t cover these services. If you need it, be sure to explore plans that cover it.
  • What extras does the plan include? Plans may include many beneficial extras, like gym memberships (SilverSneakers), medical transportation, meal delivery, telehealth, and more.

If you have additional questions, visit Medicare.gov or call 800-MEDICARE (800-633-4227, TTY 877-486-2048).

About Geisinger

Geisinger Gold Medicare Advantage plans are offered by Geisinger Health Plan, a not-for-profit health services organization based in Danville, Pennsylvania. Geisinger Health Plan provides a range of health insurance options, including Medicare Advantage Plans (Medicare Part C), Medicaid plans, and employer group plans. Known for its integrated healthcare system, Geisinger emphasizes coordinated care and community-focused health services.

Recent updates from Geisinger Health Plan include enhancements to their digital health services and expanded telehealth offerings to improve accessibility and convenience for members. These updates feature a user-friendly mobile app for managing health benefits, virtual visits with healthcare providers, and remote monitoring tools to help members manage chronic conditions from home. These initiatives aim to provide more flexible and comprehensive care options, especially beneficial for members with mobility issues or those living in remote areas.

Individuals can enroll in a Geisinger Gold Medicare Advantage plan during their Initial Enrollment Period (IEP) at age 65, the annual Open Enrollment Period (Oct 15 - Dec 7), or during a Special Enrollment Period (SEP) granted for specific circumstances like moving or losing employer coverage.

Company
Geisinger Health Plan, Inc
Phone Number
800-482-8163
Website
https://www.geisinger.org
Facebook Page
https://www.facebook.com/GeisingerHealth/
X (Twitter) Page
https://x.com/geisingerhealth?lang=en

Citations

MedicareWire uses trustworthy sources to inform its work, including government websites, government data, actuarial service data, consumer intelligence websites, and peer-reviewed studies. All content is fact-checked for accuracy, timeliness, and relevance. We used the following information sources in this review: