Geisinger Gold Preferred Enhanced Rx (PPO) H3924-062-24 Plan Details
Geisinger Gold Preferred Enhanced Rx (PPO) H3924-062-24 Plan Details
Navigating your Medicare Advantage options for 2025 can be overwhelming, but we're here to help. With Geisinger Gold Preferred Enhanced Rx (PPO) included in your plan options, you can evaluate it alongside other plans to make an informed decision. Enroll online quickly, or consult with a licensed agent if you need assistance.
Based on May, 2025 CMS enrollment data, an estimated 27,820 Medicare beneficiaries are enrolled in this plan.
Geisinger Gold Preferred Enhanced Rx Overview
| Plan ID H3924-062-24 Overview | |
|---|---|
| Health Plan ID: | H3924-062-24 |
| Medicare Advantage Plan Type: | PPO |
| Plan Year: | 2025 |
| Monthly Premium: | $64.00 Plus your Medicare Part B premium. |
| Health Plan Deductible: | $0.00 |
| Annual Out-of-Pocket Maximum: | $7,550.00 (In-Network) |
| Part B Give Back: | $0.00/mo |
| Part D Drug Plan Benefit: | Enhanced, $0.00 deductible |
| Additional Benefits: | Dental, Vision, Hearing |
| Availability: | See List |
| Insured By: | Geisinger Gold |
Plan Availability
Geisinger Gold Preferred Enhanced Rx (H3924-062-24) is available in the following locations (click to open):
Why Consider Geisinger Gold Preferred Enhanced Rx ?
This Medicare Advantage MAPD PPO plan combines full coverage with the flexibility to choose your providers. With a monthly premium of $64.00, it includes all standard Medicare Part A and Part B benefits, plus built-in prescription drug coverage. The annual Part D deductible is $0.00. You can visit any Medicare-approved provider — in or out of network — with lower costs when using in-network services.
Primary care visits have a not covered, and specialist visits come with a $35 copay. Urgent care services carry a $35 copay, and ground ambulance transportation is $275 copay. These costs apply toward your maximum out-of-pocket (MOOP) limit of $7,550.00 . Once that limit is reached, your in-network care is fully covered for the rest of the year.
You’ll find this plan listed by CMS as H3924-062-24. Cost-sharing details are outlined below. Still have questions? Check the FAQ section for more information.
| We're Here to Help You Enroll |
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Cost-Sharing Overview
Geisinger Gold Preferred Enhanced Rx includes cost-sharing, which refers to the out-of-pocket expenses you'll incur when accessing approved healthcare services. The table below outlines the most common in-network out-of-pocket costs for plan H3924-062-24.
Find out the costs for visiting your primary care doctor and specialists, as well as coverage for wellness and preventive programs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Primary: | Not Covered |
| Specialist: | $35 Copay |
Review the costs for emergency services, urgent care, ambulance services, inpatient hospital stays, and skilled nursing facility care.
| Service | Enrollee Cost |
|---|---|
| Emergency room care: | $110 Copay |
| Urgent care: | $35 Copay |
| Ground ambulance: | $275 Copay |
| Inpatient hospital care: | $165.00 per day for days 1 through 5 $0.00 per day for days 6 and beyond |
| Skilled Nursing Facility: | $0.00 per day for days 1 through 20 $160.00 per day for days 21 through 68 $0.00 per day for days 69 and beyond |
This section covers Medicare-approved foot care services, including exams and routine foot care.
| Service | Enrollee Cost (in-network) |
|---|---|
| Foot Exams and Treatments (Medicare-covered): | $35 Copay |
| Routine Foot Care: | Not Covered |
Understand the coverage for Medicare-approved chiropractic services and routine chiropractic care.
| Service | Enrollee Cost (in-network) |
|---|---|
| Medicare-covered chiropractic: | $15 Copay |
| Routine chiropractic: | Not Covered |
This section explains the costs for mental health services, including individual and group therapy, and inpatient care.
| Service | Enrollee Cost (in-network) |
|---|---|
| Outpatient individual therapy: | $10 Copay |
| Outpatient group therapy: | $5 Copay |
| Inpatient psychiatric hospital care: | $165.00 per day for days 1 through 5 $0.00 per day for days 6 and beyond |
See the cost details for rehabilitation services, including physical therapy, speech therapy, and occupational therapy.
| Service | Enrollee Cost (in-network) |
|---|---|
| Physical therapy and speech and language therapy: | $35 Copay Prior Authorization Required |
| Occupational therapy: | $35 Copay Prior Authorization Required |
Learn about the costs associated with medical equipment and supplies, including diabetes supplies, durable medical equipment, and prosthetics.
| Service | Enrollee Cost (in-network) |
|---|---|
| Diabetes supplies: | 20% Coinsurance Prior Authorization Required |
| Durable medical equipment: | 20% Coinsurance Prior Authorization Required |
| Prosthetics: | 20% Coinsurance |
This section outlines the costs for diagnostic services, lab tests, x-rays, and other imaging services.
| Service | Enrollee Cost (in-network) |
|---|---|
| Diagnostic radiology services: | $235 Copay Prior Authorization Required |
| Lab services: | $10 Copay Prior Authorization Required |
| Outpatient x-rays: | $35 Copay Prior Authorization Required |
| Diagnostic tests and procedures: | $10 Copay Prior Authorization Required |
Review the cost-sharing details for chemotherapy and other Medicare Part B-covered drugs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Chemotherapy: | 20% Coinsurance |
| Other Part B drugs (Medicare-covered): | 20% Coinsurance |
This section details the dental services covered under your plan including, Medicare-covered preventive dental, oral exams, x-rays, dental cleanings, and comprehensive dental.
| Service | Member Cost (in-network) |
|---|---|
| Medicare Covered Preventive Dental | $35 Copay Prior Authorization Required |
| Oral exam | $0 |
| Dental x-rays | $0 |
| Cleaning | $0 |
| Periodontics | Not Covered |
| Endodontics | Not Covered |
| Restorative Services | Not Covered |
This section outlines the coverage for hearing-related services, including exams, fittings, and hearing aids.
| Service | Member Cost (in-network) |
|---|---|
| Fitting/evaluation | Covered Limits may apply |
| Hearing aids | Covered Limits may apply |
| Hearing exam | $20 Copay |
Learn about the costs for vision-related services, including eye exams, eyeglasses, and contact lenses.
| Service | Member Cost (in-network) |
|---|---|
| Medicare-covered eye exam (in-network) | $0 to $35 Copay |
| Routine eye exam (in-network) | $ to $20 Copay 1 Every year |
| Eyewear benefits | Eyeglasses: Yes Contact Lenses: Yes Eyeglass Lenses: Yes Eyeglass Frames: Yes Eyewear Upgrades: Yes |
Maximum eyewear benefit: | $125.00 Every year |
Certain preventive services are covered 100% by Geisinger Gold Preferred Enhanced Rx as a Part B benefit.
Part D Prescription Drug Costs & Benefits
Geisinger Gold Preferred Enhanced Rx includes an enhanced benefit Medicare Part D plan (PDP), which offers greater coverage than basic plans. An enhanced benefit plan has a higher actuarial value, meaning it covers a larger percentage of your healthcare costs.
Part D Plan Premium
The Part D prescription drug plan premium is included in your overall Medicare Advantage plan cost. However, additional expenses or subsidies may apply through the Low-Income Subsidy (LIS) program, also known as Extra Help. LIS, provided by Social Security, helps those with limited income and resources to lower or eliminate Part D costs. LIS benefits are not part of Medicare Advantage coverage.
| Basic Part D Premium: | $41.00 |
|---|---|
| Supplemental Part D Premium: | $0.00 |
| Total Part D Premium: | $41.00 |
| Low-Income Premium Subsidy: | ${part_d_lips_amount} |
| Low-Income Premium Subsidy Paid by CMS: | $41.00 |
| Low-Income Subsidy Premium: | $0.00 |
For more details, visit the Social Security Extra Help program.
Prescription Drug Plan Deductible
This plan has a $0.00 annual Part D deductible. You'll pay this deductible at the pharmacy before Geisinger Gold starts contributing towards your prescription costs.
Prescription Drug Plan Out-of-Pocket Costs
Beyond premiums and deductibles, Geisinger Gold Preferred Enhanced Rx may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.
| Drug Tier | Retail | Mail Order |
|---|---|---|
| Preferred Generic | $0.00 | $0.00 |
| Generic | $10.00 | $0.00 |
| Preferred Brand | 25.00% | 10.00% |
| Non-Preferred Drug | 50.00% | 30.00% |
| Specialty Tier | 33.00% | 0.00% |
| Select Care Drugs | $0.00 | $0.00 |
| *Deductible does not apply. | ||
Understanding CMS Star Ratings
The Centers for Medicare & Medicaid Services (CMS) reviews and rates Medicare Advantage (Part C) and drug plans (Part D) annually, using a 5-star system to measure aspects such as member satisfaction, preventive services, and management of chronic conditions.
Higher star ratings generally indicate better plan performance, which can be a useful factor to consider when deciding on a plan that aligns with your healthcare goals and preferences.
| CMS Measure | Star Rating |
|---|---|
| 2025 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | |
| Managing Chronic (Long Term) Conditions | |
| Member Experience with Health Plan | |
| Complaints and Changes in Plans Performance | |
| Health Plan Customer Service | |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | |
| Member Experience with the Drug Plan | |
| Drug Safety and Accuracy of Drug Pricing |
If you are new to Medicare or Medicare Advantage plans, the following information will help you understand the enrollment process and restrictions.
Am I Eligible for Geisinger Gold Preferred Enhanced Rx ?
To qualify for enrollment in Geisinger Gold Preferred Enhanced Rx , you must:
- Be entitled to Medicare Part A and enrolled in Medicare Part B.
- Live within the plan’s designated service area.
If you fulfill these criteria, you can enroll in Geisinger Gold Preferred Enhanced Rx and enjoy the extensive healthcare benefits it offers.
When Should You Enroll in Geisinger Gold Preferred Enhanced Rx ?
Understanding the right time to enroll in Geisinger Gold Preferred Enhanced Rx is crucial. Here are the key enrollment periods:
- Initial Enrollment Period (IEP): Your first opportunity to enroll in Medicare starts three months before your 65th birthday and lasts until three months after your birthday month.
- Annual Enrollment Period (AEP): Occurring annually from October 15 to December 7, the AEP allows you to enroll in, switch, or drop a Medicare Advantage plan if you are currently enrolled in a Medicare Advantage plan.
- Medicare Advantage Open Enrollment Period (MA OEP): From January 1 to March 31 each year, the MA OEP gives you the chance to switch Medicare Advantage plans or return to Original Medicare.
- Special Enrollment Periods (SEPs): Certain life changes, like moving or losing other coverage, may make you eligible for a SEP, allowing you to adjust your plan outside the usual periods.
Not sure when to enroll? Call HealthCompare (our trusted enrollment partner) at 1-833-748-3201 (TTY 711) to speak with a licensed insurance agent who can guide you through your options.
Steps to Enroll in Geisinger Gold Preferred Enhanced Rx
Joining Geisinger Gold Preferred Enhanced Rx is straightforward. Here are the steps you can take:
- Online: Use our online enrollment partner's Secure Online Enrollment Form to sign up.
- By Phone: Reach out to HealthCompare (our trusted enrollment partner) at 1-833-748-3201 (TTY 711). A licensed insurance agent will help you with the enrollment process and answer any questions you might have.
- Through Medicare.gov: Enroll directly through the official Medicare website. Visit Medicare.gov, log in or create an account, and follow the steps to join Geisinger Gold Preferred Enhanced Rx .
- Direct Enrollment: You can also choose to enroll directly with Geisinger Gold Preferred Enhanced Rx . The contact information can be found below in the "Contact" section.
Make sure you enroll during the appropriate period to activate your coverage as soon as possible.
Here are some of the most frequently asked questions people have about plan ID H3924-062-24:
What’s the monthly premium for Geisinger Gold Preferred Enhanced Rx (PPO)?
Members pay their Part B premium and the plan's of $64.00 per month to be in this 2025 plan.
What’s the MOOP for Geisinger Gold Preferred Enhanced Rx in 2025?
Your costs top out at $7,550.00 (for in-network services) in 2025; after that the plan pays 100% of covered services.
What’s the prescription-drug deductible for 2025?
The 2025 drug deductible is $0.00. The plan does not have a drug tier without a deductible.
What’s the CMS star score for Geisinger Gold Preferred Enhanced Rx ?
For 2025, plan H3924-062-24 has a ★4.5 rating. The best rating is 5 stars.
How many people are enrolled in this plan?
As of last month, about 27,820 beneficiaries are enrolled.
Contact Geisinger Gold
| Website: | Geisinger Gold Plan Page |
|---|---|
| Providers: | Geisinger Gold Providers Page |
| Formulary: | Geisinger Gold Formulary Page |
| Pharmacy: | Geisinger Gold Pharmacy Page |
| New Member Health Plan Help: | (800)514-0138 |
| New Member Health Plan TTY: | 711 |
| New Member Part D Help: | (800)514-0138 |
| New Member Part D TTY Users: | 711 |
If you're eligible for Medicare but haven't enrolled or need to verify your enrollment status, visit the Social Security Administration website. For more information about Medicare Advantage, visit medicare.gov.
- Geisinger Gold, http://www.GeisingerGold.com, Last Accessed June 1, 2025
- Medicare.gov, "Understanding Medicare Advantage Plans", Last Accessed 25 May, 2025
- AARP.org, "The Big Choice: Original Medicare vs. Medicare Advantage", Last Accessed 25 May, 2025
- Medicare.gov, "Compare Original Medicare & Medicare Advantage", Last Accessed 25 May, 2025
- CMS.gov, Landscape Source Files, Last Accessed October 15, 2024
- CMS.gov, Medicare Part C & D Performance, Last Accessed October 15, 2024
- CMS.gov, Plan Benefits Package, Last Accessed October 15, 2024
- CMS.gov, Monthly Enrollment by Contract/Plan/State/County, Last Accessed June 6, 2025
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