Geisinger Gold FEHB Rx (Employer Group) (HMO)
GEISINGER HEALTH PLAN · 2027 plan year
Plan ID H3954-806-000
HMO★ 4 CMS StarsEmployer group plan
- MOOP (in-network)
- $0
- MOOP (combined)
- —
- Monthly premium
- Not published
- CMS publishes no consumer premium for this plan
- Prescription drugs
- Included
Offered only through an employer or union retiree plan; premiums are set by the group.
This plan in 2026
Plan information
- Contract / Plan / Segment
- H3954-806-000
- Medical deductible
- $0 — no deductible
More GEISINGER HEALTH PLAN plans in PA
Benefits & cost sharing
Hospital
| Benefit | In-network |
|---|---|
| Inpatient Hospital — Psychiatric | No charge |
| Worldwide Urgent Care Coverage | No charge |
| Inpatient Hospital — Additional Days (Acute) | No charge |
| Inpatient Hospital — Acute | No charge |
Pharmacy
| Benefit | In-network |
|---|---|
| Part B Drugs | See plan details |
| Chemotherapy & Radiation Drugs (Part B) | No charge |
| Other Part B Drugs | No charge |
Mental Health
| Benefit | In-network |
|---|---|
| Mental Health Specialty Services | See plan details |
| Mental Health — Individual Sessions | No charge |
| Mental Health — Group Sessions | No charge |
| Supplemental Health Benefits | See plan details |
Other
| Benefit | In-network |
|---|---|
| Radiological Services | See plan details |
| Diagnostic Radiology | No charge |
| Therapeutic Radiology | No charge |
| X-Ray Services | No charge |
| Skilled Nursing Facility (SNF) | No charge |
| Cardiac & Pulmonary Rehabilitation | See plan details |
| Cardiac Rehabilitation — Additional Sessions | No charge |
| Intensive Cardiac Rehabilitation — Additional Sessions | No charge |
| Pulmonary Rehabilitation — Additional Sessions | No charge |
| Supervised Exercise Therapy (SET) | No charge |
| Emergency Services | No charge |
| Urgently Needed Services | No charge |
| Worldwide Emergency & Urgent Coverage | See plan details |
| Worldwide Emergency Coverage | No charge |
| Worldwide Emergency Transportation | No charge |
| Partial Hospitalization Program | No charge |
| Intensive Outpatient Program (IOP) | No charge |
| Home Health Services | No charge |
| Primary Care Physician Services | No charge |
| Chiropractic Services | No charge |
| Occupational Therapy Services | No charge |
| Physician Specialist Services | No charge |
| Podiatry Services | No charge |
| Podiatry Services | No charge |
| Other Health Care Professional Services | No charge |
| Psychiatric Services | See plan details |
| Psychiatric Services — Individual Sessions | No charge |
| Psychiatric Services — Group Sessions | No charge |
| Physical Therapy & Speech-Language Pathology | No charge |
| Additional Telehealth Services (Part B) | No charge |
| Opioid Treatment Program Services | No charge |
| Diagnostic Tests & Lab Services | See plan details |
| Outpatient Hospital Services | No charge |
| Hospital Observation Services | No charge |
| Ambulatory Surgical Center (ASC) | No charge |
| Outpatient Substance Abuse Services | See plan details |
| Substance Abuse — Individual Sessions | No charge |
| Substance Abuse — Group Sessions | No charge |
| Outpatient Blood Services | No charge |
| Ambulance Services | See plan details |
| Ground Ambulance | No charge |
| Air Ambulance | No charge |
| Durable Medical Equipment (DME) | No charge |
| Prosthetics & Orthotics | See plan details |
| Prosthetic Devices | No charge |
| Medical Supplies | No charge |
| Diabetic Supplies & Services | See plan details |
| Diabetic Supplies | No charge |
| Diabetic Therapeutic Shoes & Inserts | No charge |
| Diabetic Monitors | No charge |
| Dialysis Services | No charge |
| Over-the-Counter (OTC) Items | No charge |
| Medicare-Covered Preventive Services | See plan details |
| Annual Physical Exam | No charge |
| Fitness Benefit | No charge |
| Remote Access Technologies | No charge |
| Kidney Disease Education Services | No charge |
| Glaucoma Screening | No charge |
| Diabetes Self-Management Training | No charge |
| Digital Rectal Exams | No charge |
| Welcome to Medicare EKG | No charge |
| Insulin (Part B) | No charge |
| Dental — Medicare-Covered Services | No charge |
| Vision — Eyewear | No charge |
| Hearing — Exams | No charge |
| Hearing — Routine Exams | No charge |
| Hearing — Fitting & Evaluation for Hearing Aid | No charge |
| Hearing — Prescription Hearing Aids | See plan details |
| Hearing — Hearing Aids (All Types) | $500 |
| Diagnostic Procedures & Tests | No charge |
| Laboratory Services | No charge |
| Dental — Preventive | See plan details |
| Dental — X-Rays | No charge |
| Dental — Prophylaxis (Cleaning) | No charge |
| Vision — Eye Exams | No charge |
| Hearing — Exams | See plan details |
Service area
- PA: 67 counties
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