Get free Geisinger health insurance quotes that allow you to instantly compare plans and quickly apply for a policy. Affordable medical coverage is offered in most parts of Eastern and Central Pennsylvania. Spanning 43 counties, they offer several competitively priced Exchange policies including comprehensive and low-deductible copay plans. Also available are dental benefits along with Medigap plans for Seniors. Since no referrals are required, these plans are very popular for single or married customers.
We proudly represent Geisinger Choice plans along with all of the other major companies in Pennsylvania. This respected company (based locally on Danville) offers Marketplace plans for individuals and families that are eligible for federal Exchange subsidies. Depending on your household income, the subsidy could pay most or all of the premium. Incomes under 400% of the Federal Poverty Level will qualify for the instant tax credit that is applied to your premium. However, non-subsidized plans are also offered.
As a non-profit HMO, they started offering benefits in 1985, and have become a consumer and business favorite in many Central Pa communities. Ironically, around 1972, coverage was only offered to residents of five counties near the first Medical Center. However, once certified, membership grew and has not stopped. Many additional services are provided to members, including discounts for fitness clubs and facilities, contacts and glasses, dental expenses, and various forms of therapy.
Quoting And Enrollment
The quoting and application (enrollment) process is very easy and we are available to assist you at any time. The average enrollment for 2017 benefits takes about 10-20 minutes. You are never under any obligation to keep the plan for any length of time. We create a direct online link that makes the process simple and quick. Once you have applied, we monitor the process and keep you updated until your policy and ID cards have been received.
Like most regional carriers, also included in all of their policies are many wellness-oriented perks such as weight reduction benefits through Weight Watchers, fitness center discounts, vision and laser correction, acupuncture, and programs that aid the customer in smoking cessation. More than 40,000 physicians and specialists are available for current customers.
2017 Geisinger Plans
Marketplace Value – $7,150 deductible with $7,150 maximum out-of-pocket expenses. Available only to applicants under age 30. If “financial hardship” can be proven, you may be eligible to enroll in this plan.
Marketplace PPO 30/50/5000 – Only available in the following counties: Blair, Bradford, Cambria, Cameron, Carbon, Centre, Clearfield, Clinton, Columbia, Huntingdon, Jefferson, Lackawanna, Luzerne, Lycoming, Mifflin, Monroe, Montour, Northumberland, Pike, Potter Schuylkill, Snyder, Somerset, Sullivan, Susquehanna, Tioga, Union, Wayne, and Wyoming.
Pcp office visit copay is $30 and specialist office visit copay is $50. There are no restrictions on the number of visits per person per year. Deductible is $5,000 per person, and $10,000 per family. Maximum out-of-pocket expenses are $6,000 and the coinsurance is 30%. The ER deductible is $250 and out-of-network benefits are available with higher out-of-pocket costs. Prescription drug copays for Tiers 1, 2, 3, and 4 are $10, $20, $40, and $80 respectively.
Marketplace HMO 30/60/3500 – $30 and $60 office visit copays. $3,500 deductible with $7,150 maximum out-of-pocket expenses and 20% coinsurance. Prescription drug copays for Tiers 1, 2, 3, and 4 are $3, $25, $45, and $80 respectively. However, a $250 deductible per person and $500 per family applies.
Marketplace HMO 20/40/3000 – $20 and $40 office visit copays. $3,000 deductible with $6,000 maximum out-of-pocket expenses and 20% coinsurance. Prescription drug copays for Tiers 1, 2, 3, and 4 are $3, $15, $35, and $55 respectively.
Geisinger Plan Rates
Prices can greatly vary, depending on your age, number and age of persons in the household, and AGI (Adjusted Gross Income) for calculating the federal subsidy. Monthly rates are shown below for several scenarios:
55-year-old married couple (two persons) with household income of $40,000 residing in zip code 17112 (Dauphin County).
$78 – Marketplace HMO 30/60/3500
$471 – Marketplace HMO 20/40/3000
27-year-old with household income of $27,000 residing in zip code 17112 (Dauphin County).
$84 – Marketplace HMO 30/60/3500
$176 – Marketplace HMO 20/40/3000
$260 – Marketplace Value
40-year-old with household income of $35,000 residing in zip code 17601 (Lancaster County).
$271 – Marketplace HMO 30/60/3500
$405 – Marketplace HMO 20/40/3000
In-Network Hospitals
We provide a free web link that allows you to view providers within your area. For example, if you reside in Harrisburg, listed below are network-affiliated hospitals within 50 miles.
Community General Osteopathic
Polyclinic
Harrisburg Hospital
Holy Spirit
Pinnacle West Shore
Carlisle Regional Medical Center
OSS Orthopaedic
Memorial
WellSpan Surgery And Rehab
York Hospital
Heart Of Lancaster Regional Medical Center
Lancaster General
Sunbury Community
Geisinger (Shamokin Area)
Lancaster Regional Medical Center
Ephrata Community
Schuylkill Medical Center
Hanover
Gettysburg
Surgical Institute Of Reading
Evangelical Community (Lewisburg)
Lewistown
Reading
Geisinger (Bloomsburg location)
Prescription Tiers For Marketplace Plans
There are six tier levels (shown below) of drug coverage that apply to Geisinger Pennsylvania Exchange policies. Copays and coinsurance can vary, depending on the coverage you select. The complete formulary of drugs is available upon request. NOTE: It’s 96 pages!
$0 Tier – Since there is no copay or coinsurance, the out-of-pocket cost is zero. Examples include Mircette, Yaz, Velivet, Ovcon-50, and Loestrin.
Tier 1 – Generic Preferred. Typically the lowest copay and pre-authorization is generally not needed. Examples include: Amoxicillin, Tegretol, Fluoxeitine (Prozac), Paroxetine (Paxil), Sertraline (Zoloft), Diltiazem (Cardizem), Simvastatin (Zocor), Metformin Hcl (Glucophage), and Alendronate Sodium (Fosamax).
Tier 2 – Generic Non-Preferred. Covers most, but not all generic drugs. Examples include: Acetaminophen with codeine, Divalproex Sodium (Depakote ER), Glipizide (Glucotrol XL), Quinapril HCL (Accupril), Atorvastatin Calcium (Lipitor), and Tretinoin (Retin-A).
Tier 3 – Brand Preferred. Many of these drugs have no generic substitute and pre-authorization is often required. Examples include: Lantus, Coumadin, Xarelto, Fingerstix, Glucocom, Decadron, Premarin and Prempro.
Weare always available to review details on any of the plans. At the same time, as an unbiased broker, we’ll also inform you if alternative companies (Aetna, UnitedHealthcare, Highmark BC, or Capital Blue Cross) offer better options. Depending on where you live and the type of benefits you want, plan and carrier availability will vary.
For additional information, or if you wish to apply for coverage, please call or email us. You can also “apply direct” by asking us to email you a simple online link. Enrollment takes about 10-15 minutes and you may be able to utilize your federal subsidy. It will instantly be applied towards your premium.
Other Specialties
Regional carriers are often able devote special resources towards specific conditions and diseases, along with the necessary treatment. For example rheumatoid arthritis (RA) patients treated at Geisinger facilities have shown substantial improvement along with smaller associated costs in the last two years. The research data was released at the 2014 American College of Rheumatology Scientific meeting in Boston, Ma.
The number of patients in RA remission or who saw their quality objectives reached, increased by 30% by using these new techniques. The combination of low disease activity and increased mobility has provided encouragement for other RA suffers in the area. Rheumatoid Arthritis is a debilitating chronic condition that causes selling, pain and limited mobility in several joints. More than 1 million persons in the US currently have the disease.
PAST UPDATES:
Geisinger workers in Danville will be moving to the Holy Family Convent within the next three weeks. The fifth and sixth floors will be home to their new local operations. About 80-100 employees will be impacted. The building was purchased from the Sisters of Christian Charity last year. The Sisters still living there can stay through 2017.
Flu shots are available at no charge during the month of January at two area locations. The first is at 2266 Wilkes-Barre Township Marketplace in Wilkes Barre. The second location is at Montour Plaza at 575 Montour Blvd in Bloomsburg. The first location has times on Mondays, Wednesdays and Saturdays. The Montour location has times on Tuesdays, Wednesdays and Fridays. You must be 18 years or older. Last year, shots prevented more than six million persons from becoming ill.
Geisinger has drastically reduced the number of plans offered. In many areas, Capital Blue Cross and Highmark are the only other carriers offering private coverage.
