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Geisinger Gold Secure Rx (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Geisinger Gold Secure Rx (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Geisinger Gold Secure Rx (HMO D-SNP) in 2026, please refer to our full plan details page.
Geisinger Gold Secure Rx (HMO D-SNP) is a HMO D-SNP plan offered by Risant Health, Inc. available for enrollment in 2025 to people living in Pennsylvania. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that Geisinger Gold Secure Rx (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Geisinger Gold Secure Rx (HMO D-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Geisinger Gold Secure Rx (HMO D-SNP).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For Geisinger Gold Secure Rx (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $32.70. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $615.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $9250.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The Geisinger Gold Secure Rx (HMO D-SNP) plan features an annual drug deductible of $615. Under this plan, you will pay no copay for Tier 1 preferred generic, Tier 2 generic, and Tier 6 select care drugs filled at standard pharmacies or through standard mail order. This coverage applies to one-month, two-month, and three-month supplies of these medications. For higher-tier medications, members are responsible for a 25% coinsurance. This 25% coinsurance applies to Tier 3 preferred brand drugs, Tier 4 non-preferred drugs, and Tier 5 specialty tier drugs at standard pharmacies and standard mail order. Specialty drugs under Tier 5 are limited to a one-month supply at this rate.
Additional Benefits
The Geisinger Gold Secure Rx (HMO D-SNP) offers comprehensive medical coverage with no copay and no coinsurance for essential services like inpatient hospital stays, primary care visits, home health, and skilled nursing facility care. For outpatient services, specialist visits, diagnostic tests, and ambulance transport, members generally face no copay and a 20% coinsurance. Emergency room visits require a $115 copay, which is waived if you are admitted to the hospital. This plan also includes valuable supplemental benefits, such as dental coverage up to a $4,500 annual limit and eyewear coverage up to $580 annually, both with no copay and no coinsurance. Additionally, members benefit from hearing aid coverage up to $2,950 per ear every three years, a $150 monthly allowance for over-the-counter items, and up to $500 yearly for health-related transportation with no copay or coinsurance.
Inpatient Hospital See details
Geisinger Gold Secure Rx (HMO D-SNP) covers inpatient acute and psychiatric hospital stays with no copay and no coinsurance, though prior authorization is required. While unlimited additional days are covered for acute stays, upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services under the Geisinger Gold Secure Rx (HMO D-SNP) are covered with no copays and a 20% coinsurance for outpatient hospital, ambulatory surgical center, outpatient substance abuse, and blood services. Prior authorization is required for outpatient hospital, observation, ambulatory surgical center, and substance abuse services.
Partial Hospitalization See details
Geisinger Gold Secure Rx (HMO D-SNP) covers partial hospitalization services with no copay and a 20% coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
Geisinger Gold Secure Rx (HMO D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, which is waived if you are admitted to the hospital. Transportation services are partially covered with no copay or coinsurance up to a $500 annual limit, which covers trips to any health-related location but does not cover plan-approved health-related locations.
Emergency Services See details
Geisinger Gold Secure Rx (HMO D-SNP) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 3 days. Urgently needed services require a 20% coinsurance (up to $40) and no copay, while worldwide emergency, urgent, and transportation services are covered up to a $100,000 maximum with no copay and no coinsurance.
Primary Care See details
Geisinger Gold Secure Rx (HMO D-SNP) covers primary care physician services with no copay and no coinsurance, while specialist visits, mental health, psychiatric, and therapy services require no copay and a 20% coinsurance. Chiropractic services are not covered, but routine podiatry is covered for up to four visits per year with no copay and a 20% coinsurance.
Preventive Services See details
Geisinger Gold Secure Rx (HMO D-SNP) preventive services, including annual physical exams and diabetes self-management, are covered with no copay and no coinsurance, though kidney disease education requires a 20% coinsurance and no copay. Additional preventive benefits are partially covered, offering memory fitness, home safety devices, and a personal emergency response system with no copay and no coinsurance, while sub-services like nutritional therapy and health education are not covered.
Hearing Services See details
Geisinger Gold Secure Rx (HMO D-SNP) covers hearing exams with no copay, though routine exams require a 20% coinsurance. Some prescription hearing aid services are covered with no copay or coinsurance up to $2,950 per ear every three years, but inner ear, outer ear, over the ear, and OTC hearing aids are not covered.
Vision Services See details
Geisinger Gold Secure Rx (HMO D-SNP) vision services are partially covered, offering one routine eye exam per year with no copay and 20% coinsurance, while other eye exam services are not covered. Eyewear is covered with no copay and no coinsurance up to a $580 annual maximum for contacts and glasses, though upgrades are not covered.
Dental Services See details
Dental services are partially covered under Geisinger Gold Secure Rx (HMO D-SNP), offering Medicare-covered dental care with no copay and 20% coinsurance, and other dental benefits with no copay and no coinsurance up to a $4,500 annual limit. Services not covered under this benefit include other diagnostic, other preventive, maxillofacial prosthetics, implant services, fixed prosthodontics, and orthodontics.
Home Infusion bundled Services See details
Geisinger Gold Secure Rx (HMO D-SNP) covers home infusion bundled services with no copay and no coinsurance, though prior authorization is required. Covered Medicare Part B insulin drugs require a $35 copay and range from no coinsurance to 20% coinsurance, while chemotherapy and other Part B drugs have no copay and range from no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by Geisinger Gold Secure Rx (HMO D-SNP) with no copay and a 20% coinsurance.
Medical Equipment See details
Geisinger Gold Secure Rx (HMO D-SNP) covers medical equipment, including durable medical equipment (DME), prosthetics, medical supplies, and diabetic equipment, with no copay and a prior authorization requirement. Covered DME, prosthetics, medical supplies, and diabetic shoes require a 20% coinsurance, while diabetic supplies range from no coinsurance to 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the Geisinger Gold Secure Rx (HMO D-SNP) plan with no copay and a 20% coinsurance, subject to prior authorization. This coverage applies to outpatient diagnostic procedures, lab services, diagnostic and therapeutic radiological services, and outpatient X-rays.
Home Health Services See details
Geisinger Gold Secure Rx (HMO D-SNP) covers home health services with no copay and no coinsurance, though prior authorization is required for these services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Geisinger Gold Secure Rx (HMO D-SNP) with no copay, though prior authorization is required. While some services are covered, specific programs including standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are partially covered by Geisinger Gold Secure Rx (HMO D-SNP) with no copay and no coinsurance, though prior authorization is required. The plan allows for admission without a prior three-day inpatient hospital stay, but additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered by Geisinger Gold Secure Rx (HMO D-SNP), which offers over-the-counter (OTC) items with no copay and no coinsurance up to a $150 monthly reimbursement limit. Acupuncture, meal benefits, and other miscellaneous services are not covered under this benefit.
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