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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 2025, 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 2025.
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 $48.40. 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 $590.00 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 $8850.00 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 has a $590 deductible for prescription drugs. If you qualify for the low-income subsidy, your monthly premium for Part D is $48.40. During the initial coverage phase, after you meet your deductible, you will pay the costs for your drugs based on their tier. After your total drug costs reach $2000, you enter the next coverage phase.
Additional Benefits
The Geisinger Gold Secure Rx (HMO D-SNP) plan offers a range of benefits with varying cost-sharing. Many services, including ambulance, home health, and emergency services, have no copay. Many services, including outpatient, primary care, and hearing services, have a 20% coinsurance. The plan also provides coverage for hearing aids, vision, and dental services, with specific allowances and limitations. Additionally, the plan covers over-the-counter items up to $150 per month.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services, though specific details on copays are not provided, and non-Medicare covered stays, upgrades, and additional days for Inpatient Hospital Psychiatric are not covered. Additional days for Inpatient Hospital-Acute are covered.
Outpatient Services See details
Outpatient Services are covered by the Geisinger Gold Secure Rx (HMO D-SNP) plan, including outpatient hospital services and observation services with a 20% coinsurance, and outpatient substance abuse services, individual sessions, and group sessions, also with a 20% coinsurance. Outpatient blood services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered under the Geisinger Gold Secure Rx (HMO D-SNP) plan, but requires prior authorization. You will pay 20% coinsurance for this benefit.
Ambulance and Transportation Services See details
The Geisinger Gold Secure Rx (HMO D-SNP) plan covers ambulance services with a 20% coinsurance, and no copay. Transportation services to any health-related location are covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered. For Emergency Services, you will pay a $110 copay, and for Urgently Needed Services, you will pay 20% coinsurance. Worldwide Emergency Services has a maximum plan benefit coverage of $100,000.
Primary Care See details
The Geisinger Gold Secure Rx (HMO D-SNP) plan covers Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Podiatry Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services. Chiropractic Services, Physician Specialist Services, Physical Therapy, Speech-Language Pathology Services, and Additional Telehealth Benefits have a 20% coinsurance. Occupational Therapy Services, Individual and Group Sessions for Mental Health and Psychiatric Services, and Opioid Treatment Program Services have a 20% coinsurance. Podiatry Services have a 20% coinsurance for Routine Foot Care. Routine Chiropractic Care is not covered.
Preventive Services See details
The Geisinger Gold Secure Rx (HMO D-SNP) plan covers preventive services, including Medicare-covered preventive services, annual physical exams, additional preventive services, and kidney disease education services. The plan has a 20% coinsurance for kidney disease education services. Several services are not covered, including Health Education, In-Home Safety Assessment, Medical Nutrition Therapy (MNT), and others.
Hearing Services See details
Hearing services include coverage for hearing exams with a 20% coinsurance, routine hearing exams (1 per year), and fitting/evaluation for hearing aids. Prescription hearing aids are covered up to $2950.00 per ear every three years, with 2 visits every three years for all types of prescription hearing aids, however, inner ear, outer ear, and over the ear prescription hearing aids are not covered, nor are OTC hearing aids.
Vision Services See details
Vision Services include coverage for eye exams with a 20% coinsurance, and eyewear benefits including contact lenses, eyeglasses (lenses and frames), and eyeglass lenses and frames. Eyewear has a combined maximum benefit of $425.00 per year. Upgrades are not covered.
Dental Services See details
The Geisinger Gold Secure Rx (HMO D-SNP) plan covers Medicare dental services with a 20% coinsurance, and other dental services with a maximum benefit of $4,500 per year. The plan covers oral exams (2 per year), dental x-rays, prophylaxis (cleaning) (2 per year), fluoride treatment (2 per year), restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable), and oral and maxillofacial surgery. However, maxillofacial prosthetics, implant services, prosthodontics (fixed), and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. For Medicare Part B Insulin Drugs, there is a $35 copay and coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is no copay and coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Geisinger Gold Secure Rx (HMO D-SNP) plan. The coinsurance for dialysis services is 20%.
Medical Equipment See details
Medical equipment benefits are covered, including durable medical equipment, prosthetics/medical supplies, and diabetic equipment. Durable Medical Equipment has a 20% coinsurance and requires authorization, while durable medical equipment for use outside the home is not covered. Prosthetic Devices and Medical Supplies have a 20% coinsurance, and Diabetic Supplies have a 0-20% coinsurance, while Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the Geisinger Gold Secure Rx (HMO D-SNP) plan. Diagnostic Procedures/Tests and Lab Services have a coinsurance of at most 20%, while Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services also have a coinsurance of at most 20%. There is no copay for any of these services.
Home Health Services See details
Home Health Services are covered by the Geisinger Gold Secure Rx (HMO D-SNP) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by the Geisinger Gold Secure Rx (HMO D-SNP) plan, but none of the sub-services are covered. The plan requires prior authorization.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are covered, but require prior authorization. This plan does not provide SNF services as a supplemental benefit under Part C, and additional days beyond Medicare-covered SNF stays and non-Medicare-covered SNF stays are not covered.
Other Services See details
Other Services include coverage for over-the-counter items with a maximum benefit of $150.00 every month, including nicotine replacement therapy and naloxone. Acupuncture, meal benefits, dual eligible SNPs with highly integrated services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, private duty nursing services, case management (long term care), institution for mental disease services for individuals 65 or older, services in an intermediate care facility for individuals with intellectual disabilities, case management, tobacco cessation counseling for pregnant women, freestanding birth center services, respiratory care services, family planning services, nursing home services, home and community based services, personal care services, and self-directed personal assistance services are not covered.
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