Geisinger Gold Classic Essential Rx (HMO)

Geisinger Gold Classic Essential Rx (HMO) is a HMO 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 Classic Essential Rx (HMO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.

Key Plan Facts

Below are a few key facts and commonly-asked questions about Geisinger Gold Classic Essential Rx (HMO).

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.

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:

Drug Coverage

The Geisinger Gold Classic Essential Rx (HMO) plan features a $0 drug deductible, meaning your prescription coverage begins immediately. For Tier 1 preferred generics and Tier 2 generics, you will pay no copay when using standard mail order, while standard retail pharmacy copays range from $2 to $50 depending on the supply. Additionally, Tier 6 select care drugs are fully covered with no copay for both standard pharmacy and mail order options. For higher-tier medications, cost-sharing transitions to coinsurance under this plan. Tier 3 preferred brands require a 25% coinsurance, while Tier 4 non-preferred drugs have a 35% coinsurance for both retail and mail order. Specialty drugs in Tier 5 are covered with a 33% coinsurance for a one-month supply.

Additional Benefits

The Geisinger Gold Classic Essential Rx (HMO) plan offers robust core medical coverage with no copay for primary care visits, home health services, and cardiac rehabilitation. For hospital stays, members pay a daily copay of $225 for the first five days of inpatient care and no copay for days six through ninety, all with no coinsurance. Emergency care is accessible with a $115 copay, while specialist visits require a $30 copay and outpatient services range from no copay up to a $250 copay. Diagnostic radiology and home infusions are covered with no copay, though durable medical equipment and dialysis services require coinsurance ranging up to twenty percent. While preventive services and select vision care are available with no copay, routine dental, hearing aids, and transportation services are not covered under this plan. Overall, the plan utilizes fixed copayments and select coinsurance percentages rather than deductibles for most covered medical services.