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Geisinger Health Plan

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1-855-227-1302
TTY: 711
www.ghpfamily.com

Co-Pays*

Ambulance
Per trip $0

Dental care $0

Inpatient hospital
Per day $3/adult only
Maximum with limits $21/adult only

Medical centers
Ambulatory surgical center $3/adult only
Federal Qualified Health Center/Regional Health Center $0
Independent medical/surgical center $0
Short procedure unit $3/adult only

Medical equipment
Purchase $2
Rental $0

Medical visits
Certified nurse practitioner $0
Chiropractor $1/adult only
Doctor $0
Optometrist$0
Podiatrist $0

Outpatient hospital
Per visit $0

Prescriptions
Generic $1/adult only
Brand name $3/adult only

X-rays
Per service $1/adult only

Coordination of Care

No extra services.

Care Management Programs

Care Delivery Management nurse case managers and health managers work to provide “real time” decision support and complement the care provided by the PCP and/or SCP.

Member digital tools

No extra services.

Pregnancy Benefits

No extra services.

Healthy Kids Programs

Women’s and Kids Health Programs help develop long-term healthy habits focusing on physical, mental and emotional health and wellness needs. Programs offered: Right from the Start, Healthy Beginnings Plus, Text4Baby Program, Healthy Rewards, Healthy kids are happy kids, Early and periodic screening diagnosis & treatment (EPSDT), Nurse-family partnership.

Vision Benefits

No extra services.

24 Hour Medical Help Line

Tel-A-Nurse: Talk with a nurse 24 hours a day, 7 days a week, about urgent health matters.

Urgent Care Benefits

No extra services.

Healthy Living and Health Education

Fresh Food Farmacy for members identified as having an A1C level greater than 8 can receive diabetic education through a health coach and receive enough food weekly to prepare healthy nutritious meals for the whole family.

Wellness Program: Geisinger Health Plan offers a variety of programs to help members maintain a healthy lifestyle at no cost. Programs include: Classes and workshops,
Diabetes Prevention, Challenges and competitions, Health Screenings, Health Coaching, Health Management, Incentives and discounts, Personalized online tools, Tobacco cessation, Mental health and substance abuse.

Other Benefits

Hepatitis C Center of Excellence offers members with Hepatitis C a full course treatment to help prevent transmission, prevent liver disease, and to help prevent further liver damage.

Geisinger Transportation Program provides member non-emergency transportation to medical appointments and pharmacies at no cost to the member.

Opioid Center of Excellence offers members with an opioid use disorder guidance to stay in treatment and avoid relapse by offering:  Care management, Care coordination, Transitional and follow-up care, Patient and family support, referrals to community or social services.


*Co-pays do not apply to the following: members who are pregnant, members under age 18, members age 18 through 20 who are in foster care, emergency services, or certain drugs for specific diseases. The information about the benefits from each plan was current at the time of printing. Please call the plan directly for the most up-to-date information.