Medicare Advantage · HMO · 2027
Geisinger Gold Heritage (HMO)
No referral needed to see a specialist
At a glance: $0 monthly premium, a Part B giveback of up to $70 a month, and $0 primary care visits.
This plan does not include Part D drug coverage. Before enrolling, confirm how your prescriptions will be covered. Read before you enroll
- Monthly premium
- $0
- Part B premium separate
- Yearly limit
- $6,700
- Most you’d pay for in-network care
- Part B giveback
- Up to$70/mo
- Up to $840 a year
- Doctor visits
- $0
- Primary care · specialists $15
Check this plan for you
Add your doctors to see if they’re in this plan’s network.
- Part B givebackThis plan includes a Part B giveback, which lowers what you pay for your Medicare Part B premium by up to $70 a month.Depending on how you pay Part B, the reduction may appear in your Social Security payment or on your Part B bill. Processing can take time; confirm the amount and timing with the plan.
- $70/month
- DentalPreventive & comprehensive dental allowance
- $2,000/yr
- OTC allowance
- $40/month
- HearingHearing aid allowance per 3 years ($20 exam copay)Hearing exam: $20 copay
- $1,250
- VisionEyewear allowance ($20 exam copay)Routine eye exam: $20 copay
- $200/yr
- Fitness$0 fitness benefit
- Included
This is a supplemental benefit with plan-specific limits. See plan documents for details.
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A licensed agent can review this plan and other plans in your area that fit your needs.
TTY: 711 · Monday to Friday, 8:00 AM to 6:00 PM CST
Before you enroll
Prescription coverage and who this plan may fit
This plan does not include Part D drug coverage
Who this type of plan may fit
MA-Only plans are generally considered by people who already have creditable prescription drug coverage, such as coverage from the VA, TRICARE, or a current or former employer or union. Your coverage provider (not this page) must tell you whether your current drug coverage is creditable.
Before you enroll
- Find your current plan's annual Notice of Creditable Coverage or ask its benefits administrator.
- Do not drop existing drug coverage until you understand how the change affects both coverages.
Costs and copays
Deductible, yearly limit, visits, hospital stays and drug coverage
- Medical deductiblePer year
- $0
- Drug coveragePart D
- Not included
- Yearly limitIn-network care, not counting drugs
- $6,700
- Primary doctorPer visit
- $0
- SpecialistPer visit · no referral needed
- $15
- Hospital stayNo limit on covered hospital days
- Days 1-5: $150/day, Days 6-90: $0/day
- Inpatient mental healthHospital stay
- Days 1-5: $150/day, Days 6-90: $0/day
- Outpatient surgeryPer procedure
- $200
- Emergency roomPer visit
- $130
- Urgent carePer visit
- $20
Our take
Where this plan shines, and what to know
Where this plan shines
- This plan has a $0 monthly premium.
- See your primary doctor for $0.
- The specialist copay ($15) is among the more affordable options.
- No separate medical deductible.
- Highly rated by CMS (4 stars).
Things to know before you enroll
- This plan’s out-of-pocket maximum is above the national median.
- You’ll need to use in-network providers except in emergencies.
- Limited coverage while traveling outside the plan’s service area.
- Does not include prescription drug coverage. You can't add a separate Part D plan to this plan. Joining one would end your Medicare Advantage coverage, so make sure you have other drug coverage, like VA or TRICARE.
- Late enrollment penalty risk if you go without creditable drug coverage for 63+ days.
Similar plans
Other Medicare Advantage plans offered in Pennsylvania
Browse the full 2027 Medicare Advantage without drug coverage directory. This plan is offered in Pennsylvania. Plan availability can vary by county.
More Medicare Advantage without drug coverage options
These plans are offered in at least one of the same states. Check your ZIP or county before choosing a plan.
- AARP Medicare Advantage Patriot No Rx PA-MA01 (HMO-POS)UnitedHealthcare · H5253-152Offered in Pennsylvania
- Aetna Medicare Advantra Eagle (HMO-POS)Aetna Medicare · H3959-094Offered in Pennsylvania
- Aetna Medicare Advantra Eagle Plus (HMO-POS)Aetna Medicare · H3959-041Offered in Pennsylvania
- Clover Health Valor (PPO)Clover Health · H5141-061Offered in Pennsylvania
- Freedom Blue PPO Basic (PPO)Highmark Blue Cross Blue Shield or Highmark Blue Shield · H3916-012Offered in Pennsylvania
- Freedom Blue PPO Valor (PPO)Highmark Blue Cross Blue Shield or Highmark Blue Shield · H3916-043Offered in Pennsylvania
Common questions
6 answers about this plan
What does Geisinger Gold Heritage (HMO) cover?
Geisinger Gold Heritage (HMO) is a Medicare Advantage plan that the current plan record identifies as not including Part D prescription drug coverage. The plan record does not identify Part D prescription drug coverage. Published supplemental benefits include dental ($2,000/yr preventive & comprehensive dental allowance), vision ($200/yr eyewear allowance ($20 exam copay)), hearing ($1,250 hearing aid allowance per 3 years ($20 exam copay)), and over-the-counter (OTC) ($40/month OTC allowance). Review the plan documents for covered services, limits, and rules. Coverage can change each plan year.
Learn about Medicare AdvantageHow much does Geisinger Gold Heritage (HMO) cost in 2027?
The published 2027 monthly plan premium for Geisinger Gold Heritage (HMO) is $0. Any Medicare premiums you owe are separate from the listed plan premium. The listed medical deductible is $0. The in-network medical out-of-pocket maximum is $6,700; it does not include Part D drug spending. Published visit costs include primary care $0 and specialist visits $15. These figures are plan data, not a personal yearly-cost estimate.
Can I use my current doctors with Geisinger Gold Heritage (HMO)?
CMS lists Geisinger Gold Heritage (HMO) as a HMO plan. The plan record says specialist referrals are not required. A network label alone does not confirm that a specific doctor participates. Use the doctor lookup tool, then confirm with the doctor's office and the plan before receiving care. Provider networks and member costs can change. Emergency care and travel coverage can follow different network rules.
Check your doctorsDoes Geisinger Gold Heritage (HMO) include prescription drug coverage?
Geisinger Gold Heritage (HMO) is listed in the current plan record as a Medicare Advantage plan without Part D prescription drug coverage. You can't add a separate Part D plan to this plan. Joining one would end your Medicare Advantage coverage, so make sure you have other drug coverage, like VA or TRICARE. Confirm how your prescriptions will be covered before enrolling.
What extra benefits does Geisinger Gold Heritage (HMO) offer beyond Original Medicare?
The current plan record for Geisinger Gold Heritage (HMO) lists dental ($2,000/yr preventive & comprehensive dental allowance), vision ($200/yr eyewear allowance ($20 exam copay)), hearing ($1,250 hearing aid allowance per 3 years ($20 exam copay)), over-the-counter (OTC) ($40/month OTC allowance), and fitness ($0 fitness benefit). The current data does not list transportation and meals as offered benefits. It also lists a Part B premium reduction of $70 per month. Benefit allowances, frequency, eligibility, and participating providers can have additional limits, so review the Summary of Benefits or Evidence of Coverage for the complete rules.
When can I enroll in Geisinger Gold Heritage (HMO)?
Geisinger Gold Heritage (HMO) is a 2027 Medicare Advantage plan. The Annual Enrollment Period runs from October 15 through December 7, with changes taking effect January 1. The Medicare Advantage Open Enrollment Period runs from January 1 through March 31 for people already enrolled in Medicare Advantage. A qualifying circumstance may create a Special Enrollment Period outside those dates. Confirm the enrollment window and effective date that apply to you before changing coverage.
Review Medicare enrollment periodsPlan documents
How to get this plan’s documents
- Check Your DoctorsSee if your doctors accept this plan
- Documentos en españolLlame a The Pocket Protector al 1-866-764-3312 (TTY: 711) para recibir ayuda con documentos en español
Talk to a licensed agent
Talk with a licensed advisor
A licensed agent can review this plan and other plans in your area that fit your needs.
TTY: 711 · Monday to Friday, 8:00 AM to 6:00 PM CST
