UPDATED: Nov 30, 2018
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Geisinger Medical Center began offering health insurance plans to employees and local residents in 1972 as a pilot program, and by 1985 was authorized to operate as a full-service HMO program. The company is a not-for-profit health system.
From the first location in Danville, PA, Geisinger has since grown to offer coverage in other states. In 2012 they expanded and now offer coverage in Delaware, Maine, and New Jersey. According to the company website they serve more than 500,000 members today.
Originally an HMO, Geisinger has expanded to offer extended network care through PPO plans. Partnership with other health systems in the area allows PPO members to access a wider range of providers.
Plans are sold both on and off the health insurance marketplace for individuals, and also available as employee benefits. Medicare Advantage and Supplement plans are both available.
Geisinger Gold is the company’s Medicare Advantage line of products, and there are several to choose from. The plans are only available in a specific list of counties; we selected a zip code in the headquarters city of Danville, PA for the purpose of obtaining plan information.
Gold Classic plans are the basic HMO plans offered by Geisinger. Our search returned four Classic plan options.
Classic Essential is a $0 premium plan (above regular Medicare premiums) with no deductible and copays of $10 for primary care visits and $40 for specialist visits. Inpatient hospital stays have a copay of $225 per day for the first six days. Prescription drugs start at $3 for Tier 1.
Classic Complete is a step up in cost, with copays of $5 for primary care and $35 for specialists. Inpatient hospital stays have a copay of $200 per day for the first six days. Prescription coverage is the same as the Essential plan.
Classic Advantage is the most expensive of the Classic plans. There is no copay for primary care visits, and specialist visits have a $20 copay. The hospital copay is $175 a day for the first six days. Like the other Classic plans, prescription coverage starts at $3 for Tier 1.
The fourth choice is the Classic Advantage plan without Part D prescription drug coverage included.
Our search returned three Preferred plans, which are all PPO plans.
Preferred Complete is the $0 premium plan in this category. In-network co pays are $15 for primary care and $40 for specialists, with a $225 a day copay for the first six days of an inpatient hospital stay. Prescription coverage again starts at $3 for Tier 1.
Preferred Enhanced has copays of $10 for primary care and $35 for specialist visits. Inpatient hospital visits have the same copay as the Complete plan, and prescription coverage is the same.
Preferred Advantage has copays of $5 for primary care and $25 for specialist, and a lower hospital copay of $200 per day for the first six days. Prescription coverage is again the same as the other plans.
The final plan on our list is the Gold Secure Rx. This is the third available $0 premium plan, and it is an HMO SNP plan with no co pays and no deductible across the board for any services except prescriptions. All tiers have a 25% coinsurance.
Geisinger offers a good list of the standardized letter-coded Supplement plans. They list plans A, B, C, F, F with high deductible, M, and N. That seven of the eleven possible plan choices.
Plan A is base coverage that pays for all Medicare coinsurance amounts as well as the first three pints of blood each year. All insurance companies are required to offer this plan if they write Medicare Supplement policies.
The highest level of coverage is found in Plan F, which covers all out of pocket expenses as well as travel emergency medical. That makes it the most expensive plan, which is why the high deductible option is offered to lower the monthly cost while keeping out of pocket expenses predictable.
The rest of the plans fall somewhere in between; Plan N stands out as the only one on the list that has a copay for some services in return for lower monthly payments.
As noted, Geisinger has three $0 premium plans – which means you do pay anything other than your regular Medicare premiums.
The rates go up from there, with the most expensive option being the Classic Advantage Rx at $183.
Medicare Supplement rates are readily available as well, with Plan A returning a cost of $115.16 a month. The Plan F premium is a relatively high $262.43, which drops down to $47.98 a month with the high deductible option.
These rates are only comparable in the same service area, but in general they are quite reasonable. We did find the Plan F rate to be a bit high compared to other places, and the company appears to be pushing the high deductible version.
As with most health insurance companies, Geisinger handles claims internally, so the amount of information on claims to be found on the website is very little. This is common practice for most such companies.
Ratings and Consumer Reviews
Geisinger Health Plan has a surprising D+ rating with the Better Business Bureau (BBB), which is based on one complaint that was not responded to and, according to the BBB, the length of time the business has been operating. The BBB file was opened in 2017, but this company has been operating for several decades, which makes the rating a bit confusing. There are only two complaints on file in the past three years, one of which was closed in the past year. Those are very low numbers to merit so low a grade.
The National Committee for Quality Assurance rates Geisinger Health Plans a 4.0 out of 5 for Medicare Advantage. Their rankings for consumer satisfaction are good in most areas, including a 5.0 rating for primary care physicians.
We were unable to find much in the way of reviews from customers, which is generally a positive thing when it comes to insurance companies. Our general impression is of a company with a good reputation.
The Bottom Line
Geisinger seems to have a solid reputation, putting aside the questionable rating from the BBB. They also have a long list of available plans with choices at every price point, which means most people should be able to find a plan they can afford – and there are even both HMO and PPO choices as the $0 premium level. If you live in the service area of the company it would seem to be a good one to add to your list.
For a list of companies that we recommend, visit our Best Insurance Companies page.