Geisinger Health Plans

Geisinger Marketplace Premier HMO 30/60/4650

Plan Overview

Medical Deductible
  • Individual: 4650
  • Family: 9300
  • Per Person: 4650
Prescription Drug Deductible
  • Individual: 500
  • Family: 1000
  • Per Person: 500
Medical Out-of-Pocket Maximum
  • Individual: 7600
  • Family: 15200
  • Per Person: 7600
Drug Out-of-Pocket Maximum
  • Individual: Included in Medical
  • Family: Included in Medical
  • Per Person: Included in Medical

Office Visit

Primary Doctor
  • Standard: $30 Copay
Specialist
  • Standard: $60 Copay

Prescription Drug Information

Preferred Brand Drugs
  • Standard: $50 Copay after deductible
Non Preferred Brand Drugs
  • Standard: $85 Copay after deductible
Generic Drugs
  • Standard: $20 Copay
Specialty Drugs
  • Standard: 50% Coinsurance after deductible

Inpatient Coverage

Hospital Services
  • Standard: 20% Coinsurance after deductible
Inpatient Services
  • Standard: 20% Coinsurance after deductible

Emergency and Urgent Care

Emergency Room
  • Standard: $350 Copay after deductible
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