Medicare FAQ

You're still eligible for Medicare. Sign up for Medicare Part A during your Initial Enrollment Period to avoid penalties, even if you continue working.

Review eligibility details

It scores how well Medicare Advantage and Medicare Part D plans perform in areas like quality of care, customer service, complaints, member experience, chronic conditions management and drug safety. Plans are rated from 1 to 5 Stars, with 5 being the best.

Some plans allow visits to any provider, while others offer lower costs for in-network providers. Check your plan's website or ask your provider directly.

Generally, no referral is needed for PPO, PFFS HMO or SNP plans.

Yes, Medicare Advantage plans (Medicare Part C) often provide additional benefits compared to Original Medicare (Parts A and B).

• Dental: Many plans cover routine dental care, such as cleanings, X-rays, exams and sometimes more comprehensive procedures.
• Vision: Coverage often includes annual exams, eyeglasses and contact lenses.
• Hearing: Plans may include hearing exams and hearing aids.
• Fitness: Some plans offer gym memberships, like SilverSneakers.

Note: Benefits vary by plan and provider, so be sure to review specific plans available in your area.

Geisinger Gold plans for individuals are available in these specific counties:

• Adams
• Allegheny
• Armstrong
• Beaver
• Bedford
• Berks
• Blair
• Bradford
• Bucks
• Butler
• Cambria
• Cameron
• Carbon
• Centre
• Chester
• Clarion
• Clearfield
• Clinton
• Columbia
• Crawford
• Cumberland
• Dauphin
• Delaware
• Elk
• Fayette
• Forest
• Franklin
• Fulton
• Greene
• Huntingdon
• Jefferson
• Juniata
• Lackawanna
• Lancaster
• Lawrence
• Lebanon
• Lehigh
• Luzerne
• Lycoming
• McKean
• Mifflin
• Monroe
• Montgomery
• Montour
• Northampton
• Northumberland
• Perry
• Philadelphia
• Pike
• Potter
• Schuylkill
• Snyder
• Somerset
• Sullivan
• Susquehanna
• Tioga
• Union
• Venango
• Warren
• Washington
• Wayne
• Westmoreland
• Wyoming
• York

No, but consider joining even if you don't have any prescription drugs right now. That way, you can avoid future penalties.

View Part D details

If you were eligible and didn't sign up by May 15, 2006, and haven't had similar coverage since, you may need to pay more each month.

No, enrolling in a standalone plan will automatically disenroll you from the MAPD plan.

Coverage will start on Jan. 1 of the following year.

Pennsylvania's PACE and PACENET make sure eligible residents get quality drug coverage at the lowest possible cost.

• Call a PACE/PACENET representative at 866-712-2060, Monday – Friday, 9 a.m. – 5 p.m.
• Call Geisinger Gold at 800-498-9731 (TTY: 711), Monday – Friday, 8 a.m. – 8 p.m.

Our formulary may change during the year. For updates, log into your member portal or call 800-988-4861 (TTY:711) daily, 8 a.m. – 8 p.m.

Extra help might be available to pay for premiums and costs. Check if you qualify:

• Call 800-MEDICARE (800-633-4227), 24/7
• The Social Security Office at 800-772-1213, Monday – Friday, 7 a.m. – 7 p.m.
• Your state Medicaid office

Opioid management programs limit a 7-day supply for members not established on therapy and require reviews for multiple long-acting opioids.

• You may be exempt if you have an active cancer diagnosis, sickle cell anemia or are in a hospice or long-term care facility
• For more information, call 800-988-4861 (TTY:711) daily, 8 a.m. – 8 p.m.

You may end your membership in our plan only during certain times of the year, known as enrollment periods. All members have the opportunity to leave the plan during the Annual Enrollment Period and during the annual Medicare Advantage Disenrollment Period. In certain situations, you may also be eligible to leave the plan at other times of the year.

Your membership will usually end on the first day of the month after we receive your request to change your plan.

Until your membership ends, you must keep getting your medical services through our plan. If you leave Geisinger Gold, it may take time before your membership ends and your new Medicare coverage goes into effect. During this time, you must continue to get your medical care through our plan.

If you're hospitalized on the day your membership ends, your hospital stay will usually be covered by our plan until you're discharged (even if you're discharged after your new health coverage begins).

• If you don't stay continuously enrolled in Medicare Part A and Part B.
• If you move out of our service area for more than 6 months.
• If you move or take a long trip, you need to call member services to find out if the place you are moving or traveling to is in our plan's area.
• If you go to prison.
• If you intentionally give us incorrect information when you're enrolling in our plan, and that information affects your eligibility for our plan.
• If you continually behave in a way that is disruptive and makes it difficult for us to provide medical care for you and other members of our plan.
• We cannot make you leave our plan for this reason unless we get permission from Medicare first.
• If you let someone else use your membership card to get medical care.
• If we end your membership because of this reason, Medicare may have your case investigated by the Inspector General.
• If you do not pay the plan premiums for 2 months.
• We must notify you in writing that you have 2 months to pay the plan premium before we end your membership.

For questions or more information on when we can end your membership, call Gold Customer Care Team at 800-498-9731 (TTY: 711).

• Oct. 1 – March 31, daily, 8 a.m. – 8 p.m. ET
• April 1 – Sept. 30, Monday – Friday, 8 a.m. – 8 p.m. ET; Saturday, 8 a.m. – 2 p.m. ET

We can't ask you to leave our plan for any reason related to your health. What should you do if this happens?

If you feel you're being asked to leave our plan for a health-related reason, call Medicare toll-free at 800-MEDICARE (800-633-4227). TTY users should call toll-free 877-486-2048. You may call 24 hours a day, 7 days a week.

You have the right to make a complaint if we end your membership in our plan. If we end your membership in our plan, we must tell you in writing our reasons for ending your membership. We must also explain how you can make a complaint about our decision to end your membership.