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2009 Geisinger Product Training Manual (All Products)

See Craig's 2009 Product Analysis (NEW!)

Geisinger 2009 Medicare Advantage Product Portfolio

• Medicare Advantage (not all products available in all counties)
  • Medicare HMO - Available in Select counties in Pennsylvania
    • Classic 1 - Higher premium with lower out of pocket.  Available on a stand alone basis or with 1 of 2 prescription drug options.
    • Classic 2 - Middle of the road premium and cost sharing.  Available on a stand alone basis or with 1 of 2 prescription drug options.
    • Classic 3 - No Premium plan.  Co-pays for some services (like PCP or Specialist).  Other coverages are covered initially at $500, then $1,500 deductible, then full coverage.  Only available with Prescription drugs.
  • Medicare PPO - Available in Select counties in Pennsylvania
    • Preferred PPO - Zero inpatient hospitalization co-pay.  Available on a stand alone basis or with one of two prescription drug options.
      • Premiums vary by county.
      • Out of Network Dr. and Specialist benefits are fixed co-pay.
  • Private Fee for Service - Available in all counties in Pennsylvania
    • Open 2 - Highest premium option.  Lowest fixed copay for Inpatient Hospitalization.  Includes Prescription drugs.
    • Open 3 - Zero or low premium  Highest out of pocket.  Includes Prescription drugs.
    • Open 5 - Zero or low premium.  Fixed copay for Inpatient Hospitalization.  No Prescriptions included (must pick a PDP, if desired)
  • Medicare Medical Savings Account - Available in all counties in Pennsylvania in 2009.
    •  Initial Calendar year deposit and initial Calendar year deductible vary by county.
    • Medicare Beneficiary can only enroll during Annual Enrollment Period (November 15th - December 31st) or during Initial Enrollment.
    • Geisinger makes an annual payment into the Medicare Beneficiary's Medical Savings Account which can be used to pay Medicare approved type Medical expenses to help cover the deductible and/or to pay for Medical expenses not covered by medicare.
    • Policy has Zero premium.  There is a calendar year deductible, then the plan pays 100% of Medicare Approved charges.
    • If the Medicare Beneficiary wants prescription drug coverage, they must purchase a stand alone PDP.
    • The doctor/provider choice works similarly to Private Fee for Service.
    • See Publication 502 for a List of eligible Health Care Expenses (Pages 5-14) 
    • Important Note on MSA Funding
  • Special Needs Plans - Available in Select counties in Pennsylvania
    • Dual Eligible plan
      • Available to those Medicare Beneficiaries who also are Medicaid eligible.
      • Uses an HMO network of Doctors, Hospitals and other Medical providers.
      • Includes additional value added benefits like an Over the Counter benefit and a networked dental benefit.
  • Stand Alone Precription Drug Plan
    • Standard Benefit design

Service Area for 2008

2008 Summaries of Benefits

• For HMO/PPO/PFFS/SNP Plans
  • Select a County from the Drop Down Menu
  • Click on the plan for which you would like the summary of benefits
• For MSA or PDP, just click the link.