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If you learn that our plan does not cover your drug, you have two options: • You can ask Member Serv?

Please keep it in a safe place. ABOUT THE DRUGS WE COVER IN THIS PLAN. enrollment penalty for going without other drug coverage that is at least as good as Medicare drug coverage (also referred to as creditable coverage) for 63 days or more. When you receive the list, show it to your doctor and ask him or her to prescribe a similar drug that is covered by our plan. Please keep it in a safe. dehermione granger and the chamber of secrets If you learn that our plan does not cover your drug, you have two options: • You can ask Member Services for a list of similar drugs that are covered by our plan. are part of Geisinger, an integrated health care delivery and coverage organization. For more recent information or other questions, please contact Geisinger Gold Member Services at (800) 988-4861 or, TTY … Prescription Drug Coverage Geisinger Gold Secure Rx (HMO D-SNP) Stage 1: Annual Prescription Deductible Deductible Member pays $0* Stage 2: Initial Coverage (after you pay your deductible, if applicable) until total yearly drug costs reach $5,030 Standard Retail cost-sharing (30-day supply) Cost-Sharing for Covered Drugs • $0 cost-sharing on all covered formulary … Geisinger Gold $0 Deductible Rx 2025 Formulary (List of Covered Drugs) PLEASE READ: THIS DOCUMENT CONTAINS INFORMATION ABOUT THE DRUGS WE COVER IN THIS PLAN This formulary was updated on October 1, 2024. The first are dental braces, which are not covered. caleb hammer priscilla When you receive the list, show it to your doctor and ask him or her to prescribe a similar drug that is covered by our plan. • A Geisinger Gold Formulary (list of covered drugs). • Providers can e-scribe directly to Geisinger CareSite Pharmacy. You will receive notice when necessary. 2009 pennies value Not covered Medicare Part B prescription drugs* Chemotherapy/Radiation drugs In-Network 0% - 20% coinsurance Out-of-Network 0% - 20% coinsurance Your Medicare Health Benefits and Services and Prescription Drug Coverage as a Member of Geisinger Gold Classic Advantage Rx (HMO) This booklet gives you the details about your Medicare health care and prescription drug coverage from January 1 – December 31, 2021. ….

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