About Geisinger Gold
Begun in 1985, Geisinger Health Plan is a not-for-profit managed care organization. Geisinger Gold has been offered by Geisinger Health Plan, a health plan with a Medicare contract, since 1994.
Geisinger Gold offers a variety of plan options to meet members' needs, including HMO, PFFS, MSA, Special Needs, PPO, prescription drug coverage and Medicare Supplement plans. In addition, most Geisinger Gold plans offer more benefits than original Medicare including vision and hearing benefits and fitness center memberships.
National Committee for Quality Assurance (NCQA)
NCQA is an independent, not-for-profit organization dedicated to measuring the quality of America's health care.
- Received a three-year "Excellent" Accreditation for Geisinger Gold during NCQA's 2006 review (2006)
- Received "Full" Accreditation for eight disease management programs from NCQA (2006)
Geisinger Gold was ranked the #1 Medicare health plan in Pennsylvania and #3 in the Nation in the U.S. News and World Report/NCQA America's Best Health Plans 2008-09 list. (U.S. News and World Report, 2008)
Geisinger Gold was ranked one of the top Medicare health plans in Pennsylvania and #19 in the Nation in the U.S. News and World Report/NCQA America's Best Health Plans 2007-08 list. (U.S. News and World Report, 2007)
Geisinger Health Plan was awarded the Gold Award in the Pennsylvania Division Cancer Control Impact Mission Awards by the American Cancer Society for the 2006/2007 Colorectal Cancer campaign. (American Cancer Society, 2007)
For members with a complex medical history, GHP case management nurses can help them and their families navigate through the wide variety of health-care services available.
Geisinger Health Plan Health Navigator SM
Health Navigator is a partnership between primary care providers and GHP to improve members' health. Also known as a "medical home," GHP provides a case manager who works closely with the member's health-care providers, the member and their family by coordinating care with hospital, specialists, pharmacists and skilled nursing facilities. Members have access to a Health Navigator case manager 24 hours a day, 7 days a week. This program has significantly reduced the number of hospital admissions and readmissions by providing members an additional resource at the first signs of a complication.
GHP also offer programs that provide members with specialized instruction on how to deal with specific disorders, better manage their symptoms and improve their quality of life.
These programs include:
- Adult and Pediatric Asthma Care Program
- Chronic Obstructive Pulmonary Disease (COPD) Program
- Chronic Heart Failure (CHF) Program
- Diabetes Care Program
- HeartWise Program (coronary artery disease)
- Hypertension Program
- Osteoporosis Program
- Tobacco Cessation Program
GHP does more to keep their members healthy
- Tobacco cessation.
This 12-week program is extremely successful in helping members to quit smoking. For all participants, whether or not they complete the course, our quit rate is two times the success rate of other programs.
- Health reminders by phone.
For members who scheduled a recommended appointment, GHP will contact them directly at home to remind them about childhood and adolescent immunizations, breast and cervical cancer screenings, and diabetic eye exams.
- Out-of-network services.
If a member is outside our service area and requires medical attention, GHP will still see to it he or she gets the needed care. In fact, for some plans, they will even arrange to have the member transported back home to be cared for by his or her own physician. Please note, network restrictions do not apply to Private-Fee-for-Service or Medical Savings Account Plans.