Get to Know Geisinger Gold's Classic Advantage No Rx Plan

Annual Certification for 2022

Classic Advantage No Rx benefits at-a-glance

• Premium: $0
• Annual deductible: $0
• Maximum out-of-pocket (MOOP): $3,450
• Office visit (PCP/specialist): $0/$20
• Inpatient hospital care - acute: $150/day (days 1–5) not to exceed $750 annually, $0/day (days 6–90)
• Dental (prevented and comprehensive): $0 – 2 exams/year, $0 – 1 X-ray/year, $500 benefit limit/year
• Vision: $20 – 1 exam/year, $200 eyewear limit per year
• Hearing: $20 – 1 exam/year, $500 copay per ear for hearing aids, $1,250 limit per ear every 3 years
• Fitness: $90 every 3 months
• Vaccines: $0
• Teladoc e-visits (PCP): $0 copay PC

Classic Advantage benefits at-a-glance

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