Plan year 2027 · Medicare AdvantageCMS files of Sept. 22 and Oct. 1, 2026
Geisinger Gold Classic Essential Rx, 2027
H3954Contract161Plan
HMO · 44 counties in Pennsylvania
Run by Geisinger Health Plan (contract H3954), sold as Geisinger Gold, owned by Risant Health, Inc.
Geisinger Gold Classic Essential Rx (H3954-161) costs $0 a month in 2027, the same as in 2026, with an in-network out-of-pocket limit of $7,150 ($6,750 in 2026).
What changes from 2026 to 2027?
| What you pay or get | 2026 | 2027 | Change |
|---|---|---|---|
| In-network out-of-pocket limit | $6,750 | $7,150 | ▲up $400 |
| Drug deductible | $0 | $700 | ▲up $700 |
| Specialist visit | $30 copay | $35 copay | ▲up $5 |
| Emergency room | $115 copay | $130 copay | ▲up $15 |
| Hospital stay, in network | $225 a day for days 1–5, then $0 a day for days 6–90 | $275 a day for days 1–6, then $0 a day for days 7–90 | ▲up $250for a 5-day stay |
| Skilled nursing facility, in network | $0 a day for days 1–20, then $160 a day for days 21–63, then $0 a day for days 64–100 | $0 a day for days 1–20, then $160 a day for days 21–100 | changed |
| Drug tier 1, preferred generic | $2 | $1 | ▼down $1 |
| Drug tier 2, generic | $20 | $2 | ▼down $18 |
| Drug tier 4, non-preferred drug | 35% of the cost | 34% of the cost | ▼down 1 point |
| Drug tier 5, specialty tier | 33% of the cost | 25% of the cost | ▼down 8 points |
| 12 lines do not change | |||
| Monthly premium | $0 | $0 | no change |
| Part B premium reduction, monthly | none | none | no change |
| Primary care visit | $0 copay | $0 copay | no change |
| Medical deductible, in network | none | none | no change |
| Ground ambulance, in network | $200 copay | $200 copay | no change |
| Comprehensive dental, yearly limit | not offered | not offered | no change |
| Eyewear, yearly limit | not offered | not offered | no change |
| Hearing aids, yearly limit for both ears | not offered | not offered | no change |
| Over-the-counter items, yearly | not offered | not offered | no change |
| Counties served | 44 | 44 | no change |
| Drug tier 3, preferred brand | 25% of the cost | 25% of the cost | no change |
| Drug tier 6, select care drugs | $0 | $0 | no change |
Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS plan benefit package files, 2027 and 2026; CMS plan crosswalk from 2026 to 2027 (Oct. 1, 2026). Plan details can change during the year; confirm on Medicare Plan Finder.
What will prescriptions cost?
| Tier | What the tier holds | 2026 | 2027 |
|---|---|---|---|
| Tier 1 | Preferred Generic | $2 | $1 |
| Tier 2 | Generic | $20 | $2 |
| Tier 3 | Preferred Brand | 25% of the cost | 25% of the cost |
| Tier 4 | Non-Preferred Drug | 35% of the cost | 34% of the cost |
| Tier 5 | Specialty Tier | 33% of the cost | 25% of the cost |
| Tier 6 | Select Care Drugs | $0 | $0 |
Source: CMS plan benefit package files, 2027 and 2026. Insulin is capped at $35 a month by law. A drug's tier is set by the plan's formulary.
How does it compare with plans sold where it is?
In the counties it serves, 169 plans open to everyone are sold for 2027, this one included. Against the others, 77 plans have a lower out-of-pocket limit, 27 the same, 64 a higher one. On the premium, 92 the same, 76 a higher one.
Out-of-pocket limits of the 169 plans open to everyone
Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).
Where is it sold, and what does it cost there?
The premium and the out-of-pocket limit are the same in all 44 counties: $0 a month and $7,150.
Pennsylvania
Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).
Who runs this plan?
- Plan ID
- H3954-161
- Legal name of the contract
- Geisinger Health Plan
- Sold as
- Geisinger Gold
- Parent company
- Risant Health, Inc.
- Plan type
- HMO
- 2026 star rating of the contract
- 4.5 of 5 overall; health plan 4 of 5, drug plan 5 of 5
- Members, September 2026
- 4,003
- Plan website, as filed with CMS
- www.GeisingerGold.com
Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS 2026 Star Ratings (October 2025); CMS monthly enrollment by plan and by county, September 2026 (CMS hides counts under 11). CMS publishes the 2027 Star Ratings in October 2026.
What else should you check?
- Other 2027 plans in Northumberland, PAWhere most of its members live; premiums and limits side by side
- Every Geisinger Gold plan for 2027Its contracts, counties and plans that end
- The other 6 plans of contract H3954Same company, same contract
- Is your prescription covered?Coverage share and tier for 2,259 drugs
Data, not advice. These are the plan's filed amounts, not a quote for you; confirm on Medicare Plan Finder or call the plan before you enroll.