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Medicare Advantage Plans in Clearfield County, Pennsylvania

Below are Medicare Advantage plans available to residents of Clearfield county, Pennsylvania. 6 carriers offer 30 plans throughout the county of Clearfield. Residents may choose plans from carriers such as UPMC Health Plan, Highmark Inc. and Geisinger Gold. This data has been made available by the Centers for Medicare & Medicaid Services (CMS) and is for informational purposes only. Some data may be inaccurate or incomplete. Please note that plans can vary by city, county, and state and all plans listed may not be available in all areas. To speak to an advisor and find the Medicare Advantage plan in Clearfield county that is right for you complete the form at the top of the page.

Medicare Advantage Health Plans in the county of Clearfield

Carrier	Plan Title	Plan Type
UPMC Health Plan	UPMC for Life (HMO) (H3907-002)	HMO
Premium and Other Important Information $3 400 out-of-pocket limit for Medicare-covered services. $0.00 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay a higher premium because of their yearly income (over $85 000 for singles $170 000 for married couples). For more i Doctor Office Visits $10 copay for each primary care doctor visit for Medicare-covered benefits. $35 copay for each in-area network urgent care Medicare-covered visit $35 copay for each specialist visit for Medicare-covered benefits.
UPMC Health Plan	UPMC for Life HMO Rx Enhanced (HMO) (H3907-006)	HMO
Premium and Other Important Information $3 200 out-of-pocket limit for Medicare-covered services. $196.5 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $5 copay for each primary care doctor visit for Medicare-covered benefits. $20 copay for each in-area network urgent care Medicare-covered visit $20 copay for each specialist visit for Medicare-covered benefits.
UPMC Health Plan	UPMC for Life HMO Rx (HMO) (H3907-029)	HMO
Premium and Other Important Information $3 400 out-of-pocket limit for Medicare-covered services. $69.5 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $10 copay for each primary care doctor visit for Medicare-covered benefits. $40 copay for each in-area network urgent care Medicare-covered visit $40 copay for each specialist visit for Medicare-covered benefits.
UPMC Health Plan	UPMC for Life Specialty Plan (HMO SNP) (H3907-034)	HMO
Premium and Other Important Information * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services $0 annual deductible.* ** Please consult with your plan about cost sharing when receiving services from out-of-network providers. $3 400 out-of-pocket limit for Medicare-covered services. However in this plan you will have no cost sharing responsibility for Medicare-covered services based on your level of Medicaid eligibility. $0 monthly plan premium* Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits.* $0 copay for the cost of each in-area network urgent care Medicare-covered visit.* $0 copay for each specialist doctor visit for Medicare-covered benefits.*
Highmark Inc.	FreedomBlue PPO Classic (PPO) (H3916-002)	Local Preferred Provider Organization
Premium and Other Important Information $3 400 out-of-pocket limit for Medicare-covered services. $500 annual deductible. Contact the plan for services that apply. $5 100 out-of-pocket limit for Medicare-covered services. $166 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Some physicians providers and suppliers that are out of a plan's network (i.e. out-of-network) accept "assignment" from Medicare and will only charge up to a Medicare-approved amount. If you choose to see an out-of-network physician who does NOT accept Doctor Office Visits $10 copay for each primary care doctor visit for Medicare-covered benefits. $50 copay for each in-area network urgent care Medicare-covered visit $25 copay for each specialist visit for Medicare-covered benefits. 20% of the cost for each primary care doctor visit 20% of the cost for each specialist visit
Highmark Inc.	FreedomBlue PPO HD Rx (PPO) (H3916-020)	Local Preferred Provider Organization
Premium and Other Important Information Highmark Inc. will reduce your monthly Medicare Part B premium by up to $ 3.00. $2 750 out-of-pocket limit for Medicare-covered services. $1 000 annual deductible. Contact the plan for services that apply. $4 500 out-of-pocket limit for Medicare-covered services. $0 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Some physicians providers and suppliers that are out of a plan's network (i.e. out-of-network) accept "assignment" from Medicare and will only charge up to a Medicare-approved amount. If you choose to see an out-of-network physician who does NOT accept Doctor Office Visits $10 copay for each primary care doctor visit for Medicare-covered benefits. $50 copay for each in-area network urgent care Medicare-covered visit $25 copay for each specialist visit for Medicare-covered benefits. 30% of the cost for each primary care doctor visit 30% of the cost for each specialist visit
Highmark Inc.	FreedomBlue PPO Select (PPO) (H3916-024)	Local Preferred Provider Organization
Premium and Other Important Information $3 400 out-of-pocket limit for Medicare-covered services. $500 annual deductible. Contact the plan for services that apply. $5 100 out-of-pocket limit for Medicare-covered services. $73 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Some physicians providers and suppliers that are out of a plan's network (i.e. out-of-network) accept "assignment" from Medicare and will only charge up to a Medicare-approved amount. If you choose to see an out-of-network physician who does NOT accept Doctor Office Visits $20 copay for each primary care doctor visit for Medicare-covered benefits. $50 copay for each in-area network urgent care Medicare-covered visit $30 copay for each specialist visit for Medicare-covered benefits. 30% of the cost for each primary care doctor visit 30% of the cost for each specialist visit
Geisinger Gold	Geisinger Gold Preferred 1 (PPO) (H3924-001)	Local Preferred Provider Organization
Premium and Other Important Information $195 annual deductible. Contact the plan for services that apply. $2 550 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit. $5 100 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit. $88.00 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay a higher premium because of their yearly income (over $85 000 for singles $170 000 for married couples). For more i Some physicians providers and suppliers that are out of a plan's network (i.e. out-of-network) accept "assignment" from Medicare and will only charge up to a Medicare-approved amount. If you choose to see an out-of-network physician who does NOT accept Doctor Office Visits $10 copay for each primary care doctor visit for Medicare-covered benefits. $10 copay for each in-area network urgent care Medicare-covered visit $25 copay for each specialist visit for Medicare-covered benefits. $20 copay for each primary care doctor visit $35 copay for each specialist visit
Geisinger Gold	Geisinger Gold Preferred 1 $0 Deductible Rx (PPO) (H3924-003)	Local Preferred Provider Organization
Premium and Other Important Information $195 annual deductible. Contact the plan for services that apply. $2 550 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit. $5 100 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit. $135 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Some physicians providers and suppliers that are out of a plan's network (i.e. out-of-network) accept "assignment" from Medicare and will only charge up to a Medicare-approved amount. If you choose to see an out-of-network physician who does NOT accept Doctor Office Visits $10 copay for each primary care doctor visit for Medicare-covered benefits. $10 copay for each in-area network urgent care Medicare-covered visit $25 copay for each specialist visit for Medicare-covered benefits. $20 copay for each primary care doctor visit $35 copay for each specialist visit
Geisinger Gold	Geisinger Gold Preferred 2 (PPO) (H3924-045)	Local Preferred Provider Organization
Premium and Other Important Information $60 annual deductible. Contact the plan for services that apply. $3 000 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit. $5 100 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit. $10.00 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay a higher premium because of their yearly income (over $85 000 for singles $170 000 for married couples). For more i Some physicians providers and suppliers that are out of a plan's network (i.e. out-of-network) accept "assignment" from Medicare and will only charge up to a Medicare-approved amount. If you choose to see an out-of-network physician who does NOT accept Doctor Office Visits $20 copay for each primary care doctor visit for Medicare-covered benefits. $20 copay for each in-area network urgent care Medicare-covered visit $35 copay for each specialist visit for Medicare-covered benefits. $30 copay for each primary care doctor visit $45 copay for each specialist visit
Geisinger Gold	Geisinger Gold Preferred 2 $0 Deductible Rx (PPO) (H3924-046)	Local Preferred Provider Organization
Premium and Other Important Information $60 annual deductible. Contact the plan for services that apply. $3 000 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit. $5 100 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit. $40 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Some physicians providers and suppliers that are out of a plan's network (i.e. out-of-network) accept "assignment" from Medicare and will only charge up to a Medicare-approved amount. If you choose to see an out-of-network physician who does NOT accept Doctor Office Visits $20 copay for each primary care doctor visit for Medicare-covered benefits. $20 copay for each in-area network urgent care Medicare-covered visit $35 copay for each specialist visit for Medicare-covered benefits. $30 copay for each primary care doctor visit $45 copay for each specialist visit
Geisinger Gold	Geisinger Gold Classic 1 (HMO) (H3954-007)	HMO
Premium and Other Important Information $2 800 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit. $112.00 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay a higher premium because of their yearly income (over $85 000 for singles $170 000 for married couples). For more i Doctor Office Visits $10 copay for each primary care doctor visit for Medicare-covered benefits. $10 copay for each in-area network urgent care Medicare-covered visit $20 copay for each specialist visit for Medicare-covered benefits.
Geisinger Gold	Geisinger Gold Classic 1 $0 Deductible Rx (HMO) (H3954-033)	HMO
Premium and Other Important Information $2 800 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit. $137 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $10 copay for each primary care doctor visit for Medicare-covered benefits. $10 copay for each in-area network urgent care Medicare-covered visit $20 copay for each specialist visit for Medicare-covered benefits.
Geisinger Gold	Geisinger Gold Secure 1 (HMO SNP) (H3954-097)	HMO
Premium and Other Important Information * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services ** Please consult with your plan about cost sharing when receiving services from out-of-network providers. $6 700 out-of-pocket limit for Medicare-covered services.* $34.3 monthly plan premium in addition to your monthly Medicare Part B premium.* Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits.* $0 copay for the cost of each in-area network urgent care Medicare-covered visit.* 0% or 20% of the cost for each specialist visit for Medicare-covered benefits.*
Geisinger Gold	Geisinger Gold Classic 3 (HMO) (H3954-098)	HMO
Premium and Other Important Information $1 300 annual deductible. Contact the plan for services that apply. $1 500 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit. $0.00 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay a higher premium because of their yearly income (over $85 000 for singles $170 000 for married couples). For more i Doctor Office Visits $10 copay for each primary care doctor visit for Medicare-covered benefits. $10 copay for each in-area network urgent care Medicare-covered visit $25 copay for each specialist visit for Medicare-covered benefits.
Geisinger Gold	Geisinger Gold Classic 3 $0 Deductible Rx (HMO) (H3954-100)	HMO
Premium and Other Important Information $1 300 annual deductible. Contact the plan for services that apply. $1 500 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit. $36 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $10 copay for each primary care doctor visit for Medicare-covered benefits. $10 copay for each in-area network urgent care Medicare-covered visit $25 copay for each specialist visit for Medicare-covered benefits.
Geisinger Gold	Geisinger Gold Secure 3 (HMO SNP) (H3954-135)	HMO
Premium and Other Important Information $2 000 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit. $118 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $5 copay for each primary care doctor visit for Medicare-covered benefits. $5 copay for each in-area network urgent care Medicare-covered visit $30 copay for each specialist visit for Medicare-covered benefits.
Keystone Health Plan West Inc.	SecurityBlue Standard (HMO) (H3957-006)	HMO
Premium and Other Important Information $3 400 out-of-pocket limit for Medicare-covered services. $152 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $10 copay for each primary care doctor visit for Medicare-covered benefits. $50 copay for each in-area network urgent care Medicare-covered visit $25 copay for each specialist visit for Medicare-covered benefits.
Keystone Health Plan West Inc.	SecurityBlue Deluxe (HMO) (H3957-021)	HMO
Premium and Other Important Information $3 400 out-of-pocket limit for Medicare-covered services. $189 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $5 copay for each primary care doctor visit for Medicare-covered benefits. $50 copay for each in-area network urgent care Medicare-covered visit $25 copay for each specialist visit for Medicare-covered benefits.
Keystone Health Plan West Inc.	SecurityBlue Value (HMO) (H3957-025)	HMO
Premium and Other Important Information $3 400 out-of-pocket limit for Medicare-covered services. $25.00 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay a higher premium because of their yearly income (over $85 000 for singles $170 000 for married couples). For more i Doctor Office Visits $10 copay for each primary care doctor visit for Medicare-covered benefits. $50 copay for each in-area network urgent care Medicare-covered visit $30 copay for each specialist visit for Medicare-covered benefits.
Keystone Health Plan West Inc.	SecurityBlue ValueRx (HMO) (H3957-032)	HMO
Premium and Other Important Information $3 400 out-of-pocket limit for Medicare-covered services. $38 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $15 copay for each primary care doctor visit for Medicare-covered benefits. $50 copay for each in-area network urgent care Medicare-covered visit $40 copay for each specialist visit for Medicare-covered benefits.
Keystone Health Plan West Inc.	SecurityBlue HD (HMO) (H3957-037)	HMO
Premium and Other Important Information Keystone Health Plan West Inc. will reduce your monthly Medicare Part B premium by up to $ 3.00. $1 000 annual deductible. Contact the plan for services that apply. $2 750 out-of-pocket limit for Medicare-covered services. $0 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $10 copay for each primary care doctor visit for Medicare-covered benefits. $50 copay for each in-area network urgent care Medicare-covered visit $25 copay for each specialist visit for Medicare-covered benefits.
HealthAmerica	Advantra Gold (HMO) (H3959-002)	HMO
Premium and Other Important Information $4 300 out-of-pocket limit for Medicare-covered services. $72 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $10 copay for each primary care doctor visit for Medicare-covered benefits. $50 copay for each in-area network urgent care Medicare-covered visit $35 copay for each specialist visit for Medicare-covered benefits.
HealthAmerica	Advantra Silver (HMO) (H3959-011)	HMO
Premium and Other Important Information $6 700 out-of-pocket limit for Medicare-covered services. $0 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $10 copay for each primary care doctor visit for Medicare-covered benefits. $50 copay for each in-area network urgent care Medicare-covered visit $35 copay for each specialist visit for Medicare-covered benefits.
UPMC for You Advantage	UPMC for You Advantage (HMO SNP) (H4279-001)	HMO
Premium and Other Important Information * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services $0 annual deductible.* ** Please consult with your plan about cost sharing when receiving services from out-of-network providers. $3 400 out-of-pocket limit for Medicare-covered services. However in this plan you will have no cost sharing responsibility for Medicare-covered services based on your level of Medicaid eligibility. $0 monthly plan premium* Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits.* $0 copay for the cost of each in-area network urgent care Medicare-covered visit.* $0 copay for each specialist doctor visit for Medicare-covered benefits.*
HealthAmerica	Advantra Silver (PPO) (H5522-005)	Local Preferred Provider Organization
Premium and Other Important Information $5 900 out-of-pocket limit for Medicare-covered services. $1 500 annual deductible. Contact the plan for services that apply. $10 000 out-of-pocket limit for Medicare-covered services. $23 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Some physicians providers and suppliers that are out of a plan's network (i.e. out-of-network) accept "assignment" from Medicare and will only charge up to a Medicare-approved amount. If you choose to see an out-of-network physician who does NOT accept Doctor Office Visits $10 copay for each primary care doctor visit for Medicare-covered benefits. $40 copay for each in-area network urgent care Medicare-covered visit $35 copay for each specialist visit for Medicare-covered benefits. 20% of the cost for each primary care doctor visit 20% of the cost for each specialist visit
HealthAmerica	Advantra Elite (PPO) (H5522-009)	Local Preferred Provider Organization
Premium and Other Important Information $2 000 annual deductible. Contact the plan for services that apply. $6 550 out-of-pocket limit for Medicare-covered services. $150 plan coverage limit every year for Non-Medicare Supplemental benefits. Contact the plan for services that apply. $10 000 out-of-pocket limit for Medicare-covered services. $0 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Some physicians providers and suppliers that are out of a plan's network (i.e. out-of-network) accept "assignment" from Medicare and will only charge up to a Medicare-approved amount. If you choose to see an out-of-network physician who does NOT accept Doctor Office Visits $15 copay for each primary care doctor visit for Medicare-covered benefits. $50 copay for each in-area network urgent care Medicare-covered visit $40 copay for each specialist visit for Medicare-covered benefits. 30% of the cost for each primary care doctor visit 30% of the cost for each specialist visit
UPMC Health Plan	UPMC for Life PPO High Deductible with Rx (PPO) (H5533-003)	Local Preferred Provider Organization
Premium and Other Important Information $3 400 out-of-pocket limit for Medicare-covered services. $1 250 annual deductible. Contact the plan for services that apply. $5 100 out-of-pocket limit for Medicare-covered services. $0 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Some physicians providers and suppliers that are out of a plan's network (i.e. out-of-network) accept "assignment" from Medicare and will only charge up to a Medicare-approved amount. If you choose to see an out-of-network physician who does NOT accept Doctor Office Visits $20 copay for each primary care doctor visit for Medicare-covered benefits. $35 copay for each in-area network urgent care Medicare-covered visit $35 copay for each specialist visit for Medicare-covered benefits. $30 copay for each primary care doctor visit $50 copay for each specialist visit
UPMC Health Plan	UPMC for Life PPO Rx (PPO) (H5533-004)	Local Preferred Provider Organization
Premium and Other Important Information $3 400 out-of-pocket limit for Medicare-covered services. $500 annual deductible. Contact the plan for services that apply. $5 100 out-of-pocket limit for Medicare-covered services. $81.5 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Some physicians providers and suppliers that are out of a plan's network (i.e. out-of-network) accept "assignment" from Medicare and will only charge up to a Medicare-approved amount. If you choose to see an out-of-network physician who does NOT accept Doctor Office Visits $10 copay for each primary care doctor visit for Medicare-covered benefits. $30 copay for each in-area network urgent care Medicare-covered visit $30 copay for each specialist visit for Medicare-covered benefits. $30 copay for each primary care doctor visit $50 copay for each specialist visit
Geisinger Gold	Geisinger Gold Reserve (MSA) (H8468-001)	Medical Savings Account
Premium and Other Important Information Balance billing means that a provider may charge and bill you more than the plan's payment amount for services There is a limit on what providers may charge for Medicare-covered services $3 000 annual deductible Note that only Medicare-covered services will count toward your annual deductible. Medicare will deposit $1 500 into your bank account. You will not have a monthly plan premium. Medicare pays the monthly plan premium for the Medicare MSA Plan. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay a higher premium because of their yearly income (over $85 000 for singles $170 000 for married couples). For more i Balance billing counts towards your plan deductible. Doctor Office Visits Once you reach the plan deductible Medicare MSA plans cover Original Medicare benefits. Co-pay for Medicare MSAs is $0 once deductible is met.

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