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Verified against CMS.gov · on Apr 1, 2026 Plan ID: H3954-157 Cross-check on Medicare.gov →

Geisinger Gold Classic Advantage Rx (HMO)

Plan Year 2026
$99.30 /month
Monthly Premium
$0.00 Annual Deductible
1,027 Drugs Covered
1 States Served

Top Covered Drugs

Most popular medications covered by this plan, ordered by national search frequency. Click any drug to see exact copay, restrictions, and alternatives.

# Drug Name Type Tier 30-Day Copay
1 Lorbrena lorlatinib Brand Tier 5 $0.00 Details
2 DELSTRIGO doravirine, lamivudine, and tenofovir disoproxil fumarate Brand Tier 5 $0.00 Details
3 Linzess linaclotide Brand Tier 3 $0.00 Details
4 Risperidone Brand Tier 4 $0.00 Details
5 Erlotinib Brand Tier 4 $0.00 Details
6 KOSELUGO SELUMETINIB Brand Tier 5 $0.00 Details
7 BCG VACCINE BACILLUS CALMETTE-GUERIN SUBSTRAIN TICE LIVE ANTIGEN Brand Tier 6 $0.00 Details
8 Loxapine Brand Tier 2 $0.00 Details
9 GARDASIL 9 Human Papillomavirus 9-valent Vaccine, Recombinant Brand Tier 6 $0.00 Details
10 Medroxyprogesterone Acetate Brand Tier 2 $0.00 Details
11 JAYPIRCA pirtobrutinib Brand Tier 5 $0.00 Details
12 Diltiazem Hydrochloride Brand Tier 2 $0.00 Details
13 VERQUVO vericiguat Brand Tier 4 $0.00 Details
14 Enoxaparin Sodium Enoxaparin sodium Brand Tier 4 $0.00 Details
15 Emtricitabine and Tenofovir Disoproxil Fumarate Brand Tier 3 $0.00 Details
16 Emtricitabine, Rilpivirine, Tenofovir Disoproxil Fumarate Brand Tier 5 $0.00 Details
17 Prograf Tacrolimus Brand Tier 4 $0.00 Details
18 Lenalidomide Brand Tier 5 $0.00 Details
19 Bromocriptine mesylate Brand Tier 4 $0.00 Details
20 SCEMBLIX asciminib Brand Tier 5 $0.00 Details

Showing 20 of 1,027 covered drugs.

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States Served (1)

This plan is available to Medicare beneficiaries in the following states.

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