Geisinger Health Plan

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Frequently Asked Questions

Take a look at information about our organization:

• General
• Registration/Log In
• Confidentiality/Web Security
• Members
• Health Care Providers
• Employers
• Brokers
• Requesting Information

General

• Where is Geisinger Health Plan headquartered?
We are based in Danville, Pennsylvania, with regional offices throughout our service area.


• How many members do you serve?
Approximately 290,000 are enrolled in our health coverage products.


• Does the plan have much experience?
Geisinger Health Plan, a not-for-profit health maintenance organization (HMO), serves the health care needs of members in 43 counties throughout central and northeastern Pennsylvania. Begun in 1985, the Health Plan has steadily evolved into one of the nation’s largest rural HMOs by providing high-quality, affordable health care benefits.

Geisinger Health Plan is an integral part of what is collectively referred to as Geisinger Health System. The System is a large, comprehensive health care network that provides health care services throughout 43 counties.


• Does the plan have relationships with a wide range of health care providers?
Yes. More than 43,000 health care providers participate in our network including:
  •  4,426 Primary Care Physicians
  •  39,423 Specialist Physicians
  •  104 Participating Hospitals

Registration & Log-in

• I am a member of the Health Plan. How do I register?
  Take the following steps to register:
    •  Go to the homepage.
    •  Click on the User Registration button on the left-hand side of your screen.
    •  You will be asked to select your affiliation with the Health Plan.
    •  Please click on Member. A registration form will appear.
    •  Please fill in all required fields on the registration form: your member ID number (you can find this number on the front of your member ID card), date of birth, zip code, and the last four digits of your Social Security Number. Click Register.
    •  After all required fields are entered and submitted, you will be taken to our Terms and Conditions section.
    •  Once you accept, you can choose a user name and password. On the profile screen, you will need to pick a challenge question. The challenge question will help out later if you forget your password.
    •  A confirmation letter will be sent to you via U.S. Mail. You can expect to receive it within five to seven business days.
  
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• I am an employer that has received my PIN. How do I register?
  •  First, go to the homepage and click on the User Registration button on the left side of your screen. You will be asked to select your affiliation with the Health Plan. Please select “Employer.”
  •  After selecting “Employer,” a registration form will appear. Please fill in all required fields, including your group number, your company zip code and your PIN. Click “Register.”
  •  Once the registration form is submitted, you will be taken to our Terms and Conditions section. After you accept them, you may choose a user name and password.
  •  After choosing a user name and password, you will be prompted to choose a challenge question. This challenge question will help if you forget your password.

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• I am an appointed broker for the Health Plan. How do I register?
  •  Starting at the home page, click the User Registration button on the left side of your screen. Select your affiliation with the Health Plan by clicking “Broker.”
  •  After selecting “Broker,” a registration form will appear. Please fill in all required fields, including your PA Producer License number, your agency zip code, and the last four digits of your Social Security Number. Click register.
  •  Once you have submitted the registration form, you will be directed to our Terms and Conditions section. After you accept them, you can choose a user name and password. Choose a challenge question to help later if you forget your password.
  •  A confirmation letter will be sent to you vial U.S. Mail. You can expect to receive this letter within five to seven business days.

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• I am a provider and a member. Should I register twice?
Yes, if you would like to access both the secured Provider and Member sections you will need to register for each section separately.

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• I recently changed my name. Do I need to re-register?
At this time, you may not change your user name. However, if you recently changed your name, we ask that you inform our customer service team by calling the 800-number located on the back of your member ID card.

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• I forgot my password. What should I do?
You are allowed three attempts to enter your password correctly before being locked out. (See Below: “Help! I’m having problems logging in.”)

Before being locked out, you may choose to create a new password. Begin by clicking here. Once you are at the Forgot Your Password page, choose your affiliation with the Health Plan and enter all required registration information. (Refer to the “Registration/Log-in” section above.) From here, you will be prompted to answer your challenge question and create a new password. (If you cannot remember the answer to your challenge question, click here for further assistance.) Verify your new password and continue using the Health Plan site to manage your health care benefits.

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• Help! I'm having problems logging in.
If you are having problems logging in, you may e-mail a brief description of the problem by clicking here. Please note, if you are logging in with an invalid password, you will be allowed three attempts before being locked out. If you already have tried to login three times unsuccessfully, please click here to fill out a form to have your account unlocked. If you are having problems registering, you should notify us to verify that the information you are entering matches the information in our database.

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Confidentiality & Web Security

• Is e-mail safe?
The Health Plan cannot guarantee the security of e-mail transmitted over the Internet. While we encourage you to ask questions about Geisinger Health Plan or request information, we urge you not to submit personal health information via e-mail. We offer secured messaging in the password-protected sections of our website that is not transmitted over the Internet.

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• Is the information I provide in an e-mail confidential?
If you choose to use e-mail as a communication tool, please be aware that the Health Plan cannot guarantee the security of e-mail transmitted over the Internet. We will not communicate members' personal health information via e-mail. We offer secured messaging in the password-protected sections of our website that is not transmitted over the Internet. We encourage you to refer to Terms of Use and Privacy Policy/HIPAA; both are located at the bottom of this page.

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• Is your website secured?
For your protection, we have upgraded security on our website. Some features on our site require the highest level of protection to ensure the security of transmitted information.

If you do not wish to upgrade your browser, you can still view information on the General Access section of the home page.

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• How long can I stay logged on in a secured section?
After 30 minutes with no activity, security measures will prompt the site to automatically log out the user. Activity means you must be clicking from page to page. (Note: Typing information into a form does not constitute activity.)

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• I received a GHP secure e-mail message. How do I retrieve it?
All outbound e-mail is screened by Zix software for potential confidential information or protected health information (PHI). If you have received a secure e-mail message, please click here for the steps needed to retrieve it. For Customer Support, send an e-mail to support@zixcorp.com.

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Updating Personal Information

• How do I change my e-mail address?
If you recently changed your personal e-mail address, we ask that you update that information in your Health Plan profile. Start by logging in using your user name and password. Click on the Profile button on the left side of the screen. Click Change E-mail, enter your new e-mail address, and click Submit.

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• How do I change my challenge question?
To change your challenge question, log in using your user name and password. Click on the Profile button on the left-hand side of the screen. In the body of the text you will see challenge information and an Edit button. Click on Edit and you will be able to change your challenge question, and answer. Click update. (Remember, you will need to answer this challenge question to change your password if you forget it.)

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• How do I change my password?
To change your password, log in using your user name and password. Click on the Profile button on the left-hand side of the screen. Click on Change Password, enter your new password, and verify. Click Submit.

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Members

• I lost my member ID card. Can I request a new one?
You may print a temporary identification card if you are a registered user of thehealthplan.com. Here’s how:
  •  Log in as a member
  •  Click on Service Center
  •  Click on Request New Member ID Card
  •  Click on "Click Here" for a temporary ID card
  •  You will receive a PDF of the front and back of the most current ID card that can be printed and used until a permanent ID card is received. You may also request a permanent card on thehealthplan.com or by calling customer service.

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• I'm a member. Where can I mail a claim form if I receive one in the mail?
Claims may be mailed to:
Geisinger Health Plan
P.O. Box 8200
Danville, PA 17821-8200

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• I received a monthly premium payment bill in the mail. Where do I mail my payment?
If you are not covered through your employer and are responsible for paying your monthly premium, the easiest way to make payments is to use our online Premium Payment tool. Register or log in to the secured member section and click on the "Premium Payment" link. You can choose a recurring monthly payment or a onetime payment by using a credit card or bank account.

You can also pay your premium over the phone by calling the Customer Service Team at the phone number found on the back of your ID Card.

If you prefer to mail your payment, please select the correct address from the list below. If you're unsure of the Plan name, it can be found on the front of your ID card.

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• How do I find out if my prescription drugs are covered?
Click on the Covered Drugs button on the left-hand side of the Health Plan homepage in the "Find" menu. Type in either the drug name or search by the member category drop-down listing which alphabetically lists all covered brand and generic drugs in that category.

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• How can I search for a participating provider on your website?
You can search for a provider even if you are not a registered user. Go to the Health Plan homepage and click on Doctors on the left-hand side of your screen in the "Find" menu. You may search for participating primary care providers (PCP), specialists, behavioral health providers, as well as participating hospitals and pharmacies. You may also enter your zip code and the radius in miles that you are willing to travel, so that you can select a provider that is close to your home or work. If you are looking for a specific doctor, you may also search by name.

NOTE: If you are looking for a specialist, in most cases, a referral for a specialist must be obtained by your primary care physician (PCP).

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• What is the Accessories Program and how do I access it?
The Accessories Program offers members access to a variety of discounted, health-related products and services. Log in to the Member or Employer section and click on Accessories Program under Health & Wellness on the left-hand side of your screen. Then, click on the accessories program you're interested in. Click Go. You may be linked to an external website. If so, a warning screen will indicate you're leaving the GHP site. Close the window and you will see the new site which explains the discount and provides a search for locations close to your work or home. When you are finished viewing the external site, exit the window and return the Health Plan site. Remember, after 30 minutes with no activity, security measures will require you to log in again.

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• What happens if I lose my group health insurance coverage?
If you are no longer covered under your employer-sponsored plan, you can convert to individual coverage. Click here for more information.

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Health Care Providers

• I am a participating provider. How do I register?
Take the following steps to register:
  •  Go to the homepage.
  •  Click on the User Registration button on the left-hand side of your screen.
  •  You will be asked to select your affiliation with the Health Plan. Please click Provider.
  •  A registration form will appear. Please fill in all required fields on the registration form: your Health Plan provider number, date of birth, medical license number, the state in which you are licensed, and the last four digits of your Social Security Number. Click Register.
  •  After all required fields are entered and submitted, you will be taken to our Terms and Conditions section. Once you accept, you can choose a user name and password. On the profile screen, you will need to pick a challenge question. The challenge question will help if you forget your password.
  •  A confirmation letter will be sent to you via U.S. Mail. You can expect to receive it within five to seven business days.

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• I'm a participating provider. Why should I register?
If you are a registered user you will be able to access the following information: the Quality Summary program, provider guides, operational bulletins, newsletters, care coordination information (including clinical guidelines), provider searches, and the provider formulary. Access the Health Plan hompage to log in. Buttons for each of these topics are located on the left-hand side of the screen. You will also see a button to change your user profile here.

Click here to view the information available to providers without logging in.

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• I'm a provider. How do I find out if a prescription drug is on the formulary?
Click here to view the Provider Formulary Search. Type in the drug name, or search by the therapeutic category or therapeutic sub-category drop-down listings to see if the prescription drugs are covered. Be sure to verify the spelling of the drug as you may not obtain an existing match on drug names incorrectly spelled. Please note: Certain prescription drugs listed in this formulary may not be covered for all members. A member's prescription drug benefits are dependent upon the coverage selected by the member or the member's employer.
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• I'm a pharmacist. How do I submit a Medicare Part D claim for Geisinger Gold members?
For Geisinger Gold members who have Medicare Part D prescription drug coverage, please use NCPDP version 5.1 and provide the following information for each claim submitted:

Processor Control Number (PCN): 03640000
BIN: 012353
Member ID number
Pharmacy's Usual & Customary Price (U&C)
Physician's DEA Number
Member's date of Birth

Important: Carrier Code is required for claims submission. Chain pharmacies must provide stores with the appropriate Carrier Code.

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Employers

• I'm an employer super user. How do I add additional users?
To add or terminate users of the secured Employers section for your company, log in to the employer section and click on the Manage Web Access button. For detailed information, please click here to view our Employer Web Manual.

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• I am an employer. How do I request a Personal Identification Number (PIN)?
To request a PIN, please call your Health Plan service representative to complete the Employer Group Super User registration form. Once this form is completed and returned to the Health Plan, we will send you an e-mail with your PIN (usually within five business days).

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Brokers

• I'm an appointed broker. May I request sales literature?
Yes. Login to the secured Brokers section. Then, click on Sales Literature and Forms Request. An order form will appear. Please fill in all required fields and submit order. Your order will be forwarded to our Broker Department and will be filled as quickly as possible.

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Requesting Information

• I am not a member of the Health Plan, but I'd like some information.
Click here for coverage information for individuals and families. For general information about the Plan, click on About GHP or call (800) 631-1656 and a representative will help to answer any of your questions. Thank you!

If you are no longer covered under your employer-sponsored plan, you can convert to individual coverage. Click here for more information.

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• Terms of Use
• Privacy Policy
• HIPAA
• Careers
• Site Map

Geisinger Health Plan, Geisinger Quality Options, Inc., and Geisinger Indemnity Insurance Company are affiliated entities.

Medicare medical and prescription drug plans for people 65 and older, or eligible for Medicare are available in Pennsylvania and New Jersey.