Medicare Plan Lookup Official CMS data · Contract Year 2026
CMS 2026 data

2026 Medicare plan code

H3924-059-021

Geisinger Gold Preferred Advantage Rx (PPO) · Geisinger Gold · Northeast, Central, & Midwest PA

Compact plan code: H3924059021

2026

Spaces or dashes work: H5216-435-002 · S2135 802

● CMS 2026 plan record

Geisinger Gold Preferred Advantage Rx (PPO)

H3924-059-021 Northeast, Central, & Midwest PA Local PPO
Open in quick lookup
01

In-network

Inpatient hospital

Days 1–6 $200 / day
Days 7–90 $0 / day
Total of listed copays · 6 charged days $1,200
02

Emergency transport

Ambulance

Ground · in-network$200 copay
Air · in-network$200 copay
03

Emergency services

Emergency room

$150 copay

Waived if admitted

04

Medical maximum

Maximum out-of-pocket

In-network$4,000
Combined in + out$4,000
05

Skilled care at home

Home health

In-networkNo cost share reported
Out-of-networkNo cost share reported
06

Monthly cost

Premium & giveback

Part C premium$2 / month
Consolidated C + D$114 / month

Source trail

Official CMS, Contract Year 2026

Plan identity and benefits come from CMS PBP data. Premium and MOOP figures are cross-checked against the August 2026 Landscape release. Quick-reference values should be confirmed in current official plan documents.

PBP benefits ↗ Landscape data ↗

Same CMS contract

H3924-059-022 Geisinger Gold Preferred Advantage Rx (PPO) South & East Pennsylvania · Local PPO H3924-065-000 Geisinger Gold Preferred Complete Rx (PPO) Pennsylvania · Local PPO H3924-804-000 Geisinger Gold Preferred Basic/Deluxe Rx (+) EGWP (PPO) Pennsylvania · Local PPO H3924-805-000 Geisinger Gold Preferred Basic/Deluxe (+) EGWP (PPO) Pennsylvania · Local PPO

About this code

What H3924-059-021 identifies

H3924-059-021 is a Contract Year 2026 Medicare plan segment code. The compact form H3924059021 refers to the same normalized contract, plan, and segment shown on this page.

Medicare Plan Lookup uses official CMS data as a quick reference. Benefit details, eligibility, service-area rules, and cost sharing should be confirmed in the current Summary of Benefits or Evidence of Coverage.