Medicare Plan Lookup Official CMS data · Contract Year 2027
CMS 2027 data

2027 Medicare plan code

H3954-806

Medicare Plan

Geisinger Gold FEHB Rx (Employer Group) (HMO) · Geisinger Gold · HMO · Pennsylvania

Full CMS plan ID: H3954-806-000

H3954-806-000 is the full CMS identifier for the H3954-806 Medicare plan. Common searches include H3954 806 and H3954806.

2027

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

● CMS 2027 plan record

Geisinger Gold FEHB Rx (Employer Group) (HMO)

H3954-806-000 Pennsylvania HMO Employer-only

At-a-glance

Quick view

01

In-network

Inpatient hospital

Out-of-network

Not separately reported

Point of service

Not separately reported

$0 cost share

02

Emergency transport

Ambulance

Ground · in-network$0 cost share
Air · in-network$0 cost share
03

Emergency services

Emergency room

$0 cost share

04

Medical maximum

Maximum out-of-pocket

In-network$0
Combined in + outNot reported
05

Skilled care at home

Home health

In-network$0 cost share
Out-of-networkNot separately reported
06

Monthly cost

Premium & giveback

Part C premiumNot reported
Consolidated C + DNot reported

CMS reports a Part B premium reduction of $75 per month.

Plan details

All plan benefits

Medical care3 benefits

Primary care physician

In-networkPrimary Care Physician Services: $0 cost share
Out-of-networkNot separately reported

Specialist

In-networkPhysician Specialist Services: $0 cost share
Out-of-networkNot separately reported

Preventive care

In-networkAnnual Physical Exam: $0 cost share; Kidney Disease Education Services: $0 cost share; Glaucoma Screening: $0 cost share; Diabetes Self-Management Training: $0 cost share; Digital Rectal Exams: $0 cost share; EKG following Welcome Visit: $0 cost share
Out-of-networkNot separately reported
Diagnostics & imaging4 benefits

Diagnostic procedures & tests

In-networkDiagnostic Procedures/Tests: $0 cost share
Out-of-networkNot separately reported

Laboratory services

In-networkLab Services: $0 cost share
Out-of-networkNot separately reported

X-rays & standard imaging

In-networkOutpatient X-Ray Services: $0 cost share
Out-of-networkNot separately reported

MRI, CT & PET imaging

In-networkDiagnostic Radiological Services: $0 cost share
Out-of-networkNot separately reported
Urgent & hospital care6 benefits

Urgent care

In-networkUrgently Needed Services: $0 cost share
Out-of-networkNot separately reported

Emergency room

In-network$0 cost share
Out-of-networkNot separately reported

Ground ambulance

In-network$0 cost share
Out-of-networkNot separately reported

Air ambulance

In-network$0 cost share
Out-of-networkNot separately reported

Outpatient hospital

In-networkOutpatient Hospital Services: $0 cost share; Observation Services: $0 cost share
Out-of-networkNot separately reported

Outpatient surgery / ASC

In-networkAmbulatory Surgical Center (ASC) Services: $0 cost share
Out-of-networkNot separately reported
Recovery & therapy5 benefits

Home health

In-network$0 cost share
Out-of-networkNot separately reported

Skilled nursing facility

In-networkSkilled nursing facility: $0 cost share
Out-of-networkNot separately reported

Cardiac & pulmonary rehabilitation

In-networkCardiac Rehabilitation Services: $0 cost share; Intensive Cardiac Rehabilitation Services: $0 cost share; Pulmonary Rehabilitation Services: $0 cost share; SET for PAD Services: $0 cost share; 3-1(NMC): Not applicable; 3-2(NMC): Not applicable; 3-3(NMC): Not applicable; 3-4(NMC): Not applicable
Out-of-networkNot separately reported

Occupational therapy

In-networkOccupational Therapy Services: $0 cost share
Out-of-networkNot separately reported

Physical & speech therapy

In-networkPhysical Therapy and Speech-Language Pathology Services: $0 cost share
Out-of-networkNot separately reported
Behavioral health2 benefits

Mental health services

In-networkPartial Hospitalization Program: $0 cost share; Individual Sessions for Mental Health Specialty Services: $0 cost share; Group Sessions for Mental Health Specialty Services: $0 cost share; Individual Sessions for Psychiatric Services: $0 cost share; Group Sessions for Psychiatric Services: $0 cost share; Inpatient psychiatric hospital: $0 cost share
Out-of-networkNot separately reported

Substance use treatment

In-networkIntensive Outpatient Program Services: $0 cost share; Individual Sessions for Outpatient Substance Abuse: $0 cost share; Group Sessions for Outpatient Substance Abuse: $0 cost share
Out-of-networkNot separately reported
Specialty care2 benefits

Podiatry

In-networkPodiatry Services: $0 cost share; 7f(NMC): $0 cost share
Out-of-networkNot separately reported

Chiropractic

In-networkChiropractic Services: $0 cost share
Out-of-networkNot separately reported
Supplemental benefits7 benefits

Dental

In-networkMedicare Dental Services: $0 cost share; Diagnostic and Preventive Dental: $0 cost share; Dental X-Rays: $0 cost share; Prophylaxis (Cleaning): $0 cost share
Out-of-networkNot separately reported

Vision

In-networkEye Exams: $0 cost share; Routine Eye Exams: Not applicable; Other Eye Exam Services: Not applicable; Eyewear: $0 cost share; Contact Lenses: Not applicable; Eyeglasses (lenses and frames): Not applicable; Eyeglass lenses: Not applicable; Eyeglass frames: Not applicable; Upgrades: Not applicable
Out-of-networkNot separately reported

Hearing

In-networkHearing Exams: $0 cost share; Routine Hearing Exams: $0 cost share; Fitting/Evaluation for Hearing Aid: $0 cost share; Prescription Hearing Aids (all types): $500 copay; Prescription Hearing Aids - Inner Ear: Not applicable; Prescription Hearing Aids - Outer Ear: Not applicable; Prescription Hearing Aids - Over the Ear: Not applicable
Out-of-networkNot separately reported

Transportation

Not applicable
In-network10b(NMC): Not applicable
Out-of-networkNot separately reported

Fitness & wellness

In-networkFitness Benefit: $0 cost share
Out-of-networkNot separately reported

Over-the-counter allowance

In-networkOver-the-Counter (OTC) Items: $0 cost share
Out-of-networkNot separately reported

Meals

Not applicable
In-networkMeal Benefit: Not applicable
Out-of-networkNot separately reported
Plan costs & rulesCoverage overview

Premium & Part B giveback

Part C premium not reported · CMS reports a Part B premium reduction of $75 per month.

Maximum out-of-pocket (MOOP)

In-network$0
Combined in + outNot reported

Medical deductibles

In-network$0
Out-of-networkNot reported

Annual health deductible

Not separately reported

Combined network deductible

Not separately reported

Part D premium

Not reported

Network & referrals

HMO · Referrals: Not required · Out-of-network coverage: Not reported

Prescription drugs0 tiers

Part D deductible

Plan-specific drug deductible not published

Using this plan

Understand H3954-806-000

Plain-language context built from this plan’s 2027 CMS record. It is a guide to the reported benefits, not a personalized cost estimate.

Plan at a glance

A quick read on this plan

Geisinger Gold FEHB Rx (Employer Group) (HMO) is a 2027 HMO offered by Geisinger Gold in Pennsylvania. The plan record does not require referrals.

Common benefit costs

What you may pay

These are individual in-network benefit amounts. A real visit may involve more than one separately billed service.

Routine care

Primary care physician
Primary Care Physician Services: $0 cost share
Specialist
Physician Specialist Services: $0 cost share
Laboratory services
Lab Services: $0 cost share

Separate visits or services; costs are not added together.

Tests & outpatient care

Diagnostic procedures & tests
Diagnostic Procedures/Tests: $0 cost share
MRI, CT & PET imaging
Diagnostic Radiological Services: $0 cost share
Outpatient hospital
Outpatient Hospital Services: $0 cost share; Observation Services: $0 cost share

The service setting and billing details can change what you pay.

Emergency & hospital care

Emergency room
$0 copay

Actual costs depend on the care received and plan rules.

Helpful context

Terms worth knowing

Maximum out-of-pocket (MOOP)

This is the most you generally pay during the plan year for covered Part A and Part B medical services under the applicable network limit. Premiums and prescription drug costs generally do not count toward it.

Part B premium reduction (“giveback”)

A giveback may reduce the amount you pay toward Medicare Part B; it is not usually paid to you as cash. The CMS record notes: CMS reports a Part B premium reduction of $75 per month.

Availability

Who can enroll

Service area
Pennsylvania (PA)
Plan type
HMO
Contract / plan
H3954-806
Coverage year
2027

Enrollment is limited to people eligible through the sponsoring employer or group. Confirm eligibility and the exact service area with the plan before enrolling.

Supplemental coverage

Extra benefits reported

Availability is summarized here; allowances, frequency limits, networks, and prior-authorization rules may apply.

DentalMedicare Dental Services: $0 cost share; Diagnostic and Preventive Dental: $0 cost share; Dental X-Rays: $0 cost share; Prophylaxis (Cleaning): $0 cost share
VisionEye Exams: $0 cost share; Routine Eye Exams: Not applicable; Other Eye Exam Services: Not applicable; Eyewear: $0 cost share; Contact Lenses: Not applicable; Eyeglasses (lenses and frames): Not applicable; Eyeglass lenses: Not applicable; Eyeglass frames: Not applicable; Upgrades: Not applicable
HearingHearing Exams: $0 cost share; Routine Hearing Exams: $0 cost share; Fitting/Evaluation for Hearing Aid: $0 cost share; Prescription Hearing Aids (all types): $500 copay; Prescription Hearing Aids - Inner Ear: Not applicable; Prescription Hearing Aids - Outer Ear: Not applicable; Prescription Hearing Aids - Over the Ear: Not applicable
Over-the-counter allowanceOver-the-Counter (OTC) Items: $0 cost share
Fitness & wellnessFitness Benefit: $0 cost share

Plan-specific answers

Frequently asked questions

Where is H3954-806-000 available?

Geisinger Gold FEHB Rx (Employer Group) (HMO) is listed for Pennsylvania (PA). Enrollment is limited to people eligible through the sponsoring employer or group.

What is the in-network maximum out-of-pocket limit for H3954-806-000?

The 2027 CMS record lists an in-network medical maximum out-of-pocket limit of $0. Prescription drug spending generally does not count toward this medical limit.

What does an emergency room visit cost on H3954-806-000?

The plan record lists $0 copay.

Does H3954-806-000 report extra benefits?

Yes. CMS reports dental, vision, hearing, over-the-counter allowance, fitness & wellness. See the detailed benefit rows and official plan documents for limits and conditions.

Source trail

Official CMS, Contract Year 2027

Plan identity and benefits come from CMS PBP data. Benefits and drug cost sharing come from the approved annual PBP tabular extract and its CMS dictionary. Premiums and drug deductibles are cross-checked with the annual Landscape. Geography comes from annual PlanArea and PlanRegionArea records, including exact segments and partial-county or employer/group qualifiers. Quick-reference values should be confirmed in current official plan documents.

PBP benefits ↗ Landscape data ↗ County service area ↗

Plan context

Where H3954-806-000 fits

Full CMS plan ID
H3954-806-000
Contract
H3954
Base plan code
H3954-806
Segment
000
Carrier
Geisinger Gold
Plan type
HMO
Service area
Pennsylvania (PA)

County/service-area foundation

CMS service-area entries

Service areas come from the annual CMS PlanArea and PlanRegionArea tables for this exact contract, plan, and segment. Partial-county and employer/group qualifiers remain part of the coverage area. Regional PPO county entries use the matching annual Landscape expansion of the CMS region.

  • Adams, PA
  • Allegheny, PA
  • Armstrong, PA
  • Beaver, PA
  • Bedford, PA
  • Berks, PA
  • Blair, PA
  • Bradford, PA
  • Bucks, PA
  • Butler, PA
  • Cambria, PA
  • Cameron, PA

55 additional service-area entries are retained in the data record.

Exact county navigation

These links are limited to named counties tied to this exact medical plan segment. Partial-county entries remain labeled for verification.

Show 63 county links
Pennsylvania

Same CMS contract

H3954-097-000 Geisinger Gold Secure Rx (HMO D-SNP) Pennsylvania · HMO H3954-157-021 Geisinger Gold Classic Advantage Rx (HMO) Central Pennsylvania · HMO H3954-157-022 Geisinger Gold Classic Advantage Rx (HMO) Midstate Pennsylvania · HMO H3954-157-023 Geisinger Gold Classic Advantage Rx (HMO) Midwest Pennsylvania · HMO H3954-158-013 Geisinger Gold Classic Complete Rx (HMO) Midstate Pennsylvania · HMO H3954-158-014 Geisinger Gold Classic Complete Rx (HMO) Central Pennsylvania · HMO H3954-160-000 Geisinger Gold Classic 360 Rx (HMO) Pennsylvania · HMO H3954-161-000 Geisinger Gold Classic Essential Rx (HMO) Pennsylvania · HMO

About this code

What H3954-806-000 identifies

H3954-806-000 is a Contract Year 2027 Medicare plan segment code. Searches written as H3954-806, H3954 806, or the compact full CMS ID H3954806000 refer to this plan or its base plan code.

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.