2025 PLAN DOCUMENT REQUEST
Evidence of Coverage, Provider Directory, and Formulary Directory

Request these documents for free using the simple request form below.

GEISINGER GOLD MEDICARE DOCUMENT REQUEST FORM


Fields marked with an astrisk (*) are required.


*To locate your PIN, please refer to your ANOC cover letter. You can also request materials by calling the customer care team.


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© 2025 Geisinger Gold Medicare Advantage HMO, PPO, and HMO D-SNP plans are offered by Geisinger Health Plan/Geisinger Indemnity Insurance Company/Geisinger Quality Options, Inc., health plans with a Medicare contract. Continued enrollment in Geisinger Gold depends on contract renewal. Geisinger Health Plan, Geisinger Indemnity Insurance Company, and Geisinger Quality Options, Inc. are part of Geisinger, an integrated health care delivery and coverage organization. Risant Health is the parent organization of Geisinger.

ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 800-447-4000 (TTY: 711).

注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 800-447-4000 (TTY : 711)


Last updated: 10/08/2024