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Geisinger PPO Members in PennsylvaniaGeisinger PPO members in Pennsylvania, and out-of-area behavioral health care.
If you are a Geisinger Health Plan PPO member in Pennsylvania who travels, or you have a college-age or relocated dependent, your out-of-area care reaches further than many members realize. We verify your specific benefits before you commit to anything.
The honest version.
We are out of network with commercial carriers. In-network credentialing is in progress. We verify your out-of-network benefits and tell you the real out-of-pocket number before you start.
What we will and will not tell you about cost.
We do not waive cost-shares. We do not tell you treatment is free. We verify your OON benefits, give you the real number, and if cost is a genuine barrier we will talk about it case by case.
The Cigna PPO network and Evernorth on the behavioral side.
Geisinger Health Plan is centered in central and northeastern Pennsylvania, with its strongest in-network footprint in that region. As of mid-2025, Geisinger Health Plan PPO members access out-of-area care through the Cigna PPO network, with Evernorth handling the behavioral health side. That arrangement matters most for members who are physically outside Geisinger's home territory: a member who travels, or a covered dependent who is away at college or has relocated, can reach care that the local Geisinger network alone would not cover well. The structure that matters for treatment is whether your specific plan carries an out-of-network behavioral health benefit, and what its terms are. We pull that for you before anything starts.
The pieces of the plan
- An allowed amount for each kind of visit or day of behavioral care.
- A deductible you meet before the plan starts splitting the cost.
- A coinsurance split after the deductible.
- An out-of-pocket maximum for the year, after which the plan covers more or all.
- An authorization step for intensive outpatient and PHP-intensity hour expansion, which we handle.
What we do for you on the benefits side
- Call Geisinger Health Plan, and the Evernorth behavioral line where it applies, on the back of your card and pull the actual out-of-network behavioral numbers for the level of care you need.
- Translate them into the dollar cost of a week of treatment, so there are no surprises.
- Submit the authorization and stay on the case through review and renewal.
- Bill what the plan considers reasonable, so there is no balance-bill surprise later.
The traveler, and the dependent who moved away.
Geisinger's network is built around its home region in Pennsylvania. The out-of-area situations where members most often look for care outside that footprint are the same two situations where virtual treatment makes the most sense: a member who spends real time away from home, and a covered dependent who is at college or has relocated. In both cases the question is what the plan pays on an out-of-network basis for behavioral health, and that is exactly what we verify.
Care that does not depend on the local network
If you are a Geisinger PPO member who spends time away from central or northeastern Pennsylvania, your out-of-network behavioral benefit is what reaches you when you are out of the home network. We read your specific plan and tell you what travels with you.
Start the benefit check A college-age or relocated dependentThe covered child who lives elsewhere now
If you have an enrolled dependent who is away at college or has relocated, that dependent usually carries the same behavioral health benefit as the policyholder. We verify the dependent's out-of-network benefit the same way we verify a member's. Send us the front of the card and we will read it together.
Start the benefit checkYou attend from where you are physically located.
Telehealth licensure follows the state where the patient is physically located during the session. Our clinical team is licensed in California, and we treat patients who are physically in California during their sessions. A Geisinger member or dependent who is in California, for example a relocated adult child, can attend the full program from a private space. If your situation involves another state, we will tell you honestly on the first call whether we are the right fit or whether we should help you find a licensed provider in your location.
Plain-English answers.
Are you in network with Geisinger or with Cigna?
No. We are out of network with commercial carriers, including Geisinger Health Plan, and we are not in network with Cigna. In-network credentialing is in progress. Many Geisinger PPO plans include an out-of-network behavioral health benefit, and we bill out-of-network.
How does my Geisinger PPO reach care outside Pennsylvania?
As of mid-2025, Geisinger Health Plan PPO members access out-of-area care through the Cigna PPO network, with Evernorth on the behavioral side. That is what lets a member who is away from the home network reach care. The terms that decide your out-of-pocket cost come from your specific Geisinger plan, which we verify directly.
My adult child is on my Geisinger plan but lives in another state. Are they covered?
Enrolled dependents usually carry the same behavioral health benefit as the policyholder. We verify the dependent's out-of-network benefit the same way we verify a member's. Whether we can treat that dependent depends on the state where they are physically located, because telehealth licensure follows the patient's location. We will tell you on the first call.
How do I find out what my plan really covers?
Send us the member ID and group number on the front of your card. We call the plan, pull the actual out-of-network behavioral numbers for the level of care you need, and translate them into what a typical week of treatment would cost you, before you start.
Will my employer find out?
No. Substance use treatment records are protected under 42 CFR Part 2. We do not release any information to your employer without your written consent. The exception is if the law requires it or if your safety is at risk.
How fast can I start?
Typically same or next business day for the clinical assessment, and within the same business week for program start, once benefits and authorization are confirmed.
Verify your benefits in two minutes.
Send us the member ID and group number on the front of your card. We come back with your specific out-of-network deductible, coinsurance, out-of-pocket maximum, and what a typical week of intensive outpatient or partial hospitalization-intensity care would cost you. No commitment until you decide.
If you or someone you are with is in immediate danger, call or text 988 (the Suicide & Crisis Lifeline) or call 911. Shift Support Network is an outpatient program and is not an emergency service. Substance use treatment records are protected by 42 CFR Part 2.