Over 1.2 million people receive benefits from Pennsylvania Medicare Advantage Plans each year. These benefits help policyholders afford medications and allow them to lead stress-free lives.

More than 30% of each county’s population in Pennsylvania subscribes to a Medicare Advantage insurance plan.

How Medicare Advantage Plans Work in Pennsylvania

Medicare is an alternative to traditional health insurance for people over 65 and/or with disabilities. However, Medicare Advantage Plans are private and not government-assisted programs.

There are up to 55 Medicare Advantage Plans available to Pennsylvania residents. Each offers different benefits for its policyholders. Note that not all of these plans include prescription drug coverage.

Before enrolling in a Medicare Advantage Plan, you must know what benefits each plan provides.

Medicare Advantage Plans Offered in Pennsylvania

Unlike Medigap plans, the federal government does not standardize Medicare Advantage Plans. Therefore, plan benefits vary by ZIP code. Make sure that you research Medicare Advantage plans for your city.

Below, we will list the different kinds of Medicare Advantage Plans available to Pennsylvania residents. These include packages with zero-dollar premiums, drug deductibles, five-star ratings, and more.

Medicare Advantage Plans with Zero-dollar Premiums in Pennsylvania

Many Pennsylvania residents choose to invest in a Medicare Advantage Plan with a zero-dollar premium. Please note that with a zero-dollar premium plan, you will pay more out of pocket than other coverage plans.

Below are some of the insurance providers who offer a zero-dollar premium.

Aetna

Aetna offers a zero-dollar premium with its Medicare Advantage Plan. The insurance provider has a monthly out-of-pocket cost of $5,900 for its policyholders.

Most experts give Aetna a four- or five-star rating for its Medicare policies.

Highmark

While it can be costly, Highmark is among the most trusted Medicare Advantage insurance providers.

It is an HMO plan, meaning you pay a monthly fee to access a highly touted network of healthcare professionals. The MOOP for Highmark’s insurance plan is $7,550.

Humana

Humana is a PFFS plan, meaning it has a CMS annual contract to provide policyholders with medical benefits. This policy comes with a $6,700 MOOP.

PLAN PREMIUM MOOP PLAN TYPE STAR RATINGS
Aetna $0 $5,900 HMO-POS 4
Highmark $0 $7,550 HMO 4
UnitedHealthcare $0 $5,550 HMO 4
Wellcare $0 $6,700 LOCAL PPO N/A
Humana $0 $6,700 PFFS 4

Medicare Advantage Plans with Zero-dollar Drug Deductibles in Pennsylvania

Some Pennsylvania Medicare Advantage plans come with a zero-dollar drug deductible.

Geisinger

Geisinger is a four-star MA plan with a $7,550 MOOP. It is an HMO policy that services thousands of Pennsylvania residents annually.

Wellcare

Wellcare is another MA plan that can financially assist you with prescription medication. This policy carries a $7,550 MOOP fee and holds a three-star rating.

UnitedHealthcare

The country’s leading Medicare Advantage plan offers a zero-dollar drug deductible for eligible policyholders. With a $6,700 MOOP, it is the most affordable drug deductible MA plan for Pennsylvania residents.

PLAN PREMIUM MOOP PLAN TYPE STAR RATINGS
Geisinger $0 $7,550 HMO 4
Aetna $0 $7,550 LOCAL PPO 5
UnitedHealthcare $0 $6,700 LOCAL PPO 3
Wellcare $0 $7,550 HMO 3
Humana $0 $7,550 LOCAL PPO 4

Medicare Advantage Plans with Five-Star Ratings in Pennsylvania

Most Medicare patients seek a reliable insurance provider. If there is a five-star MA insurance company near you, you may be eligible for a Special Enrollment Period. Two Medicare Advantage plans qualify as five-star providers.

Aetna – This insurance policy is a local PPO, meaning it caters its services to your county. Policyholders rave about the benefits of signing up for a plan with Aetna.

Highmark – Another local PPO plan you should consider is Highmark. Highmark offers a $7,550 five-star plan that helps you save on medical and dental coverage.

PLAN PREMIUM MOOP PLAN TYPE STAR RATING
Aetna $0 $7,550 LOCAL PPO 5
Highmark $0 $7,550 LOCAL PPO 5

Medicare Advantage Plans with Part B Reductions in Pennsylvania

Below are a few plans with Part B reductions. Please note that these plans vary by ZIP code and are not available in some parts of Pennsylvania.

Humana

Policyholders can access many benefits with a Humana Medicare Advantage plan. Humana offers a Part B reduction of $60 with a $7,550 MOOP.

Aetna

Aetna is among the leaders in Medicare Advantage plans. It offers a $50 Part B reduction and has a MOOP of $7,550.

Geisinger

Geisinger has a MOOP of only $3,450. With a $27 Part B reduction and a four-star rating, Geisinger is among the best Pennsylvania Medicare Advantage plans.

PLAN PREMIUM MOOP PART B REDUCTION STAR RATING
Wellcare $0 $7,550 $55.00 N/A
Humana $0 $7,550 $60.00 4
Aetna $0 $7,550 $50.00 5
Geisinger $0 $3,450 $27.00 4
Highmark $0 $7,550 $22.00 5

Ancillary/DVH

A Medicare Advantage plan offers many benefits that traditional Medicare or Medigap plans do not. For example, some MA plans provide financial assistance for dental, vision, and hearing appointments. Plus, some may help cover prescription drugs.

Cities in Pennsylvania with Medigap Coverage’s Estimated Premiums

The following cities have charts that lay out the estimated premiums for Medigap coverage in Pennsylvania:

FAQs

What Is the Best Medicare Advantage Plan in Pennsylvania?

Pennsylvania Medicare patients may qualify for many different plans. The CMS gives a five-star rating to Aetna, Highmark, Independence Blue Cross, UnitedHealthcare, and UPMC for their outstanding coverage plans.

What Is the Largest Medicare Advantage Insurance Company in Pennsylvania?

UnitedHealthcare is the largest Medicare Advantage insurance company in Pennsylvania. The insurance provider helps millions of Pennsylvania patients afford prescription medication and stay on top of their health.

How Much Does Medicare Cost in PA?

Traditional Medicare has two parts: A and B. Typically, you can expect to pay $499/month for Part A Medicare insurance. However, most premium-free plans include Part A benefits for free. For Part B insurance, you will pay approximately $170/month.

Is Medicare Part A Free at Age 65 in Pennsylvania?

Medicare Part A insurance is free for most senior citizens in Pennsylvania. If you pay Medicare taxes for most of your work career, you do not have to pay for Medicare Part A.

How Do You Pay for Medicare Part B if You are Not Collecting Social Security in Pennsylvania?

People that get Social Security benefits can deduct their Part B payments. However, if you do not receive Social Security payments, you will receive a Part B bill each month. Typically, you will pay the standard premium amount. However, payment amounts depend on your annual income.

How to Get Help Enrolling in a Pennsylvania Medicare Advantage Plan

We can help you find the best Pennsylvania Medicare Advantage plans available. Our team works directly with these insurance providers, and we can inform you of the benefits of each. We will compare all of your options to find the plan that best suits you.

If you need more information regarding Pennsylvania Medicare Advantage plans, give us a call at the number above. You can also complete our online rate form now to see rates.

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by Lindsay Malzone, Lindsay Malzone is the Medicare expert for Medigap.com. She's been contributing to many well-known publications as an industry expert since 2017. Her passion is educating Medicare beneficiaries on all their supplemental Medicare options so they can make an informed decision on their healthcare coverage.