About 41% of the 720,000 Philadelphians currently enrolled in Medicare Parts A and B are also enrolled in a Medicare Advantage plan. This article will review the Philadelphia Pennsylvania Medicare plans available to Medicare recipients.
Philadelphia Pennsylvania Medicare plans
Although Medicare beneficiaries all receive the same Original Medicare benefits, they can choose how they receive them. One option is to add a Medicare Advantage plan.
Medicare Advantage plans in Philadelphia Pennsylvania
Medicare beneficiaries have an average of 39 Medicare Advantage options in 2023, more than twice as many as they had in 2017.
| PLAN | PREMIUM | MOOP | Plan Type | Star Rating |
| Aetna | $0 | $6,900 | HMO | 4 |
| Wellcare | $0 | $7,550 | LOCAL PPO | N/A |
| Humana | $0 | $7,200 | LOCAL PPO | 4 |
| UnitedHealthcare | $0 | $5,550 | HMO | 4 |
| Clover Health | $0 | $7,550 | LOCAL PPO | 3 |
United Healthcare offers a Pennsylvania Medicare Advantage HMO plan with an annual premium of zero. The maximum out-of-pocket (MOOP) is $5,550 annually. The plan has a four-star rating.
Aetna’s Medicare Advantage HMO-POS plan also has a zero-dollar annual premium. Rated four stars, the plan’s MOOP is $5,900.
Humana’s Private Fee for Service (PFFS) Medicare Advantage plan has a MOOP of $6,700 annually. This four-star rated plan also has a yearly premium of zero.
Affordable Medicare Supplement plans in Philadelphia Pennsylvania
Medigap or Medicare Supplement plans in Pennsylvania are identified by an alphabet letter. The most financially beneficial Medigap or Medicare Supplement plans are Plan G, Plan N, and Plan F. Medigap or Medicare Supplement plans pay most expenses (primarily deductibles and coinsurance) that Medicare doesn’t cover.
| LETTER PLAN | LOWEST PREMIUM | HIGHEST PREMIUM |
| PLAN A | $99.33 | $369.80 |
| PLAN B | $137.65 | $393.62 |
| PLAN C | $194.36 | $528.25 |
| PLAN D | $179.01 | $277.33 |
| PLAN F | $173.59 | $530.12 |
| PLAN HDF | $50.00 | $103.04 |
| PLAN G | $144.60 | $509.57 |
| PLAN HDG | $49.47 | $102.83 |
| PLAN K | $71.53 | $162.62 |
| PLAN L | $104.33 | $304.68 |
| PLAN M | $129.94 | $345.98 |
| PLAN N | $113.38 | $435.00 |
Medicare Supplement Plan G pays the Part A deductible, Part A coinsurance, and Part B coinsurance, among other expenses. Premiums begin at $144.60 monthly in Philadelphia, PA.
Medicare Supplement Plan N pays the Part A deductible, Part A coinsurance, and Part B copays, among other expenses. In Philadelphia, PA, monthly premiums begin at around $113.38.
Medicare Supplement Plan F covers almost all medical expenses that Medicare does not. Philadelphia, PA, monthly premiums start from $173.59 per month.
Cheapest Medicare Part D prescription drug plans
Part D is Medicare for prescriptions. Since Medigap and Medicare Supplements don’t include coverage for Part D, which consists of a “donut hole” or coverage gap, many people shop for a Part D standalone plan. Aetna, Wellcare, and Humana are among other popular Part D providers in Philadelphia, PA.
| PLAN | PREMIUM | DEDUCTIBLE | STAR RATING |
| Aetna | $7.20 | $480 | 3 |
| Wellcare | $12.90 | $480 | 3 |
| Clear Spring Health | $18.20 | $480 | 2 |
| Elixir | $20.30 | $480 | 3 |
| Humana | $22.70 | $480 | 4 |
Aetna Medicare Part D insurance has a three-star rating, a $7.20 monthly premium, and a $480 annual deductible.
WellCare’s three-star Medicare Part D coverage also has a $480 deductible, with a monthly premium of $12.90.
Humana Medicare Part D insurance comes with a four-star rating, a $22.70 monthly premium, and a $480 annual deductible.
Medicare Special Needs plans.
People with chronic illnesses or disabilities qualify for a Medicare Special Needs Plan (SNP). This Medicare Advantage plan is open only to people with special medical needs and is not available in all locations in Philadelphia, Pennsylvania. Fortunately, Philadelphia, PA, has multiple insurance companies that offer Medicare SNPs.
| PLAN | PREMIUM | MOOP | Plan Type | Eligibility |
| Aetna | $0 | $7,550 | HMO | Dual |
| Wellcare | $0 | $3,450 | HMO | Dual |
| Vista Health | $0 | $3,400 | HMO | Dual |
| UPMC | $0 | $3,400 | HMO | Dual |
| Cigna | $0 | $6,900 | HMO | Chronic or Disabling |
UPMC’s Medicare SNP is a zero-premium HMO. The MOOP is $3,400 annually, and UPMC accepts dual eligibility (referring to those eligible for Medicare due to age and Medicaid due to a chronic illness or disability).
The Humana Medicare SNP plan accepts dual eligibility and is a local PPO. The MOOP is $3,450, and the annual premium is zero.
Aetna’s Medicare SNP charges a zero premium and has an annual MOOP of $7,550. Aetna also accepts dual-eligibility individuals.
FAQs
What jurisdiction is Philadelphia Medicare in?
Medicare Administrative Contractors (MACs) are private insurance companies that process Medicare claims for the government. The MAC jurisdiction (territory) that includes Philadelphia is “L” and is served by Novitas Solutions, Inc. Jurisdiction “L” covers the District of Columbia and the states of Delaware, Maryland, New Jersey, and Pennsylvania.
What documents do I need to apply for Medicare in Philadelphia, PA?
You may need to show documents that prove your age, military service, citizenship, and work/income history. Commonly requested documents are an original or certified birth certificate (or a US passport or military service record (if any), your W-2 or tax return from the past year, and your annual Social Security statement.
How much is the Philadelphia Medicare tax in Philadelphia, PA?
The Medicare tax is a standard deduction for all US paycheckUSot in Philadelphia. The amount is 1.45% on the first $200,000 of wages in a calendar year and then 0.9% on earnings over $200,000 for single filers ($250,000 for joint filers) in the same calendar year.
What is the income limit for Medicare in Philadelphia, PA?
Medicare Part B premiums vary based on the beneficiary’s income. Single individuals who earn $85,000 or less pay the lowest premium, currently $121.80 per month. As income increases, so does the monthly premium, until it maxes out at $389.80 monthly for individuals who earn more than $214,000 and married couples who make more than $428,000 annually.
Can I have two Medicare Supplement plans in Philadelphia, PA?
By law, insurance companies are not allowed to simultaneously sell more than one Medigap plan to the same person.
How to sign up for Medicare plans in Philadelphia Pennsylvania
Ready to enroll in Medicare Advantage, Medigap, or Medicare Part D? Our licensed agents are prepared to assist you, and our services are free. We work with all carriers and compare all plans to find which is best suited for your needs. Call today or submit our web form to request rates and more information.
