Medicare in Pennsylvania: compare your plan options with a licensed agent
Whether you live in Philadelphia, Pittsburgh, Allentown or a small town in between, a licensed agent can explain the Medicare plans we offer in your Pennsylvania ZIP code in plain English. There's no cost for our help.
When you call, you'll speak with a licensed insurance sales agent. Amerance Health is not connected with or endorsed by the U.S. government or the federal Medicare program.
Your guide to Medicare in Pennsylvania
Medicare is a federal program, so Parts A and B work the same way in Pennsylvania as in every other state. What changes from state to state is which private plans you can choose from, the state rules that apply to Medicare Supplement insurance, and the local programs that can help you pay for coverage. This page covers what's specific to Pennsylvania.
Your Medicare options in Pennsylvania
People with Medicare in Pennsylvania choose between two main paths:
Original Medicare, with a Medicare Supplement and Part D
Original Medicare (Part A for hospital care and Part B for medical care) lets you see any doctor or hospital in the U.S. that accepts Medicare. That's useful if you see specialists across Pennsylvania or spend part of the year out of state. Because Original Medicare has no yearly out-of-pocket limit, many people add a Medicare Supplement (Medigap) policy to cover deductibles and coinsurance, plus a stand-alone Part D plan for prescriptions.
Medicare Advantage (Part C)
Medicare Advantage plans are offered by private insurance companies approved by Medicare. They bundle hospital, medical and usually drug coverage into one plan, often with dental, vision and hearing benefits and a yearly out-of-pocket maximum. Plans are approved county by county, so what's available in Philadelphia may differ from what's available in Pittsburgh or rural Pennsylvania. Most use provider networks (HMO or PPO), so it's important to confirm your doctors and hospitals before you enroll.
Not sure which path fits you? Read our Medicare Advantage vs. Medicare Supplement comparison.
Pennsylvania Medicare Supplement (Medigap) rules
Pennsylvania follows the federal Medigap rules for people 65 and older, and adds an important protection for people under 65.
- No birthday rule: outside your open enrollment period and federal guaranteed issue situations, Pennsylvania insurers can ask health questions if you want to switch Medigap plans.
- Under 65: Pennsylvania gives people with Medicare due to a disability or End-Stage Renal Disease (ESRD) a 6-month Medigap open enrollment period when they enroll in Part B. During it, insurers must offer every Medigap plan they sell and can't deny coverage or charge more because of health.
Everywhere in the U.S., your strongest protection is your Medigap Open Enrollment Period: the 6 months starting when you're 65 or older and enrolled in Part B. During that window, insurers in Pennsylvania must sell you any Medigap plan they offer, at the same price as someone in good health. Plan G and Plan N are common choices for people new to Medicare. Compare what each Medigap plan covers.
Talk with a licensed agent in Pennsylvania
We'll compare the plans we offer in your ZIP code against your doctors, prescriptions and budget.
Call (954) 668-4095 Request a callbackTurning 65 in Pennsylvania
Your Initial Enrollment Period is the 7 months around your 65th birthday: the 3 months before your birthday month, the month itself and the 3 months after. Sign up in the 3 months before your birthday month so your coverage starts on the first day of the month you turn 65. If you already receive Social Security, you'll be enrolled in Parts A and B automatically. Otherwise, apply through Social Security online, by phone at 1-800-772-1213, or at a local Social Security office in Pennsylvania.
If you're still working, you may be able to delay Part B without a penalty. Our Turning 65 Medicare guide walks through every deadline, or you can take our 2-minute quiz to get a personal game plan.
Help paying for Medicare in Pennsylvania
- Medicaid (Medical Assistance): Pennsylvania residents with limited income and resources may qualify for Medicaid in addition to Medicare. Learn more from Medical Assistance.
- Medicare Savings Programs: run through Pennsylvania's Medicaid agency, these can pay your Part B premium ($202.90 a month in 2026), and in some cases your deductibles and coinsurance.
- Extra Help: a federal program that lowers Part D premiums, deductibles and copays. Apply through Social Security.
- Dual Special Needs Plans (D-SNPs): Medicare Advantage plans for people with both Medicare and Medicaid, which coordinate both sets of benefits.
Free, unbiased Medicare counseling in Pennsylvania
PA MEDI is Pennsylvania's State Health Insurance Assistance Program (SHIP). Trained counselors give free, unbiased help with Medicare questions and don't sell insurance. Call 1-800-783-7067 or visit their website.
Insurance in Pennsylvania is regulated by the Pennsylvania Insurance Department, which licenses agents and handles consumer complaints.
We do not offer every plan available in your area. For information on all of your options, contact Medicare.gov, 1-800-MEDICARE (1-800-633-4227) or PA MEDI.
2026 Medicare costs in Pennsylvania
Original Medicare costs are set nationally by CMS and are the same in Pennsylvania as everywhere else. Medicare Advantage, Medigap and Part D premiums vary by plan and location.
| Cost | 2026 amount |
|---|---|
| Part B standard monthly premium | $202.90 |
| Part B yearly deductible | $283 |
| Part A hospital deductible | $1,736 per benefit period |
| Part A premium | $0 for most people with 40 quarters of work |
| Part D out-of-pocket cap | $2,100 |
| Medicare Advantage in-network out-of-pocket limit | Up to $9,250 (many plans are lower) |
Key Medicare dates for Pennsylvania residents
- Annual Enrollment Period: October 15 – December 7, 2026, for coverage starting January 1, 2027.
- Medicare Advantage Open Enrollment: January 1 – March 31, 2027, if you're already in a Medicare Advantage plan.
- General Enrollment Period: January 1 – March 31 each year, if you missed signing up for Part A or Part B.
- Moving within or out of Pennsylvania: if you move out of your plan's service area, you get a Special Enrollment Period to choose a new plan.
Pennsylvania Medicare FAQs
Does Pennsylvania have a Medigap birthday rule?
No. Pennsylvania doesn't have a Medigap birthday or anniversary rule. You can apply to switch Medigap plans any time, but outside your open enrollment period or a federal guaranteed issue situation, the insurer can ask health questions.
Can I get a Medicare Supplement plan under 65 in Pennsylvania?
Yes. Pennsylvania gives people under 65 with Medicare (due to disability or ESRD) a 6-month Medigap open enrollment period starting when they enroll in Part B. During that window, insurers must offer all the Medigap plans they sell and can't turn you down or charge more because of your health.
Where can I get free Medicare counseling in Pennsylvania?
PA MEDI is Pennsylvania's State Health Insurance Assistance Program (SHIP). It offers free, unbiased Medicare counseling at 1-800-783-7067. You can also call 1-800-MEDICARE or visit Medicare.gov for information on all plans.
Can I get help paying for Medicare in Pennsylvania?
Yes, if your income and savings are limited. Pennsylvania's Medicaid program (Medical Assistance) runs the Medicare Savings Programs, which can pay your Part B premium, and Social Security runs Extra Help, which lowers prescription drug costs. People with both Medicare and Medicaid may also qualify for a Dual Special Needs Plan.
Are Medicare Advantage plans the same everywhere in Pennsylvania?
No. Medicare Advantage plans are approved county by county, so the plans, premiums, networks and extra benefits available in Philadelphia can differ from those in other parts of Pennsylvania. A licensed agent can show you the plans we offer for your ZIP code.
When can I sign up for Medicare in Pennsylvania?
Enrollment dates are the same in every state. Most people first sign up during their 7-month Initial Enrollment Period around their 65th birthday. If you already have Medicare, you can change Medicare Advantage and Part D plans during the Annual Enrollment Period, October 15 to December 7, with coverage starting January 1.
Medicare help in nearby states
We also help people with Medicare in New Jersey, Ohio and West Virginia. See all the states we serve.