If you live in Pennsylvania, you have several options for Medicare coverage, including Original Medicare (Part A and Part B), Medicare Advantage (Part C), and Medicare Part D (drug coverage).

Shopping for Medicare plans in Pennsylvania can feel a bit overwhelming. That’s because there are several different Medicare plans, each with different costs and coverage.

Certain Medicare plans are available directly through the government, while others are sold through private insurance companies. Or you may choose a combination of both types of plans.

This article reviews the Medicare options for people living in Pennsylvania, as well as what to consider when choosing a plan, plan eligibility, and how to enroll.

2025 Medicare trends in Pennsylvania

The Centers for Medicare & Medicaid Services (CMS) reported the following information on Medicare trends in Pennsylvania for the 2025 plan year:

  • A total of 2,929,235 residents of Pennsylvania are enrolled in Medicare.
  • The average Medicare Advantage monthly premium changed from $27.40 in 2024 to $25.39 in 2025.
  • There are 281 Medicare Advantage plans available in Pennsylvania for 2025, compared with 316 plans in 2024.
  • All Pennsylvania residents with Medicare have access to a Medicare Advantage plan, including plans with $0 premiums.
  • There are 10 Medigap plans offered in Pennsylvania for 2025. Plan C and F are no longer available to new Medicare members

When you turn 65 years old, you automatically become eligible to enroll in Medicare. This federal health plan is also available to people of any age who have certain disabilities or medical conditions.

Original Medicare

Original Medicare has two parts:

  • Medicare Part A: You can think of Part A as hospital insurance. It covers a portion of the cost of inpatient care in a hospital or skilled nursing facility, as well as hospice care and certain home healthcare services.
  • Medicare Part B: Part B covers a portion of the cost for outpatient care with a healthcare professional and any medical services, tests, and supplies you receive as part of this care.

While Original Medicare covers a significant portion of inpatient and outpatient healthcare services, it doesn’t cover the full amount.

It also doesn’t cover prescription drugs, dental, vision, or hearing services. But you can add to your coverage with the following options.

Medicare Advantage plans

Medicare Advantage, or Medicare Part C, plans offer an all-in-one replacement for Original Medicare. You can purchase a Medicare Advantage plan from a private insurance company.

Medicare Advantage plans are required by law to provide all the same coverage as Original Medicare, but they typically include significant extras, like prescription drug coverage. Medicare Advantage plans often also include benefits to help with dental, vision, and hearing care, plus health and wellness programs.

The following private insurance companies are some of the companies that offer Medicare Advantage plans in Pennsylvania:

These companies offer plans in many counties in Pennsylvania. However, Medicare Advantage plan offerings vary by county. To research plans in your area, you can enter your ZIP code into this online Medicare search tool.

Medicare Part D

Medicare Part D is Medicare’s prescription drug coverage. You may purchase a Medicare Part D plan from Medicare or as part of a Medicare Advantage plan.

Medicare supplement plans

Medicare supplement plans, sometimes called Medigap, help fill the gaps of what Medicare doesn’t cover. This may include enhanced coverage to help pay copays or coinsurance, as well as coverage for dental, vision, or other services.

It’s important to note that you cannot have a Medigap and a Medicare Advantage plan at the same time. Medigap helps cover certain costs associated with Original Medicare only.

You can purchase a Medicare supplement plan from a private insurance company. There are several different types of supplemental plans, depending on your budget and healthcare needs.

Many companies offer Medigap plans in Pennsylvania. Some of the companies offering Medigap plans throughout the state include:

The most important thing to remember when selecting a Medicare supplement or Medicare Advantage plan is that not all plans are structured the same way.

Here are some things to consider before choosing a plan:

  • What is the cost structure like? How much are the plan premiums? How much will you pay when you receive care or fill prescriptions?
  • Does the network include physicians and facilities that are convenient to you?
  • Is there coverage for when you travel out of network?
  • Will you need to get referrals to get care from a specialist?
  • Does the plan include programs that make sense for you? For example, if you have a chronic health condition, will you have access to a disease management or health coaching plan to support you?

Medicare plans in Pennsylvania are available to people over age 65 years and to adults with certain disabilities or chronic diseases.

You can enroll for Medicare plans if you meet the following eligibility criteria:

When can you enroll in Medicare Pennsylvania plans?

If you receive Social Security retirement benefits, you’ll most likely be automatically enrolled in Medicare when you turn 65 years old.

You may also be automatically enrolled at the start of your 25th month on Social Security Disability Insurance (SSDI) if you’re a younger adult with a disability.

If you’re not automatically enrolled in Medicare, you can sign up at certain times during the year. The following enrollment periods are available:

  • Initial enrollment period: If you’re eligible for Medicare at age 65 years, you can sign up during the 7-month initial enrollment period. This period starts 3 months before the month you turn 65 years old, includes your birth month, and ends 3 months after your birth month.
  • Medicare open enrollment period: If you have Medicare, you can make changes to your coverage between October 15 and December 7 every year. This includes joining a Medicare Advantage plan.
  • Medicare Advantage open enrollment period: Between January 1 and March 31 every year, people with Medicare Advantage plans can change their coverage. At this time, you can switch to a new Medicare Advantage plan or go back to Original Medicare.
  • Special enrollment periods: You can sign up at other times of the year if you experience certain life events, such as losing your employer-based health plan or volunteering long term in a different country.

The following resources can help you learn more about Medicare enrollment, eligibility, plans, and coverage options.

If you live in Pennsylvania, you have a number of different Medicare options to choose from. You can sign up for Original Medicare (parts A and B) and decide whether to add Medicare Part D (drug coverage).

You can also choose to enroll in a Medicare Advantage (Part C) plan. Several private insurance companies in Pennsylvania offer Medicare Advantage plans.

You also have several Medigap plan options if you live in Pennsylvania and are looking for additional coverage. But remember, you cannot have a Medigap and Medicare Advantage plan at the same time.