Compare by State – Medicare Plans in Pennsylvania

Pennsylvania Medicare Plans

Pennsylvania Medicare plans include Medicare supplements, Medicare Advantage plans, and Part D drug plans. The purpose of Pennsylvania Medicare plans is to help lower out-of-pocket costs for those enrolled in Medicare services. Because Medicare has no cap on how much they will charge a beneficiary in the year, enrolling in a Medicare plan is something all beneficiaries should consider.

Pennsylvania Medicare Plans Open Enrollment

Medicare beneficiaries in Pennsylvania are eligible for Medicare at age 65. Initial enrollment begins three months before your birth month and lasts three months after. During initial enrollment, you can also apply for Medicare Supplements.

Initial enrollment begins three months before your birth month and lasts three months after. This is also the time you can apply for Medicare Supplements. While you can enroll in a supplement at any time, initial enrollment is the best time to do so because you cannot be turned down due to health conditions considering you won’t have to answer health questions on your application. If you miss this window, you’ll likely have to answer health questions to apply, which means you could be turned down by other Pennsylvania Medicare supplement plans.

Pennsylvania Medicare Advantage Plans

Depending on what county you live on, Pennsylvania has up to 71 Medicare Advantage plans available to you.  Medicare Advantage, also known as Part C, is a private Medicare plan that provides all Original Medicare benefits but also include extra benefits like dental, vision, and prescription drugs coverage.

In Pennsylvania, open enrollment for Medicare Advantage begins on January 1 and ends on March 31. Those already enrolled in Medicare Advantage can switch to a different plan during open enrollment or opt to have Original Medicare instead.

Medicare Advantage plans in Pennsylvania offer beneficiaries an alternate type of coverage that has lower premiums. Most Medicare Advantage plans use networks, such as HMO or PPO networks. Beneficiaries who enroll in them agree to use those networks whenever possible for their care.

Pennsylvania Medicare Advantage plans often have copays that you will pay in exchange for a variety of services, such as doctor visits, hospital expenses, and diagnostic tests, and cost-sharing for lab work. If you don’t travel much and are ok staying in your local network for routine care, this plan may appeal to you.

The best Medicare Advantage plans in Pennsylvania are the ones that cover both your doctors and important medications.

Pennsylvania Medigap plans

Remember, Original Medicare and Medicare Supplement plans don’t offer coverage for prescription drugs, but there is an option to enroll in Medicare Part D, with over 30 plans available in the state of Pennsylvania. If you take, or anticipate needing, a lot of prescriptions, looking into Medicare Advantage or a standalone Part D plan is a great idea.

Medicare Supplements in Pennsylvania cover some, or even all, of the deductibles and coinsurance left over by Original Medicare.

This can save you thousands in out-of-pocket expenses, putting a cap on those costs, and this plan doesn’t limit you to a network of doctors that accept Medicare only.

There are 10 plans lettered A through N that offer standardized coverage. All plans lettered the same are required to offer the same coverage but the prices vary, so be sure to shop around for your coverage.

Medicare Advantage for Pennsylvania Residents Under the Age of 65 with Disabilities 

While Medicare is generally reserved for those turning 65, there are cases in which someone may be eligible for Medicare under the age of 65. This includes individuals with disabilities who have received Social Security Disability Income for 24 months or have End Stage Renal Disease (ESRD) or Amyotropic Lateral Sclerosis (ALS, also known as Lou Gehrig’s disease).

It is important to note that there is a five-month waiting period after a beneficiary is determined to be disabled before they can begin to collect Social Security Disability Income. People who meet all the criteria for Social Security Disability Income are generally automatically enrolled in Medicare Part A and Part B. For the people who meet the standards, but do not qualify for Social Security Income, have an option to purchase Medicare by paying a Part A premium monthly as well as a monthly Part B premium.

An exception to the 5-month waiting people does apply for those people with ESRD and ALS. These individuals do not have to collect benefits for 24 months in order to become eligible for Medicare.

The requirements for Medicare eligibility for people with ESRD and ALS are:

  • ESRD – Generally 3 months after a course of regular dialysis begins or after a kidney transplant
  • ALS – Immediately upon collecting Social Security Disability benefits

Regrettably, those with disabilities often have lower incomes, require more health care, and find it more difficult to pay for and obtain care compared to Medicare beneficiaries over 65 years of age. Take our Medicare quiz now to see if you qualify for incredible Medicare benefits, even if you are under the age of 65.

Every state is different, and so obtaining Medicare benefits in Pennsylvania can be complicated or confusing. If you are disabled or under the age of 65 wondering if you qualify, it is best to contact us directly to see if you are eligible.

What Medicare Advantage benefits am I eligible for under the age of 65 in Pennsylvania?

At 100 Insure, we can help you discover benefits you might be eligible for including:

  • Premiums starting at $0 per month
  • Coverage for copays and deductibles
  • Prescription drugs
  • Dental
  • Vision
  • Hearing
  • And transportation to the doctor and pharmacy

That’s right. Our company has helped qualified people under the age of 65 in Pennsylvania receive benefits like:

  • Massage services
  • Meals after a hospital
  • Food for their service dog
  • A gym membership
  • Money for vitamins and groceries
  • Home improvements
  • In home care & aides
  • And pest control services

Contact us today to see if you qualify.

Medicare Coverage for Working People in Pennsylvania with Disabilities

Medicare eligibility for working people with disabilities falls into three distinct time frames.

  • Trial work period – extends 9 months after a disabled individual obtains a job
  • Second period – This period is for 93 months after the end of the trial work period.
  • Third period – An indefinite period following those 93 months.

Keep in mind that Medicare eligibility during each of these periods applies only while the individual continues to meet the medical standard for being considered disabled under Social Security rules.

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