bestMedicare AdvantagePennsylvaniaTo help you find the best Medicare Advantage plan in Pennsylvania for you, we analyzed the plans based on how they are scored by the Centers for Medicare & Medicaid Services five-star quality rating system.
We also drilled down to the different plans and identified which ones offer good options if you need drug coverage and want to reduce your out-of-pocket expenses.
However, these are only general recommendations. We recommend that you do your research and ensure that the hospitals and providers you want to use are in the network of the plan you opt to purchase.
MoneyGeek also analyzed the best medicare supplement plans in Pennsylvania for those focused on covering out-of-pocket expenses.
bestMedicare AdvantagePennsylvaniaBest Medicare Advantage Plans in Pennsylvania
Best plan overall - Aetna Medicare
Best HMO plan - Highmark Blue Cross Blue Shield
Best plan without drug coverage - Highmark Blue Cross Blue Shield
Best plan for low out-of-pocket costs - Aetna Medicare
Best Medicare Advantage Plan in Pennsylvania - Overall
The best Medicare Advantage Plans in Pennsylvania for you may not be the best for someone else, so it’s essential to know your exact needs.
For example, if you want a PPO plan with drug coverage, the six core benefits and a high star rating from CMS, then Aetna Medicare’s Choice Plan might be the best option for you.
A Preferred Provider Organization is a health plan that offers flexibility and comprehensive benefits. It comes at a higher cost than a Health Maintenance Organization plan.
However, PPOs offer wider networks and allow you to see specialists without referrals, giving you more access to doctors and hospitals. PPOs are great if you’re looking for a high level of flexibility and you can afford the cost.
Aetna Medicare
While MoneyGeek found that Aetna Medicare’s Aetna Medicare Choice Plan might be the best plan for you, the best option for you will still depend on your unique situation. To help you decide if this plan fits your needs, here’s a list of some of its most notable features:
- No monthly premium
- Includes drug coverage
- An in-network max-out-of-pocket limit of $7,550
- A perfect 5-star rating from CMS
When you purchase the Aetna Medicare Choice Plan, you’ll receive all the six common additional benefits, including dental, hearing, vision, fitness, worldwide emergency and telehealth benefits.
The worldwide emergency benefit makes this plan a great option if you love to travel. It also comes with a Part D drug coverage, and has a high rating from CMS, which indicates that it has earned the trust of its customers.
Best HMO Medicare Advantage Plan in Pennsylvania
The best HMO Medicare Advantage Plan in Pennsylvania depends on your exact needs. Based on our research for our sample shopper in Pennsylvania who wants an HMO plan with drug coverage, the six core benefits and a high star rating from CMS, the Community Blue Medicare HMO Signature plan offered by Highmark tops the list.
Health Maintenance Organizations are the most common type of plans and are relatively cheaper than other health plans. If you have easy access to in-network providers and you’re looking for lower monthly payments, then an HMO is likely the right option for you.
However, keep in mind that you’ll have to stay within your network provider to receive coverage, except during an emergency. You will also need a referral to see a specialist.
Highmark Blue Cross Blue Shield
Our research shows that Highmark’s Community Blue Medicare HMO Signature plan is the best Medicare Advantage HMO option in Pennsylvania overall. The best option for you will depend on your particular needs. Here are this plan’s features:
- No monthly premium
- Includes drug coverage
- An in-network max-out-of-pocket limit of $6,700
- Received a perfect 5-star rating from CMS
The Community Blue Medicare HMO Signature plan offers all of the six common additional benefits including vision, dental, hearing, fitness, worldwide emergency and telehealth coverage. It also includes Part D drug coverage and receives a perfect rating from CMS.
Our research shows that Highmark’s Community Blue Medicare HMO Signature plan is the best Medicare Advantage HMO option in Pennsylvania overall. The best option for you will depend on your particular needs. Here are this plan’s features:
- No monthly premium
- Includes drug coverage
- An in-network max-out-of-pocket limit of $6,700
- Received a perfect 5-star rating from CMS
The Community Blue Medicare HMO Signature plan offers all of the six common additional benefits including vision, dental, hearing, fitness, worldwide emergency and telehealth coverage. It also includes Part D drug coverage and receives a perfect rating from CMS.
Best Medicare Advantage Plan in Pennsylvania Without Drug Coverage
If you don’t need Part D prescription drug coverage, then you can consider other plans in Pennsylvania. For our sample shopper in the state who needs a Medicare Advantage plan with or without drug coverage, including the six core benefits and a high star rating from CMS, we found that the best plan overall is Community Blue Medicare HMO Signature from Highmark.
Highmark Blue Cross Blue Shield
The Community Blue Medicare HMO Signature plan might be the best option for you whether or not you need drug coverage. This plan does include drug coverage.
To help you gauge whether Community Blue Medicare HMO Signature is right for you, here are its features:
- No monthly premium
- A $6,700 in-network max-out-of-pocket limit
- A perfect 5-star rating from CMS
In addition to being top-rated by CMS, the Community Blue Medicare HMO Signature plan offers the six common additional benefits, including vision, dental, hearing, fitness, worldwide emergency and telehealth coverage.
Best Medicare Advantage Plan in Pennsylvania for Low Max Out-of-Pocket Costs
Whether you’re paying low or no premiums for your Medicare Advantage plan, you may still shell out thousands of dollars in out-of-pocket costs. To reduce your financial burden, you may consider opting for a plan with a low in-network max out-of-pocket limit.
If you prefer a Medicare Advantage plan with a low in-network MOOP limit, drug coverage, the six core benefits and a high star rating from CMS, Aetna Medicare’s Advantra Silver (PPO) plan is likely your best option in Pennsylvania.
Aetna Medicare
If you’re looking to reduce your out-of-pocket costs, whether or not you need drug coverage, you should consider Aetna Medicare’s Advantra Silver (PPO) plan. Here’s what you can expect from this plan:
- A monthly premium of $14
- An in-network max out-of-pocket limit of $5,900
If you’re struggling with high annual expenses on your health payments, a plan with a low MOOP limit is a big help.
With the Aetna Medicare Advantra Silver (PPO) plan, in-network coverage is on your provider once you’ve hit your MOOP limit, which is $3,900. However, since it’s a PPO plan, you’ll have a different MOOP limit for out-of-network coverage, which is $11,300.
Medicare Advantage Plan in Pennsylvania - Statistics
If you are interested in a Medicare Advantage Plan in Pennsylvania, you can shop options provided by 15 organizations. The section below includes statistics about Medicare Advantage in Pennsylvania to help you identify rare and common plan components offered by your prospective provider.
1
Pennsylvania Medicare Advantage Plans are a mix of HMO and PMO plans with 80.7% offering drug coverage
In Pennsylvania, the number of Preferred Provider Organization plans is slightly higher than the available Health Maintenance Organization plans. Around 80.7% of these plans offer drug coverage. If you need a plan with drug coverage, you may consider both HMO and PPO plans.
2
51% of Medicare Advantage Plans in Pennsylvania have a $0 premium
There are around 72 unique plans with $0 premium in Pennsylvania, making up 51% of the available plans on the market. The remaining 49% of plans require a monthly premium, which costs an average of $83.90.
3
Hearing, telehealth, and vision benefits are typical in Pennsylvania, with most plans offering them
The most common benefits that come with a Medicare Advantage Plan in Pennsylvania are hearing, telehealth, and vision. The rarest benefits in the state are in-home support, emergency response devices, and home safety devices & modifications.
Expert Advice: The Best Medicare Advantage Plan in Pennsylvania
- 1. What types of Medicare Advantage Plans are offered in Pennsylvania?
- 2. What is the best way to shop around for Medicare Advantage plans in Pennsylvania?
Claudia Guerrazzi Young
Assistant Professor in the School of Business Administration at Widener University
Methodology
MoneyGeek collected data from the Centers for Medicare & Medicaid Services 2022 MA Landscape Source Files released in October 2021. Plans in Pennsylvania were filtered down to those that offer drug coverage (unless otherwise noted), offer six of the most common Medicare Advantage coverage benefits and are available to at least 50% of the population of Pennsylvania based on county availability.
About Mark Fitzpatrick
