Best Medicare Advantage Plans in Pennsylvania (2026)

Key Takeaways

Pennsylvania Medicare beneficiaries have access to 29 Medicare Advantage plans through 12 different insurers, offering HMO, HMO-POS, PPO, PFFS and Regional PPO options. Seven plans cost nothing monthly, while premiums reach $194 for more comprehensive coverage.

UPMC for Life secures the top HMO spot in Pennsylvania, with Blue Cross Blue Shield and Geisinger Gold earning best-in-class ratings for HMO-POS and PPO plans, respectively.

Compare monthly premiums, out-of-pocket maximums, provider networks and prescription coverage when selecting a plan. Verify your doctors and medications are covered before you enroll.

Best Medicare Advantage Companies in Pennsylvania

Based on CMS star ratings, premiums, MOOP costs and coverage features, we identified Pennsylvania's best Medicare Advantage plans. UPMC for Life offers the top HMO option with a $21 average monthly premium, $5,771 average MOOP, and a 4.5-star CMS rating.

Blue Cross Blue Shield leads for HMO-POS plans while Geisinger Gold provides the best PPO coverage, with both maintaining star ratings of 4.45 and 4.5, respectively. These providers deliver competitive pricing and broad benefits across all plan types.


HMO	UPMC for Life	4.50	$21	$5,771	UPMC for Life HMO Deductible Rx (HMO)
HMO-POS	Blue Cross Blue Shield	4.45	$91	$5,279	Security Blue HMO-POS ValueRx (HMO-POS)
PPO	Geisinger Gold	4.50	$54	$5,600	Geisinger Gold Preferred Complete Rx (PPO)

Medicare Advantage plans bundle hospital stays, doctor visits and prescription drugs into comprehensive coverage packages. These private insurance alternatives to Original Medicare must match traditional Medicare's benefits while adding dental, vision and hearing services.

CMS Star Ratings: Plans receive 1 to 5 star ratings based on quality metrics and member satisfaction. Higher ratings mean better performance, with 4-star plans delivering superior care and customer service.
Monthly premiums: You'll pay your Part B premium plus any plan-specific costs, though many Medicare Advantage plans charge no additional premium. Your total cost depends on your coverage level and location.
Maximum out-of-pocket (MOOP) limits: MOOP caps protect you from high medical expenses by limiting annual spending on covered services. After hitting this limit, your plan pays 100% of covered care.
Drug coverage: Most plans include prescription drug benefits as part of their comprehensive coverage. Check your plan's drug list to confirm your medications are covered and understand any usage restrictions.

UPMC Health Plan

Best HMO

MoneyGeek Rating

4.4/ 5

4.2/5Affordability

5/5Quality

2.5/5Availability

CMS Star Rating
4.5
Plan Types
HMO, PPO

pros
- Eleven plans across HMO and PPO types
- Consistent 4.5-star CMS ratings on all plans
- One HMO plan is available at $0 monthly premium
- Enhanced Part D drug coverage on all plans
cons
- HMO plans require referrals for specialists
- Average MOOP of $5,771 exceeds some competitors
- PPO plans have higher out-of-pocket maximums, averaging $7,060
UPMC for Life's 5 HMO plans earn a solid 4.5-star CMS rating and feature broad networks that give members access to numerous local providers at competitive costs. The provider averages $5,873 in out-of-pocket maximums across HMO options, with enhanced Part D drug coverage included on all plans. One plan charges $0 monthly, while the UPMC for Life HMO Deductible Rx plan starts at $22 per month for those wanting additional benefits.

With 6 PPO options also rated 4.5 stars by CMS, UPMC for Life offers flexibility through wider networks that make them a strong choice for those seeking more provider options in Pennsylvania. The PPO plans include enhanced Part D coverage and let members see out-of-network doctors when needed.

Blue Cross Blue Shield

Best HMO-POS

MoneyGeek Rating

5/ 5

5/5Affordability

5/5Quality

5/5Availability

CMS Star Rating
4.45
Plan Types
HMO-POS, HMO, PPO

pros
- Out-of-network flexibility with HMO-POS coverage
- Lowest MOOP among Pennsylvania HMO-POS plans
- Enhanced Part D prescription drug coverage
- Strong preventive care and wellness programs
cons
- Out-of-network services cost more
Blue Cross Blue Shield offers five HMO-POS plans in Pennsylvania, averaging $91 monthly with a $5,279 maximum out-of-pocket limit. The provider also operates 10 HMO plans and 22 PPO plans across the state. Beyond standard Medicare coverage, members receive vision benefits including eyewear allowances, hearing aid coverage, preventive dental services and fitness programs. Some plans include over-the-counter allowances and transportation benefits for medical appointments.

Geisinger Gold

Best PPO

MoneyGeek Rating

4.4/ 5

4.3/5Affordability

5/5Quality

2.5/5Availability

CMS Star Rating
4.5
Plan Types
PPO, HMO

pros
- PPO has lowest maximum out-of-pocket at $5,600
- Affordable $54 monthly premium for PPO coverage
- Both plans include enhanced Part D drug benefits
- Silver Circle wellness program for members 55+
cons
- HMO costs less but has higher out-of-pocket maximum
- Only two standard plan options statewide
Geisinger Gold offers two Medicare Advantage plans. The PPO plan stands out with an affordable $54 monthly premium and the lowest maximum out-of-pocket cost at $5,600. Both plans include enhanced Part D prescription drug coverage and access to over 30,000 doctors and 180 hospitals statewide.

The HMO option costs $41 per month but has a higher maximum out-of-pocket limit of $6,623. Geisinger Gold also offers specialized HMO D-SNP plans for qualifying members. Both standard plans include routine dental coverage, hearing aids, vision benefits, and a free Silver Circle membership for members 55 and older. Members can access health coaching, mental health support and a 90-day prescription refill program.

Best HMO Medicare Advantage Plans in Pennsylvania

Pennsylvania's HMO Medicare Advantage market offers strong quality. CMS star ratings range from 3.0 to 4.5 stars, with 20 of 31 plans earning 4 stars or higher. Six providers offer 16 plans with $0 monthly premiums, and the median premium stays at $0. Out-of-pocket maximums run from $3,450 to $9,250, averaging $6,527 annually.

UPMC for Life tops the state with five 4.5-star plans at $21 monthly and $5,771 average maximum out-of-pocket costs.
Ten zero-premium plans from Blue Cross Blue Shield carry 4.5-star ratings and $6,133 MOOPs.
Cigna HealthCare offers four $0 premium plans averaging $5,743 in out-of-pocket maximums, though they earn just 3.0 CMS ratings.


UPMC for Life	4.50	$21	$5,771	5	4.36
Blue Cross Blue Shield	4.50	$26	$6,133	10	4.33
Cigna HealthCare	3.00	$7	$5,743	4	4.23
Geisinger Gold	4.50	$41	$6,623	5	4.16
Humana	3.50	$0	$8,105	4	4.16
Jefferson Health Plans	3.50	$16	$6,250	3	4.04

WHY CHOOSE AN HMO PLAN?

HMO plans work well for seniors who want a defined network of providers. You'll need to choose a primary care physician and get referrals for specialist visits, but you'll enjoy lower premiums and out-of-pocket costs compared to other Medicare options.

Best HMO-POS Medicare Advantage Plans in Pennsylvania

Pennsylvania's HMO-POS Medicare Advantage plans earn solid quality ratings, with 13 receiving 4 CMS stars and just two earning 3 stars. Four providers offer 23 coverage options statewide, and eight don't charge monthly premiums. Maximum out-of-pocket costs hit $6,175, spanning from $2,900 to $8,500.

A perfect 5.0 MoneyGeek score puts Blue Cross Blue Shield at the top with five plans rated 4.45 stars on average. Monthly premiums run $91 with a $5,279 maximum out-of-pocket cost.
Wellcare also scores 5.0 across two plans charging $33 per month with a $5,500 MOOP, though CMS ratings reach only 3.5 stars.
Eight plans from UnitedHealthcare score 4.34 at $18 monthly and $6,321 out-of-pocket maximums. Aetna offers eight coverage options scoring 3.8, with $21 monthly premiums and $6,509 MOOP costs.


Blue Cross Blue Shield	4.45	$91	$5,279	5	5.00
Wellcare	3.50	$33	$5,500	2	5.00
UnitedHealthcare	4.05	$18	$6,321	8	4.34
Aetna	3.92	$21	$6,509	8	3.80

WHY CHOOSE AN HMO-POS PLAN?

Looking for affordable coverage that's more flexible than standard HMOs? HMO-POS plans cost less than PPO options while letting you see out-of-network providers when you need specialized care that's not available in your network. You'll pay higher rates for those out-of-network visits, but you won't need referrals to access specialists outside your plan.

Best PPO Medicare Advantage Plans in Pennsylvania

Pennsylvania offers 65 PPO Medicare Advantage plans with broader provider access than HMO options, though you'll pay more. Monthly premiums range from $0 to $231, around $14. Out-of-pocket maximums span $4,000 to $9,250, averaging $6,904 statewide.

Most plans meet high-quality standards. Forty-seven earned 4 or more CMS stars, including 38 at 4.5 stars and 9 at 4 stars. Seventeen plans scored 3.5 stars, with just one at 3 stars.

Two plans from Geisinger Gold earned a 4.4 MoneyGeek score and 4.5-star CMS rating. Monthly premiums average $54 with a $5,600 maximum out-of-pocket limit.
Blue Cross Blue Shield matches that 4.4 MoneyGeek score with a 4.47-star CMS rating across 22 PPO plans. Expect to pay $141 monthly on average with a $5,004 typical out-of-pocket maximum.
Cigna HealthCare scored 4.38 on MoneyGeek's rating through a single plan at $0 monthly premium. The trade-off is a $6,215 out-of-pocket limit and 3.0-star rating.


Geisinger Gold	4.50	$54	$5,600	2	4.39
Blue Cross Blue Shield	4.47	$141	$5,004	22	4.38
Cigna HealthCare	3.00	$0	$6,215	1	4.38
UnitedHealthcare	4.04	$22	$6,697	7	4.34
UPMC for Life	4.50	$17	$7,060	6	4.19
Aetna	4.50	$52	$7,433	10	4.10
Peak Health	3.50	$10	$5,700	2	4.07
Humana	3.50	$0	$8,000	8	4.00
Clover Health	3.50	$0	$7,499	1	3.88
Devoted Health	3.50	$2	$7,710	6	3.83

WHY CHOOSE A PPO PLAN?

PPO plans work best for Pennsylvania residents who value complete provider freedom and don't mind paying higher premiums for that flexibility. You can see any doctor without referrals and access out-of-network specialists when needed, though staying in-network saves money.

How to Choose the Best Pennsylvania Medicare Advantage Plan

Choosing Medicare Advantage coverage in Pennsylvania means weighing costs against benefits and provider access.

1
Confirm Your Doctors and Hospitals Are In-Network
Verify your doctors accept your specific Medicare Advantage plan before enrolling. Call each provider's office directly. Plans from the same insurer maintain separate networks.
2
Compare Total Costs, Not Just Premiums
Zero-premium plans charge more through copays and deductibles. Add your medication costs and specialist fees to find your true annual spending. Plans with premiums sometimes cost less overall through reduced out-of-pocket expenses.
3
Check Prescription Drug Coverage
Look up your medications on each plan's formulary before enrolling. Higher tiers mean higher costs per prescription. Some drugs require prior authorization, adding delays of several days.
4
Compare Different Plan Types
Pick an HMO plan type for the lowest premiums and coordinated care through your primary doctor. HMO-POS works if you want occasional out-of-network flexibility. PPO suits frequent travelers or those wanting unrestricted specialist access.
5
Review Star Ratings and Quality Metrics
Medicare rates plans 1-5 stars based on quality and service. Plans rated 4 or 5 stars deliver better care and faster claim processing.
6
Compare Extra Benefits
Pennsylvania plans might include dental, vision, hearing, gym memberships or over-the-counter allowances.
7
Check Out-of-Pocket Maximums
Lower maximums protect you better financially but increase monthly premiums.

How Much Does Medicare Advantage Cost in Pennsylvania?

Plan type drives Medicare Advantage costs across Pennsylvania, with HMO plans being the lowest cost option. HMOs offer $0 median premiums and $37 average monthly costs, though their out-of-pocket maximums average $6,527. HMO-POS plans cost slightly more at $42 average monthly premiums but provide the lowest out-of-pocket maximums at $6,175. PPO plans top the cost spectrum with $43 average monthly premiums and $6,904 out-of-pocket maximums because they let you see out-of-network providers and access specialists without referrals.


HMO	$0	$37	$6,527
HMO-POS	$31	$42	$6,175
PFFS	$0	$0	$7,100
PPO	$14	$43	$6,904
Regional PPO	$52	$52	$6,700

Best Pennsylvania Medicare Advantage: FAQ

Get answers about enrollment processes, what's covered and enrollment timing for Medicare Advantage plans across Pennsylvania.

How do you get a Medicare Advantage plan in Pennsylvania?

Enroll through Medicare.gov, contact insurers directly, or work with a licensed agent during Annual Enrollment (Oct. 15 to Dec. 7) or during other qualifying periods.

What does Medicare Advantage cover?

Medicare Advantage plans cover everything Original Medicare does plus frequently include prescription drugs, dental, vision, hearing services, and fitness benefits.

What's the difference between Medicare Advantage and Medicare Supplement?

Medicare Advantage replaces Original Medicare with bundled coverage from private insurers, while Medicare Supplement (Medigap) works alongside Original Medicare to cover deductibles and copays.

When is open enrollment for Medicare Advantage in Pennsylvania?

Pennsylvania offers multiple Medicare Advantage enrollment periods: the main Annual Enrollment Period from Oct. 15 to Dec. 7, plus Jan. 1 to March 31 for current enrollees.

Our Methodology: How We Ranked Pennsylvania's Best Medicare Advantage Plans

Our analysis of Medicare Advantage plans uses a scoring methodology and three key factors:

Affordability (50%): Cost comprises half of our overall score because it affects your budget. We evaluated monthly premiums for Part C and Part D coverage combined (30% weight) and in-network maximum out-of-pocket limits (20% weight). Plans with lower premiums and MOOP amounts score higher since they reduce your total annual health care spending.
Star Ratings (40%): CMS star ratings measure plan quality across categories like care effectiveness, customer service and member satisfaction. The Overall Star Rating combines both Part C (medical coverage) and Part D (prescription drug) ratings on a scale from 1 to 5 stars. Plans with higher ratings earn better scores in our analysis.
Availability (10%): We score providers based on how many states they operate in, including Washington, D.C. Providers with broader geographic availability score higher because they're more likely to maintain coverage if you move and often have more resources for customer support and plan improvements.

This scoring system helps you compare plans objectively while accounting for what matters most: what you'll pay and the quality of care you'll receive.

About Mark Fitzpatrick

Mark Fitzpatrick, a Licensed Property and Casualty Insurance Producer, is MoneyGeek's resident Personal Finance Expert. He has analyzed the insurance market for over five years, conducting original research for insurance shoppers. His insights have been featured in CNBC, NBC News and Mashable.

Fitzpatrick holds a master’s degree in economics and international relations from Johns Hopkins University and a bachelor’s degree from Boston College. He's also a five-time Jeopardy champion!

He writes about economics and insurance, breaking down complex topics so people know what they're buying.

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