Key takeaways

  • Pennsylvania residents have multiple Medicare options, including Original Medicare (parts A and B), Medicare Advantage (Part C), and Medicare Part D for prescription drug coverage.
  • When choosing a plan, consider that Medicare Advantage plans, offered by private insurers, often include extra benefits like vision, dental, and hearing coverage, but you can’t have a Medicare Advantage and Medigap plan simultaneously.
  • Enrollment in Part A is generally automatic when you turn 65 years old if you receive Social Security benefits, but if you aren’t automatically enrolled, you can sign up during specific enrollment periods.

Medicare is a health insurance program for people ages 65 years and older, as well as people of any age who have certain health conditions and disabilities.

It’s made up of four parts:

  • Part A (hospital insurance) and Part B (medical insurance) are known as Original Medicare.
  • Part C, also known as Medicare Advantage, is an alternative to Original Medicare.
  • Part D, which is prescription drug coverage.

You can also purchase a supplemental insurance plan (Medigap) to help cover the out-of-pocket costs associated with Original Medicare. Medicare Advantage beneficiaries are not eligible for Medigap.

Read on to learn more about your Medicare options in Pennsylvania and when to enroll.

Snapshot of Medicare in Pennsylvania

The Centers for Medicare & Medicaid Services (CMS) reported the following information on Medicare trends in Pennsylvania for the 2026 plan year:

  • A total of 2,981,142 residents of Pennsylvania are enrolled in Medicare.
  • The average monthly Medicare Advantage plan premium changed from $24.26 in 2025 to $22.99 in 2026.
  • There are 334 Medicare Advantage plans available in Pennsylvania in 2026, compared with 316 plans in 2025.
  • All Pennsylvania residents with Medicare have access to buy a Medicare Advantage plan with a $0 premium.
  • For 2026, 12 stand-alone Medicare Part D plans are available in Pennsylvania, and the lowest monthly premium for a stand-alone Part D plan is $6.60.
  • Roughly 22.21% of people with a stand-alone Part D plan get Extra Help.
  • As in most states, 10 different Medigap plans are offered in Pennsylvania for 2026.

Medicare is more than just one plan. Different plans and components cover different aspects of your healthcare.

  • Original Medicare: Original Medicare is managed by the federal government and includes two main parts: Part A (hospital insurance) and Part B (medical insurance). Original Medicare includes limited prescription drug coverage.
  • Medicare Advantage (Part C): These plans are private plans that cover the same benefits as Original Medicare, and may also cover benefits like vision, dental, or prescription drugs. Some Medicare Advantage plans have limited provider networks, so confirm your doctors and facilities are in-network before enrolling.
  • Medicare Part D: This is another private, stand-alone plan option for prescription drug coverage. You’d enroll in Part D with Original Medicare or with a Part C plan without lumped-in drug coverage.
  • Medicare supplement (Medigap): Medigap plans help cover the gaps in Original Medicare coverage, which might include copays and coinsurance. Medigap plans are standardized in most states, and you can choose among 10 plans to supplement Original Medicare. You cannot use Medigap with Medicare Advantage.

For all private Medicare options, availability varies by county, so check Medicare.gov for what’s available in your area.

If you live in Pennsylvania, you can qualify for Medicare at age 65 years if you’re a U.S. citizen or legal resident for at least 5 years. If you’re under 65 years, you may also qualify through disability or by living with end stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS).

When choosing a plan, consider provider networks, costs, and quality ratings. You may be able to join a plan or modify your coverage during one or more of the following enrollment periods:

  • Initial enrollment: Enroll 3 months before to 3 months after the month of your 65th birthday.
  • Open enrollment: Join or change plans from October 15 to December 7.
  • Medicare Advantage open enrollment: Switch Medicare Advantage plans or return to Original Medicare from January 1 to March 31.
  • Special enrollment period: Enroll after a life change, such as losing job-based coverage.

If you’re eligible for Medicare due to a disability, you’ll be automatically enrolled. If you’re eligible based on age, you’ll need to enroll yourself.

Choose a plan that:

  • has doctors you like and facilities convenient to your location
  • covers the services you need
  • provides affordable coverage
  • has a high star rating for quality and patient satisfaction from CMS

Find answers to questions and get help with Pennsylvania Medicare plans from the following resources:

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.