How many Medicare beneficiaries are in Pennsylvania?

Pennsylvania has approximately 2.9M Medicare beneficiaries. Roughly 50% are enrolled in Medicare Advantage plans, with the balance on Original Medicare — often paired with a Medigap plan and a standalone Part D drug plan.

When is Pennsylvania Medicare enrollment?

The Annual Enrollment Period (AEP) runs October 15 through December 7 each year, with changes effective January 1. The Medicare Advantage Open Enrollment Period (MA OEP) runs January 1 through March 31. New-to-Medicare beneficiaries use their 7-month Initial Enrollment Period around their 65th birthday.

Is Medigap available in Pennsylvania?

Yes. Pennsylvania has all federal Medigap letter plans (A, B, D, G, K, L, M, N, and high-deductible G and F for those eligible) available from multiple carriers. Medical underwriting typically applies outside your one-time 6-month Medigap Open Enrollment window, so timing matters.

Pennsylvania · Medicare · 2026 plan year

Pennsylvania Medicare plans for 2026.

Q: What are the top Medicare Advantage carriers in Pennsylvania?

Leading Medicare Advantage carriers in Pennsylvania include Highmark, Independence Blue Cross, Aetna, UnitedHealthcare (AARP), Humana, Geisinger, UPMC Health Plan, and Capital BlueCross. Plan availability and network depth vary by county.

Pennsylvania has approximately 2.9M Medicare beneficiaries — about 50% on Medicare Advantage, the rest on Original Medicare. We compare Medicare Advantage, Medigap, and Part D options from Highmark, Independence Blue Cross, Aetna, UnitedHealthcare (AARP), Humana, Geisinger, UPMC Health Plan, and Capital BlueCross.

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2.9M

Pennsylvania Medicare beneficiaries

~50%

on Medicare Advantage in PA

All 67

Pennsylvania counties served

Carriers pay us — never you

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The core decision

Medicare Advantage vs. Medigap in Pennsylvania

For most Pennsylvanians, the choice between Medicare Advantage (Part C) and Original Medicare plus a Medigap (Supplement) plan is the biggest decision you'll make.

Medicare Advantage in Pennsylvania

Bundles Part A, Part B, and usually Part D into a private plan. Most Pennsylvania metros offer competitive $0-premium plans with dental, vision, hearing, OTC, and transportation benefits.

Most Pennsylvania MA plans are HMOs with local networks including UPMC, Penn Medicine, Jefferson Health, Geisinger, Allegheny Health Network. We verify your doctors before enrolling.

Medigap in Pennsylvania

Pairs with Original Medicare and covers the deductibles, coinsurance, and copays Medicare doesn't pay. Any doctor or hospital nationwide that accepts Medicare accepts Medigap — no networks.

Pennsylvania Medigap premiums vary by ZIP and age, and carriers may medically underwrite outside your one-time 6-month Medigap Open Enrollment window.

Carriers

Top Medicare carriers in Pennsylvania

Plan availability and network depth vary by county.

Highmark & Independence Blue Cross

Pennsylvania has multiple Blue plans by region. Highmark dominates western and central PA (including Pittsburgh), Independence Blue Cross covers the Philadelphia area, and Capital BlueCross serves central PA. All three have deep Medicare Advantage and Medigap presence.

UPMC Health Plan

The insurance arm of the UPMC health system. Strong Medicare Advantage presence in Western Pennsylvania built on UPMC's hospital network — a good fit if your doctors are at UPMC Presbyterian, UPMC Shadyside, or UPMC Children's.

Geisinger Health Plan

Central and Northeast PA-rooted system, integrated with Geisinger Medical Center and clinics. Frequently top-rated in CMS Star Ratings — popular among PA seniors who already see Geisinger doctors.

Humana, Aetna & UnitedHealthcare

All three national carriers offer competitive Medicare Advantage and Part D plans across PA, with UnitedHealthcare's AARP Medigap plans being a popular option for Pennsylvania seniors.

Part D

Part D prescription coverage in Pennsylvania

Under the Inflation Reduction Act, 2026 Part D caps out-of-pocket drug costs at $2,100 per year and eliminates the old "donut hole."

Every Pennsylvania Medicare beneficiary needs prescription drug coverage (or creditable alternative coverage) to avoid the Part D late enrollment penalty. Pennsylvania has dozens of standalone Part D plans plus drug coverage bundled into most MA-PD plans.

Formulary check: The same medication can land in very different tiers across plans. We run your drug list against every Part D plan in your ZIP.
Preferred pharmacy: Many Pennsylvania Part D plans offer lower copays at preferred pharmacies (CVS, Rite Aid, Walgreens, Walmart, Giant Eagle, Costco). Which pharmacy you prefer can change which plan is cheapest.
Extra Help / LIS: Pennsylvania beneficiaries with limited income may qualify for the Low Income Subsidy that significantly reduces drug costs.

Timing

Medicare enrollment dates for Pennsylvania

Annual Enrollment Period (AEP): October 15 – December 7. Change Medicare Advantage or Part D plans; changes effective January 1.
Medicare Advantage Open Enrollment (MA OEP): January 1 – March 31. One plan change allowed for members already in a Medicare Advantage plan.
Initial Enrollment Period (IEP): 7 months around your 65th birthday — 3 months before, your birthday month, and 3 months after.
Medigap Open Enrollment: 6 months from your Part B effective date — the one-time window when Pennsylvania Medigap carriers cannot deny you or charge more for health reasons.
Special Enrollment Periods: Moving into Pennsylvania, losing employer coverage, qualifying for Extra Help, or moving into or out of a nursing facility may each trigger a SEP.

Common questions

Pennsylvania Medicare FAQ

Are there Pennsylvania-specific Medicare rules?

Medicare is federal, so core rules match nationwide. What varies in Pennsylvania is plan availability, network depth, Medigap pricing, and carrier mix.

Can I switch from Advantage to Medigap later?

Sometimes. Outside your one-time Medigap Open Enrollment window, Pennsylvania Medigap carriers can medically underwrite — which means they can decline you or charge more for health conditions. We walk through your specific options carefully.

What if my doctor is at a different network?

We verify every doctor and hospital you want to keep against each plan's network before recommending anything. Networks like UPMC, Penn Medicine, Jefferson Health, Geisinger, Allegheny Health Network are common in Pennsylvania — but specifics vary plan by plan.

What does SilverEdge cost?

Nothing. Medicare carriers pay us a commission when you enroll. We earn the same regardless of which carrier you pick — our job is to find your best Pennsylvania fit.

Coverage

Pennsylvania counties we cover

All 67 Pennsylvania counties. A few of the counties where we have the most active members:

Philadelphia Allegheny (Pittsburgh) Montgomery Bucks Delaware Lancaster Chester York Berks Lehigh Northampton Westmoreland Luzerne Cumberland Dauphin Erie Washington Butler Lackawanna Beaver + 47 more

★★★★★

$1,680 / yr saved

on Medicare Advantage switch · Pittsburgh, PA

"I had a UPMC plan but my new specialist was at AHN. SilverEdge found me a Highmark plan that covered both networks and even threw in dental and vision. Painless switch."

Jane T.

MA-PD switch · Pittsburgh, PA

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