Medicare in Pennsylvania
Medicare in Pennsylvania looks similar to Medicare anywhere else on paper. The federal rules apply the same. The differences live in the carriers, the hospital networks, and the state programs that exist on top of it.
We're an independent PA-licensed agency. We review your doctors, your prescriptions, your hospital systems, and your budget. Then we tell you what fits. If your current plan still fits, we tell you to stay.
What's worth knowing about Medicare in PA
No Birthday Rule. Pennsylvania doesn't have a Medigap Birthday Rule. A handful of states (California and Oregon, for example) let residents switch Medigap plans during a window around their birthday without medical underwriting. Pennsylvania is not one of them. Outside guaranteed-issue periods, switching Medigap plans usually means going through underwriting.
PACE and PACENET. Pennsylvania runs two state-funded prescription assistance programs for residents 65 and over. They sit on top of Medicare Part D and can lower your out-of-pocket drug costs if you fall under the income thresholds. They are administered by the Pennsylvania Department of Aging, not by Medicare or by us, but they interact with your Part D choice.
Regional hospital networks. Penn Medicine, Jefferson, Tower Health, Main Line Health, St. Luke's, Lehigh Valley Health Network, UPMC, Geisinger, and the various community hospitals all have different in-network status across Medicare Advantage carriers. A plan that's strong in Bucks County may be thin in Allegheny County. We pull the actual provider directory before you sign anything.
Major metros we cover in Pennsylvania
We work with Pennsylvania residents by in-person and video review. The metro-specific guides below add local hospital-network detail on top of the state-level info above.
PA
Medicare in Philadelphia
Hospital systems, network considerations, and metro-specific FAQs.
PA
Medicare in Pittsburgh
Hospital systems, network considerations, and metro-specific FAQs.
PA
Medicare in Allentown
Hospital systems, network considerations, and metro-specific FAQs.
PA
Medicare in Harrisburg
Hospital systems, network considerations, and metro-specific FAQs.
Pick your county
We do in-person reviews across southeastern Pennsylvania. Pick your county to see the towns we visit, the local hospital systems your plan should cover, and a few things most agents won't mention.
Montgomery County
Independent licensed PA agency reviewing Medicare, hospital indemnity, and final expense coverage in person across Montgomery County, PA. From King of Prussia to Pottstown to Lansdale.
72 town pages →
Bucks County
Independent licensed PA agency reviewing Medicare, hospital indemnity, and final expense coverage in person across Bucks County, PA. Doylestown, Newtown, Bensalem, Levittown, Yardley, and the rest.
50 town pages →
Chester County
Independent licensed PA agency reviewing Medicare, hospital indemnity, and final expense coverage in person across Chester County, PA. West Chester, Phoenixville, Kennett Square, Exton, Malvern, and the Main Line.
73 town pages →
Delaware County
Independent licensed PA agency reviewing Medicare, hospital indemnity, and final expense coverage in person across Delaware County, PA. Media, Drexel Hill, Springfield, Havertown, Newtown Square, and beyond.
49 town pages →
Philadelphia
Independent licensed PA agency reviewing Medicare, hospital indemnity, and final expense coverage in person across Philadelphia neighborhoods. Center City, Northeast Philly, South Philly, Chestnut Hill, Mt Airy, Roxborough, and more.
49 town pages →
Berks County
Independent licensed PA agency reviewing Medicare, hospital indemnity, and final expense coverage across Berks County, PA. Reading, Wyomissing, West Reading, Boyertown, Kutztown, and the Pennridge edge.
63 town pages →
Your complete coverage picture in Pennsylvania
Medicare is one layer. Hospital indemnity catches the out-of-pocket costs Medicare doesn't cover. Final expense protects the people you love from the bill that arrives when you don't. We help you think through all three with one licensed agent.
Foundation
Medicare
Hospital, medical, and prescription coverage. The plan that fits depends on your doctors, prescriptions, and budget. We compare carriers in PA against your full provider list.
Get a PA Medicare review →Gap protection
Hospital Indemnity & Cancer
Pays a fixed cash benefit directly to you for hospital stays, ER visits, ICU days, ambulance rides, or a covered cancer diagnosis. Use the cash for copays, coinsurance, deductibles, or anything else.
- ✓AccidentWise · injury cash benefits
- ✓AdvantageGuard · daily hospital cash
- ✓CriticalGuard · cancer & critical illness
Family protection
Final Expense & Life
Final expense (whole life) covers the funeral, burial, and end-of-life bills so they don't land on your family. Term and permanent life replace your income for the people who depend on it.
- ✓Final expense (simplified issue)
- ✓Whole life (lifelong coverage)
- ✓Term life (income replacement)
All three with one licensed agent in Pennsylvania. Book a free 15-minute review.
Common questions about Medicare in Pennsylvania
Are there Medicare Advantage plans available in Pennsylvania?
Yes. Most Pennsylvania counties have a wide selection of Medicare Advantage plans from major carriers. The specific plans, premiums, and provider networks vary by county and ZIP code, and they change every plan year. We pull what's actually available in your ZIP and compare against your doctors and prescriptions before recommending anything.
Does Pennsylvania have a Medigap Birthday Rule?
No. Pennsylvania does not have a Birthday Rule. A handful of states (California and Oregon, for example) let you switch Medigap plans during a window around your birthday without medical underwriting. Pennsylvania is not one of them. Outside guaranteed-issue periods, switching Medigap plans in PA generally requires going through underwriting.
When can I enroll in Medicare in Pennsylvania?
The federal enrollment windows apply the same in every state.
Your Initial Enrollment Period is the 7 months around your 65th birthday. The Annual Enrollment Period runs October 15 through December 7 each year. The Medicare Advantage Open Enrollment Period runs January 1 through March 31. Special Enrollment Periods can open up after qualifying life events like moving, losing employer coverage, or qualifying for Extra Help.
We can sit down with you in person across most of southeastern Pennsylvania, or by video call anywhere else in the state.
What is PACE and PACENET, and how do they work with Medicare in Pennsylvania?
PACE and PACENET are Pennsylvania state programs that help residents 65 and over with prescription drug costs. They are separate from Medicare Part D but can work alongside it.
Income limits apply and they change. PACE has a lower income threshold and broader benefits. PACENET has a higher income threshold and a smaller subsidy. Both are administered by the Pennsylvania Department of Aging, not by Medicare or by us.
If your income falls in the qualifying range, PACE or PACENET can meaningfully reduce what you pay out of pocket on top of Part D. We can flag whether it's worth applying based on what you tell us about your situation.
Will my Pennsylvania Medicare Advantage plan cover hospitals across the whole state?
Not always. Medicare Advantage networks are built county by county and carrier by carrier. A plan that includes Penn Medicine in Philadelphia might not include the same hospital system in Lancaster or Pittsburgh, and a plan strong in Lehigh Valley might be thin in southwestern PA. If you split time between regions or travel inside Pennsylvania for specialty care, network coverage is one of the things we check before you sign anything.
Do I need to switch Medicare plans every year in Pennsylvania?
No. You don't need to switch. But you should review. Plans change their formulary, network, and cost-sharing each plan year, and the plan that fit you last year may not fit this year. The Annual Enrollment Period (October 15 to December 7) is when you can make a change for the following year if a review shows a better fit.
Are you connected to Medicare or to the Pennsylvania state government?
No. The Right Choice Agency is an independent licensed insurance agency. We are not connected with or endorsed by the United States government, the federal Medicare program, or the Pennsylvania state government. We help you compare options from the carriers we represent. For information on all your options, contact Medicare.gov or call 1-800-MEDICARE.
If a 15-minute review changes nothing, that's a useful answer too
We don't do paperwork on the first call. We look at what you have, check your scripts and providers against what's actually available in your Pennsylvania ZIP code this plan year, and if your current plan is the right one, we tell you to stay where you are. That's the whole pitch.
Required disclosures. We are not connected with or endorsed by the United States government or the federal Medicare program. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. Plan availability, premiums, and benefits vary by county, ZIP code, and plan year. This is not a complete description of benefits.