Medicare Advantage Plans in Pennsylvania 2026
Last reviewed: June 2026 · Data sourced from CMS.gov
Pennsylvania has about half of its Medicare beneficiaries in Advantage plans. Philadelphia and Pittsburgh are both large, competitive markets. UPMC and Highmark compete vigorously for market share in western PA, while Independence Blue Cross is dominant in the Philadelphia region. The rural counties in central Pennsylvania between the two metros have fewer choices.
Plan availability varies by county. Enter your ZIP code to see the exact plans, premiums, and coverage available where you live in Pennsylvania.
Rural Coverage Note
Parts of Pennsylvania have limited Medicare Advantage plan availability. If you live in a rural county, you may find fewer plans or smaller provider networks. Comparing your options alongside Medicare Supplement plans is worth doing before you decide.
What to Look for in a Pennsylvania Medicare Advantage Plan
- ✓ Whether your current doctors and specialists are in-network
- ✓ Drug formulary — does it cover your prescriptions at a reasonable cost?
- ✓ Monthly premium and annual out-of-pocket maximum
- ✓ Extra benefits: dental, vision, hearing, fitness programs
- ✓ Star rating — CMS rates plans from 1 to 5 stars based on quality and member experience
- ✓ HMO vs. PPO — HMOs require referrals and restrict out-of-network care; PPOs are more flexible
2026 Medicare Advantage Costs in Pennsylvania
| Cost | Typical Range |
|---|---|
| Monthly premium | $0 to $50 (many plans at $0) |
| Annual out-of-pocket maximum | Up to $9,350 in-network (2026 CMS limit) |
| Primary care visit copay | $0 to $20 typical |
| Specialist visit copay | $20 to $50 typical |
| Inpatient hospital stay | $250 to $350/day for first few days (varies by plan) |
| Part B premium (always required) | $202.90/month standard (2026) |
Medicare Advantage vs. Medigap in Pennsylvania
Pennsylvania's Medigap market reflects the strength of its regional Blues plans. Residents who want access to Penn Medicine, Jefferson Health, or UPMC without network restrictions often choose Medigap. National carriers also compete strongly in both major metros.