Medicare Plans in Pennsylvania in 2022
Signing up for Medicare can be confusing, especially when taking into account all of the variables that can impact your enrollment. Plan availability depends on so many factors, one of the most important being where you live.
Being aware of your state-specific Medicare rights can help you to find the best plan options possible. That’s why it’s so important to have a good understanding of the nuances of Medicare in your state. Read on to learn more about your Medigap, Medicare Advantage, and Part D options in Pennsylvania.
How To Apply for Medicare in Pennsylvania
If you are a Pennsylvania resident who is only interested in enrolling in Original Medicare, you can do so through your local Social Security office. You can sign up in-person, online, or over the phone as early as three months before your 65th birthday.
However, if you want to enroll in a Medicare Advantage plan, Medicare Supplement Insurance, or Part D drug coverage, we recommend you speak with a licensed insurance agent. They can walk you through the process and help you to find the right plan for you.
Reach out to a team member here at Medicare Plans Direct today to have all of your Medicare-related questions answered.
Medicare Supplement Plans in Pennsylvania
Which Medigap plans are available to you in Pennsylvania will depend on a number of factors, such as which insurance company you enroll with and where you reside.
There were 711,230 Pennsylvania residents enrolled in Medicare Supplement Insurance in 2019. This figure represented over a quarter (26%) of all Medicare enrollees in the state that year.
The most popular Medigap plans in Pennsylvania include Plans C, F, G, and N. These plans offer some of the most comprehensive coverage around.
However, beneficiaries who first became eligible for Medicare on or after January 1, 2020 will no longer be allowed to enroll in Plan C or Plan F. Plans G and N are good alternatives.
Medigap Enrollment in Pennsylvania
If you are interested in enrolling in Medigap insurance in Pennsylvania, the best time to do so is during your Medigap Open Enrollment Period (OEP).
This occurs when you first become eligible for Medicare and enroll in Part B, and it lasts for 6 months. During this time, you can enroll in any Medigap plan offered in your area regardless of your health history.
Unless you qualify for a guaranteed issue right, you may have to undergo medical underwriting if you want to sign up for a Medigap plan after your OEP finalizes. In this case, insurance companies reserve the right to deny you coverage and/or charge you higher rates.
Examples of guaranteed issue rights in Pennsylvania include moving out of your Medicare Advantage plan’s coverage area, a change in retiree benefits, and losing your employer coverage.
You should be aware that Medigap insurers in Pennsylvania can implement pre-existing condition waiting periods. This means that your insurance company can delay coverage for your condition for up to six months when you first enroll in your Medigap plan.
These waiting periods apply to conditions that are diagnosed or treated (or for which treatment was recommended) during the six months before your policy comes into effect. Having prior creditable coverage can shorten these waiting periods.
Medigap in Pennsylvania for Disability Enrollees
Federal law does not require Medicare Supplement Insurance companies to provide coverage to beneficiaries under the age of 65 who qualify for Medicare because of a disability. However, many states have implemented protections that allow these individuals to enroll in a Medigap plan, Pennsylvania included.
Pennsylvania law states that beneficiaries under the age of 65 who qualify for Medicare because of a disability are guaranteed the right to enroll in any Medicare Supplement plan they would like during their six month Open Enrollment Period.
People who qualify for Medicare before they turn 65 can sign up for Medigap insurance during the first six months that they are enrolled in Medicare Part B. Plus, insurance companies may not charge these individuals higher premiums than they would charge beneficiaries aged 65 and older. This is a protection that is not offered in many other states.
Medigap Premiums in Pennsylvania
There were 65 insurance companies that offered Medicare Supplement Insurance in Pennsylvania in 2021. State law allows each one to decide how they set monthly premiums, and the vast majority of them offer attained-age rated policies.
With attained-age rated policies, your monthly premium will likely increase as you get older, which is important to consider when choosing a Medigap plan.
A couple of companies offer issue-age rated plans. In this case, premiums are determined by the age you were when you enrolled in the policy.
Finally, one company offers plans with community-rated premiums in 2022. When it comes to these plans, premiums are typically the same for everyone in your area.
Though Medigap plans’ benefits are federally standardized, premium rates can vary significantly between insurance companies. For that reason, we always recommend consulting with a knowledgeable insurance agent before deciding on a Medicare Supplement policy to ensure that you are getting the best value plan for you.
Medicare Advantage Plans in Pennsylvania
Another coverage option for people looking for more benefits than those offered by Original Medicare is Medicare Advantage. Also known as Medicare Part C, these plans provide the coverage that you get under Original Medicare on top of additional benefits, which can include drug coverage, hearing coverage, vision coverage, dental coverage, and more.
46.3% of Pennsylvania Medicare beneficiaries were enrolled in a Medicare Advantage plan in 2021. In 2022, there are 240 Medicare Advantage plans available in Pennsylvania.
All Pennsylvania Medicare beneficiaries have access to at least one Medicare Advantage plan in 2022. However, which Medicare Advantage plans you have access to depends on where exactly you reside, as plan availability varies significantly from county to county.
For example, Pennsylvania Medicare enrollees who live in Lancaster County can choose between 89 Medicare Advantage plans in 2022, while residents of Pike County only have 29 plans available to them.
When it comes to monthly premiums, what you pay for your Medicare Advantage plan depends on where you live, the plan that you choose, and more. In 2022, the average Part C monthly premium in Pennsylvania is $32.79, and 100% of Medicare enrollees in the state have access to at least one plan with a $0 monthly premium.
Deciding which is the right Medicare Advantage plan for you is best done with the help of an experienced insurance agent. Here at Medicare Plans Direct we help you make the best Medicare choices possible at no extra cost to you. Reach out today to receive free Medicare advice.
Medicare Part D in Pennsylvania
Another thing for Pennsylvania Medicare beneficiaries to keep in mind is their Medicare Part D prescription drug coverage options. In 2022, there are 25 stand-alone Medicare drug plans available to Pennsylvania Medicare enrollees.
How much you will have to pay for your Part D premium depends on where you live and which insurance company you purchase your plan through. In 2022, the average Part D premium in Pennsylvania is $52.86.
You can also find drug plans with $0 deductibles, though insurance companies may charge higher monthly premiums for these plans. In 2022, there are five no-deductible plans available to Pennsylvania residents, the least-expensive of which offering a monthly premium of $69.00.
It is typically a good idea to enroll in prescription drug coverage when you are first eligible if you foresee it being necessary in the future. If you don’t sign up for Medicare Part D when you first qualify and don’t have some other form of creditable drug coverage, you could face late enrollment penalty fees down the line.
Some Medicare Advantage plans include prescription drug benefits, but if you are enrolled in Original Medicare and/or a Medigap policy, you will need a stand-alone drug plan to cover the costs of your prescription drugs.
As you can see, it is important to understand the ins and outs of Medicare coverage when choosing a plan. Here at Medicare Plans Direct, we help seniors through the process of enrolling in Medicare. Reach out today for a free consultation with a licensed insurance agent.
