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Highmark

Highmark

Medicare 

in 

Pennsylvania

Three older women happy gynecologist accepts medicare with gray hair smiling and embracing outdoors in cool-weather clothing.

Highmark

 Plans Available 

in 

Pennsylvania

Plans Available in Pennsylvania

Monthly premiums, out-of-pocket maximums, and CMS star ratings for 25 plans.

Plan NameTypeMonthly PremiumMax Out-of-PocketStar Rating
Complete Blue Plus PPO Merit (PPO)PPO$0.00$8,950.00★★★★★
Community Blue Medicare Plus PPO Signature (PPO)PPO$0.00$10,000.00★★★★★
Complete Blue Plus PPO Distinct (PPO)PPO$72.00$8,950.00★★★★★
Complete Blue HMO Distinct (HMO)HMO$20.00$5,900.00★★★★★
Security Blue HMO-POS Deluxe (HMO-POS)HMO-POS$179.00$8,950.00★★★★★
Security Blue HMO-POS Standard (HMO-POS)HMO-POS$122.00$8,950.00★★★★★
Security Blue HMO-POS Basic (HMO-POS)HMO-POS$20.00$8,950.00★★★★★
Security Blue HMO-POS ValueRx (HMO-POS)HMO-POS$35.00$8,950.00★★★★★
Complete Blue PPO Signature (PPO)PPO$0.00$8,950.00★★★★★
Freedom Blue PPO Select (PPO)PPO$139.00$8,950.00★★★★★
Freedom Blue PPO Classic (PPO)PPO$248.00$8,950.00★★★★★
Blue Rx PDP Complete (PDP)PDPNot ApplicableNot ApplicableNot yet rated
Blue Rx PDP Plus (PDP)PDPNot ApplicableNot ApplicableNot yet rated
Highmark Wholecare Medicare Assured Ruby (HMO D-SNP)HMO$0.00$8,000.00★★★★★
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP)HMO$0.00$9,250.00★★★★★
Community Blue Medicare HMO Distinct (HMO)HMO$27.00$6,250.00★★★★★
Community Blue Medicare HMO Signature (HMO)HMO$0.00$6,750.00★★★★★
Complete Blue PPO Merit (PPO)PPO$0.00$8,950.00★★★★★
Community Blue Medicare PPO Signature (PPO)PPO$0.00$10,000.00★★★★★
Complete Blue PPO Distinct (PPO)PPO$55.00$8,950.00★★★★★
Freedom Blue PPO Valor (PPO)PPO$0.00$8,950.00★★★★★
Freedom Blue PPO ValueRx (PPO)PPO$66.00$8,950.00★★★★★
Freedom Blue PPO Standard (PPO)PPO$121.00$8,950.00★★★★★
Freedom Blue PPO Basic (PPO)PPO$41.00$8,950.00★★★★★
Freedom Blue PPO Deluxe (PPO)PPO$226.00$8,950.00★★★★★

Key Benefits Across Highmark Plans

Primary care copays, specialist visits, OTC credit, and dental maximums.

Plan NamePCP CopaySpecialistOTC CreditDental Max
Complete Blue Plus PPO Merit (PPO)$0.00$40.00Not covered$0.00
Community Blue Medicare Plus PPO Signature (PPO)$0.00$50.00$0.00$0.00
Complete Blue Plus PPO Distinct (PPO)$0.00$40.00$0.00$0.00
Complete Blue HMO Distinct (HMO)$0.00$20.00$0.00$0.00
Security Blue HMO-POS Deluxe (HMO-POS)$0.00$25.00Not covered$0.00
Security Blue HMO-POS Standard (HMO-POS)$0.00$30Not covered$0.00
Security Blue HMO-POS Basic (HMO-POS)$0.00$30Not covered$0.00
Security Blue HMO-POS ValueRx (HMO-POS)$0.00$35.00Not covered$0.00
Complete Blue PPO Signature (PPO)$0.00$35.00$0.00Included
Freedom Blue PPO Select (PPO)$0.00$30Not covered$0.00
Freedom Blue PPO Classic (PPO)$0.00$25Not covered$0.00
Blue Rx PDP Complete (PDP)IncludedIncludedNot coveredNot covered
Blue Rx PDP Plus (PDP)IncludedIncludedNot coveredNot covered
Highmark Wholecare Medicare Assured Ruby (HMO D-SNP)$0.00$0.00$0.00$0.00
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP)$0.00$0.00$0.00$0.00
Community Blue Medicare HMO Distinct (HMO)$0.00$20$0.00$0.00
Community Blue Medicare HMO Signature (HMO)$0.00$20$0.00$0.00
Complete Blue PPO Merit (PPO)$0.00$40.00Not covered$615.00
Community Blue Medicare PPO Signature (PPO)$0.00$50.00$0.00$0.00
Complete Blue PPO Distinct (PPO)$0.00$30$0.00$0.00
Freedom Blue PPO Valor (PPO)$0.00$10.00$0.00$0.00
Freedom Blue PPO ValueRx (PPO)$0.00$40Not covered$0.00
Freedom Blue PPO Standard (PPO)$0.00$35Not covered$0.00
Freedom Blue PPO Basic (PPO)$0.00$35Not covered$1.00
Freedom Blue PPO Deluxe (PPO)$0.00$30Not covered$0.00
Smiling elderly couple missed enrollment deadline lying on a blanket in green grass looking content.Four smiling older adults with great medicare coverage in pennsylvania standing closely together outdoors under a clear blue sky, embracing each other affectionately.Senior couple joyfully dancing on news that their healthcare is not leaving the state of Pennsylvania, back-to-back in a cozy living room with natural light.

Compare 

Highmark

vs Other 

Pennsylvania

 Plans

Highmark

 vs UnitedHealthcare

Side-by-side: premium, MOOP, dental, and drug tiers

Highmark

 vs Aetna

Compare PPO options from two top 
Pennsylvania
 carriers

Wellcare vs 

Highmark

Pennsylvania
's 
local plan vs national carrier — 
what differs

Compare costs, coverage, star ratings

Find the Medicare plan tailored for your needs.

Compare Plans
Elderly couple embracing outdoors surrounded by green plants and trees.

Where 

Highmark

 Plans Are Available

 in 

Pennsylvania

Powhatan Point

Fort Loramie

Kaysville

Beaver

Haskins

Youngstown

Turtle Creek

Lower Burrell

Sewickley

Trenton

Painesville

Morton

Forest

 County

Luzerne

 County

Fulton

 County

Lehigh

 County

Blair

 County

York

 County

Cambria

 County

Adams

 County

Union

 County

Lebanon

 County

Tioga

 County

Mercer

 County

Other 

Pennsylvania

 Medicare Carriers 

Capital Blue Cross

10
 plans
Medicare Advantage Prescription Drug PPO

CommuniCare Advantage

2
 plans

Zing Health

5
 plans
Medicare Advantage Prescription Drug HMO

Valor Health Plan

1
 plans
Medicare Advantage Special Needs Plan

SilverScript

3
 plans
Part D Prescription Drug Plan

The Health Plan

5
 plans
Medicare Advantage Prescription Drug PPO

Provider Partners

3
 plans
Medicare Advantage Special Needs Plan

PrimeTime Health Plan

4
 plans
Medicare Advantage HMO-POS

Perennial Advantage

6
 plans
Medicare Advantage Prescription Drug HMO

Paramount

4
 plans
Medicare Advantage HMO-POS

Mount Carmel MediGold

7
 plans
Medicare Advantage Prescription Drug PPO

Medical Mutual

8
 plans
Medicare Advantage HMO-POS

Jefferson Health Plans

9
 plans
Medicare Advantage Prescription Drug PPO

CareSource

1
 plans
Medicare Advantage Special Needs Plan

AmeriHealth

1
 plans
Medicare Advantage Special Needs Plan

Clover Health

2
 plans
Medicare Advantage Prescription Drug PPO

Peak Advantage

2
 plans
Medicare Advantage Prescription Drug PPO

Molina Healthcare

4
 plans
Medicare Advantage HMO-POS

Erickson Advantage

6
 plans
Medicare Advantage HMO-POS

SummaCare

7
 plans
Medicare Advantage HMO-POS

Geisinger

9
 plans
Medicare Advantage Prescription Drug PPO

Independence Blue Cross

14
 plans
Medicare Advantage HMO-POS

Anthem

12
 plans
Medicare Advantage PPO

UPMC

19
 plans
Medicare Advantage Prescription Drug PPO

Aetna

53
 plans
Medicare Advantage PPO

Cigna Healthcare

6
 plans
Medicare Advantage PPO

Devoted Health

49
 plans
Medicare Advantage Prescription Drug PPO

Wellcare

18
 plans
Medicare Advantage HMO-POS

UnitedHealthcare

59
 plans
Medicare Advantage PPO

Select Health

8
 plans
Medicare Advantage PPO

Regence BlueCross BlueShield of Utah

3
 plans
Medicare Advantage PPO

HealthSpring

17
 plans
Medicare Advantage Prescription Drug PPO

Humana

75
 plans
Medicare Advantage PPO

American Health Advantage of Utah

2
 plans
Medicare Advantage HMO-POS
Smiling elderly couple forgets medicare ID, wearing beige coats sitting at outdoor café table with croissants and drinks.Two elderly men worried medication won't be covered by medicare insurance, in a kitchen, one taking a selfie while the other playfully raises his hand behind his head.Two older women love aetna medicare, wearing sunglasses smiling and taking a selfie outside under clear blue sky.

Common Questions About 

Highmark

Medicare Plans

Do I qualify for Medicare if I have ESRD or ALS?

Do I need to re-enroll in Medicare every year?

What is the difference between Medigap and Medicare Advantage?

What red flags should I watch for when someone is selling Medicare plans?

How do I apply for a Medicare Savings Program in Utah?

Highmark

 Plan Types Available 

in 

Pennsylvania

Highmark

PPO Plans

Flexibility to see any Medicare-accepting doctor

Highmark

HMO Plans

Lower premiums, in-network care, referrals required

Highmark

SNP Plans

Specialized for dual-eligible or chronic condition needs
Decision area Tool What it answers
Enrollment Initial Enrollment Period Calculator When your 7-month Medicare eligibility window begins and ends based on your 65th birthday
Enrollment When Should I Sign Up for Medicare? The best time to enroll based on your work status, other coverage, and age
Enrollment Special Enrollment Period Checker Whether a life event qualifies you for enrollment outside the standard windows
Enrollment Late Enrollment Penalty Checker How much extra you'll pay monthly if you missed your enrollment window
Enrollment Part B Penalty Calculator The exact 10%-per-year premium increase for delayed Part B enrollment
Enrollment Part D Penalty Calculator The 1%-per-month premium increase for gaps in creditable drug coverage
Costs Cost Scenario Planner Estimated annual spending across plan types at different health utilization levels
Costs Advantage vs. Medigap Cost Comparison True cost difference between Medicare Advantage and Original Medicare with Medigap
Costs IRMAA Calculator Whether your income triggers higher Part B and Part D premiums
Costs Part A Premium Estimator Your monthly Part A premium based on work history and quarters of coverage
Costs M3P Calculator How the Medicare Prescription Payment Plan smooths your drug costs into monthly payments
Coverage Doctor & Drug Assessment Whether your providers and prescriptions are covered by a specific plan
Coverage Part D Shopping Tool Which Part D plan has the lowest total annual cost for your specific medications
Coverage Travel & Network Risk Assessment How your coverage works outside your home area and which plan types travel best
Employer/COBRA COBRA vs. Medicare Why COBRA can trigger permanent Medicare penalties and how costs compare
Employer/COBRA Employer Coverage vs. Medicare Whether your employer plan or Medicare is primary and when to transition
Employer/COBRA HSA & Medicare Compatibility How Medicare enrollment affects HSA eligibility and what to do before enrolling
Planning Caregiver Readiness Checklist Whether you have everything in place to help a loved one with Medicare decisions
Planning Document Gatherer Which documents you need to have ready before enrolling or changing plans
Planning Medigap Fit Assessment Whether Medigap or Medicare Advantage is the better fit for how you use healthcare
Planning Medigap Open Enrollment Window Whether you're inside your one-time guaranteed issue window for Medigap
Planning Medicare Savings Program Eligibility Whether your income qualifies you for help paying Medicare premiums and cost-sharing

‍CMS TPMO Compliance Disclaimer: We do not offer every plan available in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.

Participating sales agencies represent Medicare Advantage [HMO, PPO, PFFS, and PDP] organizations that are contracted with Medicare. Enrollment depends on the plan’s contract renewal.

Not Government Affiliated: Resting Sycamore Advisors is a licensed Medicare insurance agency. We are not affiliated with or endorsed by the U.S. government or the federal Medicare program.

‍Data & Methodology for Research Articles: All provider, facility, quality star ratings, and enrollment data is sourced from primary CMS records (cms.gov), including the December 2025 CPSC Enrollment files and the January 2026 Provider Data Catalog. Calculations for patient-to-provider ratios are performed using indexed clinician and facility data. Everything on restingsycamore.com is for educational purposes and does not constitute an endorsement of any specific plan or provider.

Non-CMS Data Sources: Some  specific data was obtained from https://opendata.gov