Provider Partners

Medicare 

in 

Pennsylvania

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

Provider Partners

 Plans Available 

in 

Pennsylvania

Plans Available in Pennsylvania

Monthly premiums, out-of-pocket maximums, and CMS star ratings for 3 plans.

Plan NameTypeMonthly PremiumMax Out-of-PocketStar Rating
Provider Partners Pennsylvania Essential Plan (HMO I-SNP)HMO$32.70$9,250.00Not yet rated
Provider Partners Pennsylvania Community Plan (HMO I-SNP)HMO$0.00$2,600.00Not yet rated
Provider Partners Pennsylvania Advantage Plan (HMO I-SNP)HMO$32.70$9,250.00Not yet rated

Key Benefits Across Provider Partners Plans

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

Plan NamePCP CopaySpecialistOTC CreditDental Max
Provider Partners Pennsylvania Essential Plan (HMO I-SNP)IncludedIncluded$120.00Included
Provider Partners Pennsylvania Community Plan (HMO I-SNP)$10.00$10$150.00Included
Provider Partners Pennsylvania Advantage Plan (HMO I-SNP)IncludedIncluded$105.00Included
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.

Other 

Pennsylvania

 Medicare Carriers 

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 

Provider Partners

Medicare Plans

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