• Its 2020 Census population was just 7,351.
• By 2024, estimates put the population around 7,200, with the slow decline that defines most of Pennsylvania's most rural counties.
• The county seat — and largest community — is Tionesta, a small borough on the Allegheny River with a population barely exceeding 400 people.
• Adults 65 and older make up approximately 21 to 24 percent of the population — somewhere between 1,500 and 1,700 residents.
• Medicare enrollment estimates follow that age profile, meaning roughly 1,500 or more Forest County residents are Medicare beneficiaries.
• For a county with a total population under 7,500, that is an enormous proportion.

Forest County is the third-least populous county in Pennsylvania. Its 2020 Census population was just 7,351. By 2024, estimates put the population around 7,200, with the slow decline that defines most of Pennsylvania's most rural counties. The county seat — and largest community — is Tionesta, a small borough on the Allegheny River with a population barely exceeding 400 people. The age distribution in Forest County skews significantly older. Adults 65 and older make up approximately 21 to 24 percent of the population — somewhere between 1,500 and 1,700 residents. Medicare enrollment estimates follow that age profile, meaning roughly 1,500 or more Forest County residents are Medicare beneficiaries. For a county with a total population under 7,500, that is an enormous proportion. Poverty is a serious concern in Forest County. The poverty rate runs around 14 to 17 percent, well above the Pennsylvania average. Median household income is estimated in the range of $40,000 to $45,000 — among the lowest in the state. These economic conditions mean that many Medicare beneficiaries here qualify for additional financial help programs — Medicare Savings Programs and Extra Help for drug costs — but the challenge is making sure people know about these programs and have help applying. The county's economy is heavily tied to public land. Forest County contains the Allegheny National Forest (on its borders) and state forest land, with timber, hunting, recreation, and some natural gas production making up much of the economic activity. There is no major employer, no large institution, no university. Healthcare itself has become one of the county's largest employment sectors, largely because of the prison populations that cycle through SCI Forest, the state correctional facility in Marienville. SCI Forest (State Correctional Institution Forest) is a significant presence in the county and serves a distinctive population — incarcerated individuals who are enrolled in Medicaid-eligible programs and who access healthcare through the state corrections system. This population is generally separate from the civilian Medicare picture, but the facility does affect local economic and demographic data.

Forest County has no hospital within its borders. This is not a gap waiting to be filled — it reflects the county's population size and geography, and it is unlikely to change. Instead, Forest County residents depend entirely on facilities in surrounding counties for any hospital-level care. The primary hospital options for Forest County residents are in neighboring counties. To the south, Clarion Hospital (Penn Highlands Clarion) is the closest major facility for many residents. To the north, Hamot Medical Center in Erie (UPMC Hamot) is an option for northern Forest County residents, though Erie is a significant drive. To the east, Penn Highlands Elk in Saint Marys and various Venango County facilities to the west (including UPMC Northwest in Seneca) are possibilities depending on where in the county you live. Within Forest County itself, primary care is extremely limited. There are physician offices and clinic outposts in Tionesta and surrounding communities, but coverage is thin. Telehealth has become an essential component of healthcare delivery for Forest County residents — many of whom can only reasonably see a specialist via video call rather than making lengthy round trips to a hospital town. Home health services, delivered by agencies operating across the multi-county region, are an important part of the healthcare infrastructure for Forest County's elderly population. Skilled nursing care, physical therapy, and home health aide visits can bring services directly to homebound patients — a critical advantage in a county where getting to a clinic is a major undertaking. For Medicare beneficiaries in Forest County, plan selection is particularly consequential. You need a plan whose network includes hospitals and specialists in multiple surrounding counties, because you will not be receiving care within Forest County for anything beyond very basic outpatient services. Understanding what your plan covers when you're at a facility in Clarion, Venango, or Elk County — and what your cost-sharing looks like — is essential planning.

If you're turning 65 or new to Medicare, you have real choices. In your area, about 1,500 people already have Medicare. Understanding your options matters.

With median income around $40,000, keeping costs low matters. Ask about Extra Help for prescriptions and Medicare Savings Programs if money is tight. Review your plan every year—your needs and available options change.

Free Medicare counseling is available. A counselor can walk you through Original Medicare, Medicare Advantage, Medigap, and Part D options without pressure.

Your health situation may change, so don't just pick once and forget. Compare plans at open enrollment to make sure you're still in the right one.