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Pennsylvania Medicare Plans

Medicare Supplement (Medigap) Policies
Pennsylvania requires insurers to offer at least one Medicare Supplement policy to adults under sixty-five.

Mini-COBRA Policies
Pennsylvania does not mandate continuation coverage for small employers

State Pharmaceutical Assistance Program
Pennsylvania has three pharmaceutical assistance programs

State Medicare Savings Programs
Pennsylvania has three Medicare Savings Programs:

  • Qualified Medicare Beneficiaries (QMBs): For individuals with a monthly income under $903 and for couples with a monthly income under $1215, the state pays all premiums for Part B and all Co-Pays and Deductibles for Parts A & B
  • Specified Low-Income Medicare Beneficiaries (SLMBs): For individuals with income under $1083 or couples with income under $1457, the state pays premiums for Part B.
  • Qualified Individuals (QIs): For individuals with income under $1219 or for couples with an income under $1640, the state pays premiums for Part B.

To qualify for any one of these programs, participants must have assets below $6,600 or be part of a couple with assets below $9,910.

State Health Insurance Assistance Program
The APPRISE Health Insurance Counseling and Assistance Program operates a toll-free telephone system with call centers in 11 AAAs throughout the state. State grants to local sponsors fund a paid coordinator at locations throughout the state and support other related SHIP activities. APPRISE coordinates with community partners throughout the State to enhance information dissemination to beneficiaries as well as promote volunteer participation in the program.

High-Risk Pool
Pennsylvania does not have a state-run high-risk insurance pool.

Low-Income Subsidy (“extra-help”) for Prescription Drugs
This program is a subsidy for Part D recipients with resources under $13,070 (or $26,120 for a couple) to receive money towards a Medicare prescription drug plan. The benchmark of support is different depending on which region of the country you live in. In Pennsylvania in 2012, the low-income subsidy was $34.32 per month.

If you live in Pennsylvania, consult with one of our insurance specialists to get personal assistance that is specific to your area. One of our experienced specialists can compare plans in your area and help you find the Medicare insurance benefits that are right for your needs.