Philadelphia County seniors can choose from a wide range of Medicare and other health insurance products to supplement their traditional Medicare coverage. Use the links below to narrow your options to a specific type of Medicare insurance. Click here to learn more about your Medicare options.
To speak with a Medicare adviser, call us toll-free at 877-549-1452 (TTY 411). Our telephone hours are 6AM to 5PM PST, Monday through Friday.
Philadelphia County Medicare Insurance Options
Traditional Medicare coverage – that's Part A and Part B – are not based on where you live in Philadelphia County or Pennsylvania. This is not true of Medicare Part C and Part D, or Medigap plans. Private Medicare insurance is regional, and costs and availability vary widely.
As if all of the various health insurance options aren’t confusing enough, you also need to make sure your doctor accepts the insurance you want, or find a doctor that does. Some doctors only work through insurance networks, while others treat patients with Original Medicare (and Medicaid). Some doctors do both.
Our goal is to help you find all of the information you need to narrow your plan options to a small number so you can get on the phone with licensed adviser and make your final election for the year. In our experience, people who take a little more time investigating their options generally have better results with their healthcare.
Medicare Advantage Insurance in Philadelphia County
If the risk of high out-of-pocket costs with Original Medicare has you worried, then a Philadelphia County Medicare Advantage plan is one alternative you need to consider. Medicare Advantage offers all of the same basic benefits as Original Medicare, and plans have the option to add additional benefits, including prescription drug coverage.
For most Philadelphia County seniors cost is a factor, so let's talk about it. You have plans as low as $0.00 per month and some as high as $78.00 per month. It's not always true that the higher the premium the more benefits and coverage you get. Be a good shopper and compare. Be sure to compare prescription drug benefits. There are 2 plans that give you prescription drug coverage and 1 that don't include it.
There are several different type of plans, including Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), Private Fee-for-Service (PFFS), and Medical Savings Account (MSA). HMO and PPO plans are the most common. We identify the plan type and its benefits on each plan page.
Zero dollar ($0) plans are available in most areas, but not all. Zero dollar does not mean free, it simply indicates that there's no additional monthly premium to enroll. However, you are still required to pay your monthly Part B premium. This is the case with all Medicare Advantage plans.
A low premium is not the only cost to consider when comparing health insurance. Don't forget to look at the MOOP. That's the maximum out-of-pocket expenses you will pay each year. It's an important feature, because it helps you avoid the heavy burden of high medical bills. Be aware that the MOOP does not include the cost of your premiums or your prescriptions.
About one-third of all seniors on Medicare enroll in a Medicare Advantage plan. You can learn more about this private health insurance option on our Medicare Advantage Frequently Asked Questions page and our Medicare Advantage Coverage page.
Medicare Supplement Insurance in Philadelphia County
If you like the flexibility of being able to see any doctor you choose, but you're concerned about paying 20% of all your medical bills, the solution is Medicare Supplement insurance. Commonly called Medigap, supplemental Medicare insurance helps pay your share of the Medicare costs.
A Medigap policy is indemnity insurance that pays the portion of your bill not paid by Medicare (up to the limits of the policy). There are ten lettered plans in Pennsylvania (A through N) that are all standardized. So, no matter what carrier you choose, the lettered plan will be the same, only the premium will be different.
The most important thing to know about Medigap insurance policies is that if Original Medicare doesn’t cover a healthcare service, a Medigap plan won't cover it or any portion of it either. So, unlike Medicare Advantage plans that can offer extras, like coverage for prescription medications, hearing, vision, dental and more, Medicare Supplements are in lock-step with Original Medicare Parts A and B.
Medicare Prescription Drug Plans in Philadelphia County
One of the most important healthcare benefits needed by most Pennsylvania seniors is prescription medication coverage, and it's not included in Original Medicare. If you want assistance paying for your prescriptions you must enroll in a Medicare Advantage plan that includes it, or join a Medicare Part D plan (PDP).
There are a total of 12 PDPs available to Pennsylvania seniors. Premiums range from $33.30 to $169.00 per month. Also, be aware that some plans have an annual deductible that you must pay at the pharmacy before assistance begins. Some plans have a $0 deductible, but premiums are generally higher.
Don't make the mistake of enrolling in a Medicare Part D plan because it's cheap. Your prescription drug insurance is important. Learn more about it by reading Medicare Part D Frequently Asked Questions and Medicare Part D Coverage.
How-To Find a Medicare Doctor in Philadelphia County, Pennsylvania
We've recently added all Philadelphia County Medicare doctors (primary care physicians for now) to MedicareWire.com. Doctors who treat Medicare patients are listed by city or town. We have school information, years of experience, hospital affiliations and insurances for doctors in Philadelphia, and surrounding areas.
This page was last updated on: 11/12/2014.