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. If you're not ready to make a decision click here to discover your 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
Medicare Part A (inpatient) and Medicare Part B (outpatient), commonly called Original Medicare, is the same for everyone with Medicare benefits, including Philadelphia County. This is not true of the other parts of Medicare, which are highly dependent on where you live.
In addition to regional Medicare insurance options, you must match your most important doctor (generally your primary care physician) with a plan. Tens of thousands of doctors don't treat Medicare patients, and those that do don't accept all types of Medicare payment. Some only work with Medicare directly, some only work with specific Medicare Advantage plans, and some do both.
The purpose of the MedicareWire.com website is to help guide you through the process of choosing your health insurance. It's all about providing you with the information you need so you can get on the phone with a licensed adviser and finalize your Medicare elections for the year.
Medicare Advantage Insurance in Philadelphia County
Medicare Advantage is a private health insurance replacement for Original Medicare. If you enroll in a Philadelphia County Medicare Advantage plan you are opting to receive all of your healthcare benefits through the plan. There are strict rules governing going back to Original Medicare, so read and be informed. In most cases you must wait until the next Annual Election Period.
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 $222.50 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 17 plans that give you prescription drug coverage and 9 that don't include it.
Plans are not all the same, and there are several common types, including Private Fee-for-Service (PFFS), Health Maintenance Organization (HMO), and Preferred Provider Organization (PPO). Some areas also offer one or more Medical Savings Account (MSA) plans, but they are rare. HMO and PPO plans are by far the most common.
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.
Are you aware that Medicare Advantage has an annual out-of-pocket spending limit? This feature, called the Maximum Out-of-Pocket (MOOP) expense, is what safeguards you from the threat of high medical bills. Each year the Centers for Medicare and Medicaid Services (CMS) sets the maximum and an alternative minimum MOOP that plans may offer, so be sure to look for it when comparing your health insurance options.
A full thirty-three percent of all Medicare beneficiaries enroll in Medicare Advantage each year. The reason is simple: it's a cost-effective alternative to Original Medicare. We encourage you to learn more by visiting our Medicare Advantage Frequently Asked Questions and Medicare Advantage Coverage pages.
Medicare Supplement Insurance in Philadelphia County
The only relief Pennsylvania seniors have from the high cost of medical bills is additional insurance. That's because Original Medicare does not set limits on your annual out-of-pocket expenses. It's a serious risk that you need to consider. If you plan to keep your Original Medicare, the solution is Medicare Supplement insurance (Medigap).
Medigap insurance is available in Pennsylvania in ten standardized letter plans, A, B, C, D, F, G, K, L, M and N. There's also a high deductible version of Plan F. Plan A is the most basic and Plan F offers the most coverage possible.
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
Most Pennsylvania seniors will eventually need help paying for their prescription medications. Unfortunately, this is not a benefit provided by Original Medicare, you have to buy it. You can get prescription drug coverage assistance by enrolling in a Medicare Part D plan (PDP) or a Medicare Advantage plan that includes a PDP.
There are a total of 34 PDPs available to Pennsylvania seniors. Premiums range from $12.60 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.
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.