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Your Guide to Medicare Advantage in Somerset County, PA

by , last updated

Many of the plans featured here are available through our partner, HealthCompare, who may compensate us when you enroll in a plan. This does not influence our evaluations. Our opinions are our own, based on our independent research. Learn more about how we make money.

In Somerset County, Pennsylvania, there are 66 Medicare Advantage Plans available for the 2025. From basics to specialized care, each of the 66 plans caters to distinct health needs and priorities. Our guide will help you weigh your options so you can make an informed decision.

Available Medicare Advantage Plans in Somerset County, Pennsylvania

Find your Medicare Advantage Plan options in Somerset County below. Click on any of the 66 plans to access full details, including coverage and costs.

Somerset County, Pennsylvania Medicare Advantage Plans

Medicare Advantage Plans in Somerset County, PA for 2024
Plan Name Type Premium MOOP Rx Ded. Rating
Community Blue Medicare HMO Signature* HMO $0 $5,500 $0
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Security Blue HMO-POS Basic* HMO-POS $37 $5,900 N/A
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Security Blue HMO-POS Deluxe* HMO-POS $178 $4,500 $0
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Security Blue HMO-POS Standard* HMO-POS $119 $5,000 $0
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Security Blue HMO-POS ValueRx* HMO-POS $17 $5,500 $0
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Aetna Medicare Advantra Credit Value* PPO $0 $7,500 $590
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Aetna Medicare Advantra Eagle* HMO-POS $0 $5,500 N/A
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Aetna Medicare Advantra Gold* HMO-POS $19 $4,900 $590
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Aetna Medicare Advantra Silver* HMO-POS $0 $5,500 $0
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Aetna Medicare Gold* PPO $142 $7,500 $590
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Aetna Medicare Value* PPO $0 $5,500 $590
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Aetna Medicare Value Plus* PPO $13 $5,900 $590
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Complete Blue PPO Choice* PPO $0 $6,500 $0
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Complete Blue PPO Choice Deluxe* PPO $6 $6,500 $0
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Complete Blue PPO Distinct* PPO $12 $5,500 $0
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Complete Blue PPO Merit* PPO $0 $7,950 $550
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Complete Blue PPO Premier* PPO $49 $4,500 $0
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Complete Blue PPO Signature* PPO $0 $6,500 $0
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Freedom Blue PPO Classic* PPO $224 $4,500 $0
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Freedom Blue PPO Select* PPO $96 $5,000 $0
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Freedom Blue PPO Valor* PPO $0 $6,000 N/A
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Freedom Blue PPO ValueRx* PPO $42 $5,500 $0
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Geisinger Gold Classic Advantage Rx* HMO $98 $3,450 $0
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Geisinger Gold Classic Complete Rx* HMO $39 $4,400 $0
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Geisinger Gold Classic Essential Rx* HMO $0 $7,550 $0
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Geisinger Gold Heritage* HMO $0 $6,700 N/A
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Geisinger Gold Preferred Advantage Rx* PPO $97 $4,000 $0
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Geisinger Gold Preferred Complete Rx* PPO $0 $8,000 $0
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Geisinger Gold Preferred Enhanced Rx* PPO $76 $7,550 $0
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Geisinger Gold Value Rx* HMO $23 $8,850 $0
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UPMC for Life HMO Deductible Rx* HMO $22 $6,000 $175
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UPMC for Life HMO No Rx* HMO $0 $5,000 N/A
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UPMC for Life HMO Premier Rx* HMO $0 $6,000 $350
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UPMC for Life HMO Rx* HMO $97 $4,500 $0
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UPMC for Life HMO Rx Choice* HMO $35 $6,000 $175
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UPMC for Life HMO Rx Enhanced* HMO $295 $7,550 $0
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UPMC for Life PPO Essential Care Rx* PPO $0 $8,000 $350
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UPMC for Life PPO High Deductible Rx* PPO $33 $7,550 $175
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UPMC for Life PPO Premier Rx* PPO $0 $6,500 $350
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UPMC for Life PPO Rx Choice* PPO $21 $6,000 $175
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UPMC for Life PPO Rx Enhanced* PPO $140 $7,550 $0
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UPMC for Life PPO Salute* PPO $0 $6,750 N/A
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AARP Medicare Advantage from UHC PA-0002 HMO-POS $0 $6,700 $340
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AARP Medicare Advantage from UHC PA-0003 HMO-POS $26 $5,900 $255
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AARP Medicare Advantage from UHC PA-0011 PPO $0 $6,700 $420
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AARP Medicare Advantage from UHC PA-0014 PPO $31 $5,900 $255
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AARP Medicare Advantage Giveback from UHC PA-12 PPO $0 $8,900 $495
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AARP Medicare Advantage Patriot No Rx PA-MA01 HMO-POS $0 $6,700 N/A
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Humana Gold Choice H8145-163 PFFS $108 $1,500 N/A
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Humana USAA Honor Giveback PPO $0 $6,700 N/A
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Humana USAA Honor Giveback with Rx PPO $0 $7,850 $300
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HumanaChoice Giveback H5216-116 PPO $0 $4,150 N/A
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HumanaChoice Giveback H5525-058 PPO $0 $7,500 $225
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HumanaChoice H5216-120 PPO $105 $7,600 $300
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HumanaChoice H5525-017 PPO $26 $6,300 $300
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HumanaChoice H5525-051 PPO $0 $7,500 $300
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HumanaChoice R0110-007 Regional PPO $0 $4,500 N/A
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HumanaChoice R0110-008 Regional PPO $63 $6,700 $0
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Wellcare Assist HMO $30 $5,200 $490
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Wellcare Patriot Giveback HMO $0 $7,550 N/A
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Wellcare Simple HMO $0 $5,900 $420
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Wellcare Simple HMO $0 $5,900 $420
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Wellcare Giveback Open PPO $0 $7,550 $420
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Wellcare Simple Open PPO $0 $6,700 $420
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Devoted CHOICE GIVEBACK Pennsylvania PPO $0 $9,350 $590
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Devoted CHOICE Pennsylvania PPO $0 $7,000 $590
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**Certain PFFS, MSA, and HMO-POS plans have a combined in and out-of-network maximum. Limits are detailed on the plan pages.

Understanding Your Medicare Advantage Options

Medicare Advantage Plans, also known as Medicare Part C, are private health plans that provide all-in-one coverage, including Medicare Part A (hospital insurance) and Medicare Part B (medical insurance). On top of the core benefits, many of the plans in Somerset County throw in some nice extras - think prescription drug coverage, dental, vision, and wellness programs - making them a solid choice for those in Mohave County looking for something more than Original Medicare.

  • Health Maintenance Organization (HMO): Members must use the plan's network of doctors and hospitals in Somerset County, and typically need a referral to see a specialist. Some Medicare Advantage HMO Plans may have lower costs but offer less flexibility in choosing healthcare providers.
  • Preferred Provider Organization (PPO): Offers more provider flexibility, allowing members to see any doctor or specialist without a referral, often at a higher cost. Medicare Advantage PPO Plans generally have higher premiums and out-of-pocket expenses compared to HMOs.
  • Private Fee-for-Service (PFFS): Allows members to visit any Medicare-approved doctor or hospital in Somerset County that accepts the plan's payment terms. Medicare PFFS plans offer more flexibility but may result in higher costs.
  • Medicare Savings Account (MSA): Combines a high-deductible Medicare Advantage plan with a tax-advantaged savings account. The plan deposits money into the account each year, which you can use for healthcare expenses before your deductible is met. MSAs offer control over healthcare spending, with the potential to save on future costs if the savings account funds are not fully used.

Another option you might encounter is the HMO-POS plan, a type of Medicare Advantage plan that provides more flexibility compared to a standard HMO. While it still requires members to use a network of doctors and hospitals and typically requires referrals to see specialists, an HMO-POS plan stands out by allowing members to access certain healthcare services outside of the network, though at a higher cost.

If you qualify for Original Medicare or Medicare Advantage in Somerset County but don't know where to begin, we have licensed insurance agents[1] at 1-855-728-0510 (TTY 711) who can answer your questions (Mon-Fri: 8 am – 10 pm, and Sat-Sun: 8 am – 9 pm EST) and help you get enrolled. There's no obligation.

Advantages of Enrolling in Medicare Advantage

Enrolling in a Medicare Advantage Plan can offer significant benefits compared to Original Medicare. These plans provide all-in-one coverage, including hospital and medical insurance, and often come with added perks like drug coverage, dental care, and wellness programs. With a Medicare Advantage Plan, you can access a wider range of services while potentially reducing your overall healthcare costs.

Below are some of the key benefits you can enjoy in Somerset County with a Medicare Advantage Plan:

  • Coordinated Care: Plans often include care coordination services, which helps you manage your healthcare across different providers and services.
  • Cost Savings: Many plans have low or $0 premiums and offer capped out-of-pocket costs, providing financial protection against high medical expenses.
  • Comprehensive Coverage: Includes Medicare Part A, Part B, and often Part D (prescription drug coverage), along with additional benefits like dental, vision, and hearing.
  • Wellness Programs: Many Somerset County plans offer free gym memberships, wellness programs, and preventive care services. You need to stay healthy, right?

Tips for Selecting a Medicare Advantage Plan

Choosing the right Medicare Advantage Plan out of the 66 plans available in Somerset County requires careful consideration of several key factors:

  1. Provider Network: Verify that your current doctors and preferred hospitals are included in the plan's network. Access to your healthcare providers can significantly impact your care experience.
  2. Prescription Drug Coverage: Make sure the plan covers your medications, particularly if you have specific prescriptions you rely on regularly.
  3. Costs: Examine the plan's premiums, copayments, and out-of-pocket limits. Compare these costs against your budget to avoid unexpected expenses.
  4. Additional Benefits: Consider what extra services, such as dental, vision, or wellness programs, are important to you, and check if the plan offers them.
  5. Plan Ratings: Look into the plan's star ratings, which provide insight into the plan's overall quality and member satisfaction.

Learn more about the basics of comparing Medicare Advantage Plans.

Getting Enrolled in a Somerset County Medicare Advantage Plan: Know Your Enrollment Periods

Making sense of Medicare Advantage enrollment periods can seem overwhelming, but it's worth the effort for better health coverage. Missing these key dates could delay your coverage or limit your plan choices for 2025 in Somerset County.

  • Initial Enrollment Period (IEP): This is your first opportunity to enroll in a Medicare Advantage Plan when you first become eligible for Medicare. Your Initial Enrollment Period lasts for seven months, starting three months before your 65th birthday.
  • Annual Enrollment Period (AEP): Occurs every year from October 15 to December 7. During the Annual Enrollment Period, you can switch, drop, or join a Medicare Advantage Plan.
  • Open Enrollment Period (OEP): From January 1 to March 31, you can switch Medicare Advantage plans or return to Original Medicare if you’re already enrolled in a Medicare Advantage Plan.

For more detailed information on the enrollment periods and how to enroll, visit our comprehensive guide on Medicare Advantage Plan Enrollment.

Are you ready to enroll? Do you still have questions? Our licensed insurance agents are ready to help with no obligation. Call 1-855-728-0510 (TTY 711) for assistance, Mon-Fri 8am-9pm, Sat 9pm-8pm EST.

Plan Availability

The MA and MAPD plans on this page are available to people on Medicare enrolled in both Medicare Part A and Part B living in and all other areas of Somerset County, Pennsylvania.

Plans Offered

Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Baylor Scott & White Health Plan, Capital Blue Cross, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, GlobalHealth, Health Care Service Corporation, Healthy Blue, HealthSun, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.

Citations & References