Medicare by State
Medicare Advantage Plans Pennsylvania 2027: 338 Plans, Medigap Rights and PACENET
Pennsylvania gains Medicare Advantage plans for 2027: CMS counts 338, up from 332, and the average premium dips from $21.75 to $20.07. The state’s Medigap window applies at any age, and PACE and PACENET can cut drug costs.
- Pennsylvania has 338 Medicare Advantage plans for 2027, up from 332 in 2026, per CMS.
- The average Pennsylvania Medicare Advantage premium falls from $21.75 to $20.07 a month.
- 31 Pa. Code § 89.778 ties Medigap open enrollment to your first six months of Part B, without regard to age.
- PACENET covers singles with income from $14,501 to $33,500, and PA MEDI gives free counseling at 1-800-783-7067.
Table of Contents
Medicare Advantage plans Pennsylvania residents can join for 2027 are moving against the national trend in one way: there are more of them. CMS counts 338 plans for 2027, up from 332, while the average premium dips from $21.75 to $20.07. Pennsylvania also has two features that change how you should shop: a Medigap open enrollment rule that applies at any age, and the state’s PACE and PACENET drug programs. This guide explains both, using CMS and Commonwealth sources.
Medicare Advantage plans Pennsylvania: the 2027 numbers
CMS published a Pennsylvania fact sheet on September 28, 2026. It says 3,037,586 people in Pennsylvania are enrolled in Medicare. Here are its figures:
| Measure (Pennsylvania) | 2026 | 2027 |
|---|---|---|
| Medicare Advantage plans available | 332 | 338 |
| Average monthly Medicare Advantage premium | $21.75 | $20.07 |
| Lowest monthly Medicare Advantage premium | — | $0 |
| People with access to a $0-premium plan | — | 100% |
| Stand-alone Part D drug plans | — | 8 |
| Lowest stand-alone Part D premium | — | $5.30 |
| Stand-alone Part D enrollees who get Extra Help | — | 22.01% |
A dash means the fact sheet gives no 2026 figure. Figures are from the CMS Pennsylvania fact sheet as of September 28, 2026, and are shown for illustration only. They are not quotes or offers, and they can change. Confirm current numbers with Medicare Plan Finder, PA MEDI or a licensed agent.
What the numbers mean
- Six more plans. Pennsylvania gains plans (332 to 338) while CMS projects the national count to slip from 5,553 to about 5,532.
- A higher-than-average premium. Pennsylvania’s $20.07 average is above the national figure, which CMS projects will fall from $14.37 to $12.00, per its 2027 press release. An average that high means some Pennsylvania plans charge a premium, even though $0 plans are available to everyone.
- Cheaper drug plans for everyone in one. The fact sheet says 100% of people in a Pennsylvania stand-alone drug plan can find one with a lower premium than in 2026, from a choice of eight plans.
More choice still means more homework. The Medicare Advantage plans Pennsylvania offers differ by county, network and out-of-pocket limit, and a $0 premium still leaves the Part B premium ($202.90 a month in 2026, per CMS) and copays.
If your Pennsylvania plan is not renewing for 2027
A rising statewide count doesn’t mean every plan returns. Some Medicare Advantage plans Pennsylvania members had in 2026 may have sent non-renewal letters this fall. If you got one, Medicare.gov says you can switch between December 8 and the last day of February. If you don’t choose, you go to Original Medicare when the plan ends. Choose by December 31 to avoid a gap in drug coverage. Our guide on what to do when a Medicare Advantage plan is not renewing has the full timeline.
You also get a federal Medigap right. When a Medicare Advantage plan leaves Medicare or your area, Medicare.gov says you can buy any Medigap policy sold in your state. Apply as early as 60 days before coverage ends and no later than 63 days after.
Medigap open enrollment in Pennsylvania, at any age
Pennsylvania’s Medigap open enrollment rule is 31 Pa. Code § 89.778. It says an issuer may not deny or condition a Medigap policy, or discriminate in its price because of health status, claims experience or medical condition, if you apply during the six months beginning with the first day of the first month you are enrolled in Part B.
Two details make Medigap open enrollment in Pennsylvania broader than the federal version:
- No age 65 requirement. The rule ties the window to Part B and requires each policy to be available “without regard to age.” People under 65 with Medicare because of a disability or ESRD get the same six months.
- Preexisting conditions. With at least six months of continuous creditable coverage, the issuer may not exclude benefits for a preexisting condition.
If you join one of the Medicare Advantage plans Pennsylvania carriers sell during your first six months of Part B, that window keeps running, so a quick change of mind can still land you in Medigap without health questions.
The rule doesn’t say an issuer must charge under-65 buyers the same price as 65-year-olds, so ask each company. After the window, outside federal guaranteed issue situations, a Pennsylvania insurer may use underwriting; our underwriting guide explains it. Section 89.778 contains no birthday or anniversary rule. Our birthday rule guide lists the states that have one. The Medicare section of our Pennsylvania life insurance guide covers the under-65 rule too.
PACE and PACENET: Pennsylvania help with drug costs
PACE and PACENET are Pennsylvania’s prescription assistance programs for older adults. The Department of Aging’s PACE page says they work with Medicare Part D plans and Medicare Advantage HMO and PPO plans to lower what you pay for medicine. To qualify you must be 65 or older and a Pennsylvania resident for at least 90 days before you apply, with income limits based on the previous calendar year:
| Program | Single person | Married couple |
|---|---|---|
| PACE | $14,500 or less | $17,700 or less |
| PACENET | $14,501 to $33,500 | $17,701 to $41,500 |
Limits are as published by the Pennsylvania Department of Aging and are shown for illustration only; confirm them at 1-800-225-7223. If you qualify for PACE and PACENET, ask how your chosen plan’s drug coverage coordinates with it before you enroll. With 22.01% of Pennsylvania stand-alone drug plan members getting Extra Help, check that too.
How to compare Medicare Advantage plans Pennsylvania offers
Open Enrollment runs October 15 to December 7, 2026, and coverage starts January 1, 2027, per CMS. PA MEDI says the Medicare Advantage Open Enrollment Period, January 1 to March 31, allows one switch between plans or a return to Original Medicare.
- Bring your list. PA MEDI suggests bringing your Medicare card, a list of your providers and a list of your medicines to enrollment help.
- Use Medicare Plan Finder. Sort by estimated total yearly cost, not premium.
- Check networks for 2027. PA MEDI notes that plans vary by company and location and generally require in-network doctors.
- Compare out-of-pocket limits and star ratings. CMS posted 2027 star ratings on or around October 8, 2026.
- Price Original Medicare too. If you are still in your Part B window, Medigap can be bought without health questions.
A plan with a premium is not automatically better than a $0 plan. Among the Medicare Advantage plans Pennsylvania offers, compare what each charges for the care you actually use: specialist visits, a hospital stay, and your drugs. Then add the premium. Our Medicare enrollment calculator maps your windows, and our IRMAA calculator estimates income-based surcharges. For plan types, read our Medicare Part C guide.
Hypothetical example: a Pennsylvania couple and PACENET
Hypothetical example. Joan and Walt, both 72, live in Allentown. Their combined income last year was $40,000, which falls inside the PACENET range for a married couple ($17,701 to $41,500).
- If each picks a plan priced at the 2027 Pennsylvania average of $20.07, they pay $20.07 x 12 x 2 = $481.68 a year in plan premiums.
- At the 2026 average of $21.75, the same math is $21.75 x 12 x 2 = $522.00.
- The difference is $522.00 − $481.68 = $40.32 a year.
Their Part B premiums add $202.90 x 12 x 2 = $4,869.60 at the 2026 rate. PACENET could then lower their prescription costs. Averages are not prices for a real plan, so Joan and Walt still need Plan Finder. This is an illustration, not a quote or an eligibility decision.
PA MEDI Medicare counseling and other free help
Pennsylvania’s State Health Insurance Assistance Program is PA MEDI (Pennsylvania Medicare Education and Decision Insight), run by the Department of Aging through 52 local Area Agencies on Aging. PA MEDI Medicare counseling is free and confidential, and the program says it does not sell or recommend insurance products, agents or brokers.
- PA MEDI Helpline: 1-800-783-7067, Monday to Friday, 8 a.m. to 5 p.m.
- PACE/PACENET: 1-800-225-7223.
- Pennsylvania Senior Medicare Patrol: 800-356-3606, to report suspected fraud.
- Medicare: 1-800-633-4227, 24 hours a day.
A licensed agent can enroll you in a plan and is paid by the insurance company. PA MEDI Medicare counseling gives you a neutral second opinion.
Checklist before you choose for 2027
Use this with any of the Medicare Advantage plans Pennsylvania carriers sell:
- Read your Annual Notice of Change or non-renewal letter.
- If your plan is ending, choose by December 31.
- Confirm doctors and hospitals for 2027, by phone.
- Check your drugs on the 2027 formulary.
- Compare the premium and the out-of-pocket limit together.
- Check your income against PACE and PACENET limits.
- Note the end of your six-month Part B Medigap window, at any age.
- Keep your enrollment confirmation and new ID card.
Medicare Advantage plans Pennsylvania: frequently asked questions
How many Medicare Advantage plans are there in Pennsylvania for 2027?
CMS counts 338 plans for 2027, up from 332 in 2026. Your county has fewer; Plan Finder shows the list by ZIP code.
What is the average premium in Pennsylvania?
CMS reports $20.07 a month for 2027, down from $21.75. Everyone has access to at least one $0-premium plan.
Can I buy Medigap in Pennsylvania if I’m under 65?
Yes. 31 Pa. Code § 89.778 ties Medigap open enrollment in Pennsylvania to your first six months of Part B and requires policies to be available without regard to age.
Does PACENET work with Medicare Advantage?
The Department of Aging says PACE and PACENET work with Part D plans and Medicare Advantage HMO and PPO plans to lower medication costs.
Does Pennsylvania have a Medigap birthday rule?
Not in § 89.778. Use your Part B window or a federal guaranteed issue right.
Who gives free Medicare help in Pennsylvania?
PA MEDI, through the Department of Aging. Call 1-800-783-7067.
Compare your options with a licensed agent
Octans Insurance is an independent agency based in Massachusetts. Our licensed agents work with 120+ carriers and can compare the Medicare Advantage plans Pennsylvania carriers offer in your county with Medigap options, at no fee to you. Call (617) 935-9220. For free, unbiased counseling, you can also call PA MEDI at 1-800-783-7067 or 1-800-MEDICARE.
Keep Reading: Related Guides
- Life insurance in Pennsylvania
- Medicare Part C
- Medicare Advantage plan not renewing
- Medicare enrollment calculator
- Free Medicare help in Pennsylvania
- Pennsylvania Medicaid burial rules
- Unclaimed life insurance in Pennsylvania
We do not offer every plan available in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
This article is for general information and is not tax, legal, or medical advice.
About examples and tools: Hypothetical examples, sample rates, calculators and quizzes on this site are for general educational and illustrative purposes only. They are not quotes, offers of coverage, or guarantees of eligibility, approval, price or benefits, and they are not legal, tax, financial or medical advice. The insurance company decides eligibility and price; Medicare rules are set by CMS and the Social Security Administration. Octans Insurance is not connected with or endorsed by the U.S. government or the federal Medicare program.
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