Medicare in Pennsylvania
Free counseling, Medigap rules and help paying costs in Pennsylvania.
Medicare is a federal program, so Parts A and B work the same way in Pennsylvania as everywhere else. What changes by state is who can buy a Medicare Supplement (Medigap) policy and when, which private plans are sold where you live, and the state programs that help with costs.
Free Medicare counseling in Pennsylvania
Pennsylvania’s State Health Insurance Assistance Program (SHIP) is PA MEDI (Pennsylvania Medicare Education and Decision Insight). Its counselors give free, one-on-one help with enrollment, comparing plans, Medigap, and programs that lower costs. They don’t sell insurance. Read more about what a SHIP counselor can do.
Medigap if you’re under 65
Pennsylvania's Medigap open enrollment applies regardless of age, so people newly on Part B because of a disability or ESRD can buy any plan an insurer sells during the 6 months after Part B starts.
Federal law only guarantees a Medigap Open Enrollment Period to people 65 and older, so state law decides what’s available before then. See Medicare under 65 on disability.
Switching Medigap plans in Pennsylvania
Pennsylvania has no birthday or anniversary rule. Outside your 6-month Medigap Open Enrollment Period and the federal guaranteed issue situations, an insurer can generally ask health questions, charge more, or decline your application when you switch policies.
Every state also has the federal guaranteed issue rights, such as losing employer coverage or a Medicare Advantage plan leaving your area. See Medigap guaranteed issue rights and switching Medigap plans.
Help paying Medicare costs in Pennsylvania
Pennsylvania’s Medicaid program (Medical Assistance (MA, Pennsylvania Medicaid); HealthChoices managed care; Community HealthChoices (CHC) for older adults, people with disabilities and dual-eligibles) also runs the Medicare Savings Programs, which can pay your Part B premium and, for some people, deductibles and coinsurance. States may set limits higher than the federal minimums, so apply even if your income is a little over them. Qualifying for one also gets you Extra Help with drug costs automatically.
Pennsylvania also has a state pharmaceutical assistance program: PACE and PACENET. Ask the SHIP whether you qualify.
If you qualify for both Medicare and full Medical Assistance (MA, Pennsylvania Medicaid); HealthChoices managed care; Community HealthChoices (CHC) for older adults, people with disabilities and dual-eligibles coverage, read Medicare and Medicaid together.
Medicare Advantage and Part D plans in Pennsylvania
Medicare Advantage and Part D plans are sold by county, so the plans, premiums and networks available in one part of Pennsylvania can differ from another. The Medicare Plan Finder lists every plan for your ZIP code. You can change plans during Medicare Open Enrollment, October 15 to December 7.
Common questions
Pennsylvania's State Health Insurance Assistance Program is PA MEDI (Pennsylvania Medicare Education and Decision Insight), reachable at 1-800-783-7067. SHIP counselors give free, unbiased Medicare help and don't sell insurance.
Pennsylvania's Medigap open enrollment applies regardless of age, so people newly on Part B because of a disability or ESRD can buy any plan an insurer sells during the 6 months after Part B starts.
Pennsylvania has no birthday or anniversary rule. Outside your Medigap Open Enrollment Period and federal guaranteed issue situations, insurers in Pennsylvania can generally use medical underwriting when you apply to switch.
Original Medicare's rules, premiums and deductibles are the same in every state (the standard Part B premium is $202.90 a month in 2026). What varies is which Medicare Advantage and Part D plans are sold in your county, state Medigap rules, and state programs that help pay costs.
Want help with your own choices?
Every state runs a State Health Insurance Assistance Program (SHIP) with trained counselors who give free, unbiased Medicare help and do not sell plans. Find yours on our Medicare by state pages, or call Medicare at 1-800-MEDICARE (1-800-633-4227) (TTY 1-877-486-2048, 24 hours a day, 7 days a week).
Planning the rest of your coverage in retirement? We can help with life insurance later in life and final expense coverage.
Sources
- PA MEDI (Pennsylvania Medicare Education and Decision Insight), pa.gov. Checked September 29, 2026.
- State Medigap Rules: Birthday Rule and Coverage for Under 65 (as of May 11, 2026), National Association of Insurance Commissioners. Checked September 29, 2026.
- Medigap rules and consumer protections, pa.gov. Checked September 29, 2026.
- Medigap rules and consumer protections, pacodeandbulletin.gov. Checked September 29, 2026.
- Medigap rules and consumer protections, pa.gov. Checked September 29, 2026.
- Medigap rules and consumer protections, pa.gov. Checked September 29, 2026.
- Medigap rules and consumer protections, pa.gov. Checked September 29, 2026.
- Pennsylvania Insurance Department, pa.gov. Checked September 29, 2026.
- Choosing a Medigap Policy (March 2026), Centers for Medicare & Medicaid Services. Checked September 29, 2026.
- Medicare Savings Programs, Medicare.gov. Checked September 29, 2026.
General information about the federal Medicare program, not advice about your situation. Figures are for 2026 unless stated and change every year; last reviewed September 29, 2026. Quote My Policy is a private company. Not connected with or endorsed by the United States government or the federal Medicare program.
Quote My Policy does not sell Medicare plans on this site. For plan-specific help, contact Medicare at 1-800-MEDICARE (1-800-633-4227) (TTY 1-877-486-2048, 24 hours a day, 7 days a week) or your State Health Insurance Assistance Program.