Medicare Plans in
Allegheny County, PA

73 Medicare Advantage Plans Found in Allegheny County. See Plans

Allegheny County, PA
Medicare Information

For Allegheny County’s Medicare beneficiaries, private plans like Medicare Advantage plans offer an alternative to Original Medicare and Part D plans (PDP) can work alongside your Original Medicare benefits.

Currently, 73 private Medicare plans are available in Allegheny County, and coverage is provided through Medicare-approved private companies, following rules set by Medicare.

For Allegheny County’s Medicare beneficiaries, private plans like Medicare Advantage plans offer an alternative to Original Medicare, and Part D plans (PDP) can work alongside your Original Medicare benefits.

Currently, 73 private Medicare plans are available in Allegheny County, and coverage is provided through Medicare-approved private companies, following rules set by Medicare.

MA plans, which are also referred to as Medicare Part C, may offer additional benefits that aren't available through Original Medicare.

Part D plans, also referred to as PDPs, cover retail prescription drugs.

Some Medicare Part C plans include coverage for prescription medications. Known as Medicare Advantage Prescription Drug plans, or MAPDs, these plans offer comprehensive coverage for seniors who want to minimize their out-of-pocket costs.

Learn more about some of the Medicare plans in Allegheny County, Pennsylvania, including average costs, out-of-pocket expenses and what’s involved in obtaining prescription drug coverage.

Average Cost of Medicare
Plans in Allegheny County

Average Cost of Medicare Advantage Plans in Allegheny County, Pennsylvania
Average Monthly Premium	$69.72
Average in-network out-of-pocket spending limit	$6,143.77
Average drug deductible in 2023 (weighted)	$389.47
Percentage of plans rated 4 stars or higher	50.7%

Average Cost of Medicare Advantage Plans in Allegheny County, Pennsylvania
Average Monthly Premium $69.72
Average in-network out-of-pocket spending limit $6,143.77
Average drug deductible in 2021 (weighted) $389.47
Percentage of plans rated 4 stars or higher 50.7%

Learn More About Medicare
Prescription Drug Plans

Allegheny County Medicare beneficiaries who are interested in a private Medicare policy may choose among the following types of plans, depending on their needs and circumstances:

Plan Type	Description
HMO	HMO enrollees typically receive services through in-network providers and must obtain referrals for visits to specialists. However, most plans permit out-of-network care in emergencies or out-of-area dialysis. HMO plans often include prescription drug coverage.
PPO	Members of PPO plans can typically go in or out of network for care, including hospitalization, although visits to non-network providers may cost considerably more. Referrals are usually not needed for visits to specialists, and many PPO plans include prescription drug coverage.
PFFS	Private fee-for-service plans determine how much a doctor or facility will be paid for services, and members may seek care from any in or out-of-network provider that agrees to the plan's terms. Some PFFS plans include prescription drug coverage. Otherwise, members may seek coverage for medications through standalone Medicare drug plans, which are also known as Part D plans.
SNP	Special Needs Plans are designed for individuals with specific conditions or medical characteristics. Benefits such as providers and drug formularies are tailored to members' unique needs, and most care is provided by in-network physicians and facilities. SNPs are required to provide prescription drug coverage.

Plan Type and Description
HMO enrollees typically receive services through in-network providers and must obtain referrals for visits to specialists. However, most plans permit out-of-network care in emergencies or out-of-area dialysis. HMO plans often include prescription drug coverage.
Members of PPO plans can typically go in or out of network for care, including hospitalization, although visits to non-network providers may cost considerably more. Referrals are usually not needed for visits to specialists, and many PPO plans include prescription drug coverage.
Private fee-for-service plans determine how much a doctor or facility will be paid for services, and members may seek care from any in or out-of-network provider that agrees to the plan's terms. Some PFFS plans include prescription drug coverage. Otherwise, members may seek coverage for medications through standalone Medicare drug plans, which are also known as Part D plans.
Special Needs Plans are designed for individuals with specific conditions or medical characteristics. Benefits such as providers and drug formularies are tailored to members' unique needs, and most care is provided by in-network physicians and facilities. SNPs are required to provide prescription drug coverage.

Some beneficiaries may be eligible for standalone prescription drug plans. Otherwise known as a PDP or Part D plan, a standalone prescription drug plan adds coverage for prescription medications to Original Medicare and some PFFS plans. It’s important to note that some MA plans, such as HMOs, may disenroll members who sign up for a separate drug plan.

Medicare Advantage Plans

Aetna Inc. Medicare Plans in Allegheny County, PA

The following table includes cost information and other plan details for Aetna Inc. private Medicare plans available in Pennsylvania in 2023.