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, Medicare Advantage plans offer an alternative to Original Medicare. Currently, 73 MA 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.

For Allegheny County’s Medicare beneficiaries, Medicare Advantage plans offer an alternative to Original Medicare. Currently, 73 MA 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.

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 Medicare Advantage 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 Advantage
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 Advantage
Prescription Drug Plans

Allegheny County Medicare beneficiaries who are interested in a Part C 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.

In addition to these primary types of plans, some members 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.

Aetna Inc. Medicare Advantage Plans in Allegheny County, PA

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

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Plan Name Plan Code Monthly Premium Deductible Out of
Pocket Max
Prescription Drug Coverage Medicare
Star Rating
Aetna Medicare Value (PPO) H5521: 261 $0 $0 $6,400 Yes
3.5 out of 5
Aetna Medicare Advantra Silver (HMO-POS) H3959: 010 $0 $0 $5,900 Yes
4.5 out of 5
Aetna Medicare Advantra Cares (HMO D-SNP) H3959: 036 $0 $0 $8,300 Yes
4.5 out of 5
Aetna Medicare Advantra Eagle (HMO) H3959: 041 $0 N/A $4,000 No
4.5 out of 5
Aetna Medicare Advantra Credit Value (PPO) H5522: 017 $0 $0 $7,550 Yes
4.5 out of 5
Aetna Medicare Advantra Premier Plus (PPO) H5522: 001 $33 $0 $6,001 Yes
4.5 out of 5
Aetna Medicare Advantra Gold (HMO) H3959: 001 $35 $0 $5,500 Yes
4.5 out of 5
SilverScript Choice (PDP) S5601: 012 $40 $505 N/A Yes
3.5 out of 5
Aetna Medicare Silver (HMO) H3931: 070 $47 $0 $7,550 Yes
3.5 out of 5
SilverScript Plus (PDP) S5601: 013 $78 $0 N/A Yes
3.5 out of 5
Aetna Medicare Gold Plan (PPO) H5521: 122 $176 $0 $7,550 Yes
3.5 out of 5
Cigna

Cigna Medicare Advantage Plans in Allegheny County, PA

The following table includes cost information and other plan details for Cigna Medicare Advantage plans available in Pennsylvania in 2023.

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Plan Name Plan Code Monthly Premium Deductible Out of
Pocket Max
Prescription Drug Coverage Medicare
Star Rating
Cigna True Choice Medicare (PPO) H7849: 106 $0 $0 $6,100 Yes
3 out of 5
Cigna True Choice Savings Medicare (PPO) H7849: 111 $0 $0 $6,050 Yes
3 out of 5
Cigna TotalCare Plus (HMO D-SNP) H3949: 009 $0 $0 $0 Yes
3 out of 5
Cigna Preferred Medicare (HMO) H3949: 047 $0 $0 $4,600 Yes
3 out of 5
Cigna Preferred Plus Medicare (HMO) H3949: 048 $26 $0 $3,900 Yes
3 out of 5
Cigna True Choice Plus Medicare (PPO) H7849: 107 $27 $0 $5,500 Yes
3 out of 5
Cigna Extra Rx (PDP) S5617: 251 $58 $100 N/A Yes
3 out of 5

Highmark Health

Highmark Health Medicare Advantage Plans in Allegheny County, PA

The following table includes cost information and other plan details for Highmark Health Medicare Advantage plans available in Pennsylvania in 2023.

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Plan Name Plan Code Monthly Premium Deductible Out of
Pocket Max
Prescription Drug Coverage Medicare
Star Rating
Complete Blue PPO Signature (PPO) H3916: 041 $0 $0 $7,550 Yes
5 out of 5
Freedom Blue PPO Valor (PPO) H3916: 042 $0 N/A $6,000 No
5 out of 5
Community Blue Medicare HMO Signature (HMO) H3957: 047 $0 $0 N/A Yes
5 out of 5
Together Blue Medicare HMO Signature (HMO) H3957: 048 $0 $0 N/A Yes
5 out of 5
Complete Blue PPO Distinct (PPO) H3916: 035 $25 $0 $6,500 Yes
5 out of 5
Community Blue Medicare HMO Prestige (HMO) H3957: 039 $50 $0 N/A Yes
5 out of 5
Security Blue HMO-POS Basic (HMO-POS) H3957: 043 $50 N/A $5,900 No
5 out of 5
Security Blue HMO-POS ValueRx (HMO-POS) H3957: 031 $59 $0 $5,500 Yes
5 out of 5
Freedom Blue PPO ValueRx (PPO) H3916: 032 $71 $0 $5,500 Yes
5 out of 5
Freedom Blue PPO Select (PPO) H3916: 022 $166 $0 $5,000 Yes
5 out of 5
Security Blue HMO-POS Standard (HMO-POS) H3957: 045 $193 $0 $5,000 Yes
5 out of 5
Security Blue HMO-POS Deluxe (HMO-POS) H3957: 046 $256 $0 $4,500 Yes
5 out of 5
Freedom Blue PPO Classic (PPO) H3916: 001 $278 $0 $4,500 Yes
5 out of 5
Humana Inc.

Humana Inc. Medicare Advantage Plans in Allegheny County, PA

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

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Plan Name Plan Code Monthly Premium Deductible Out of
Pocket Max
Prescription Drug Coverage Medicare
Star Rating
HumanaChoice H5216-116 (PPO) H5216: 116 $0 N/A $3,900 No
4.5 out of 5
Humana Honor (PPO) H5216: 221 $0 N/A $6,700 No
4.5 out of 5
HumanaChoice SNP-DE H5216-227 (PPO D-SNP) H5216: 227 $0 $0 $0 Yes
4.5 out of 5
HumanaChoice H5525-051 (PPO) H5525: 051 $0 $0 $7,550 Yes
4 out of 5
HumanaChoice H5525-058 (PPO) H5525: 058 $0 $505 $7,550 Yes
4 out of 5
Humana USAA Honor with Rx (PPO) H5525: 059 $0 $250 $7,550 Yes
4 out of 5
HumanaChoice H5525-060 (PPO) H5525: 060 $0 $0 $7,550 Yes
4 out of 5
HumanaChoice R0923-001 (Regional PPO) R0923: 001 $0 N/A $4,500 No
4 out of 5
HumanaChoice H5525-017 (PPO) H5525: 017 $18 $0 $4,900 Yes
4 out of 5
Humana Walmart Value Rx Plan (PDP) S5884: 185 $31 $505 N/A Yes
3 out of 5
Humana Value Plus H5216-117 (PPO) H5216: 117 $41 $505 $7,000 Yes
4.5 out of 5
HumanaChoice R0923-002 (Regional PPO) R0923: 002 $71 $0 $6,700 Yes
4 out of 5
Humana Premier Rx Plan (PDP) S5884: 152 $88 $200 N/A Yes
3 out of 5
HumanaChoice H5216-120 (PPO) H5216: 120 $123 $0 $6,700 Yes
4.5 out of 5

Mutual of Omaha

Mutual of Omaha Medicare Advantage Plans in Allegheny County, PA

The following table includes cost information and other plan details for Mutual of Omaha Medicare Advantage plans available in Pennsylvania in 2023.

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Plan Name Plan Code Monthly Premium Deductible Out of
Pocket Max
Prescription Drug Coverage Medicare
Star Rating
Mutual of Omaha Rx Essential (PDP) S7126: 108 $20 $505 N/A Yes
2 out of 5
Mutual of Omaha Rx Premier (PDP) S7126: 075 $71 $505 N/A Yes
2 out of 5
Mutual of Omaha Rx Plus (PDP) S7126: 005 $91 $505 N/A Yes
2 out of 5
UnitedHealthcare

UnitedHealthcare Medicare Advantage Plans in Allegheny County, PA

The following table includes cost information and other plan details for UnitedHealthcare Medicare Advantage plans available in Pennsylvania in 2023.

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Plan Name Plan Code Monthly Premium Deductible Out of
Pocket Max
Prescription Drug Coverage Medicare
Star Rating
UnitedHealthcare Dual Complete Choice (PPO D-SNP) H1889: 007 $0 $0 $0 Yes
4 out of 5
AARP Medicare Advantage Flex Plan 1 (HMO-POS) H1944: 010 $0 $0 $5,900 Yes
4 out of 5
AARP Medicare Advantage Patriot (HMO-POS) H1944: 030 $0 N/A $5,500 No
4 out of 5
AARP Medicare Advantage Choice Plan 2 (PPO) H2577: 029 $0 $0 $6,900 Yes
3 out of 5
UnitedHealthcare Dual Complete (HMO-POS D-SNP) H3113: 009 $0 $0 $0 Yes
4 out of 5
UnitedHealthcare Dual Complete Select (HMO-POS D-SNP) H3113: 014 $0 $0 $0 Yes
4 out of 5
AARP MedicareRx Walgreens (PDP) S5921: 388 $33 $350 N/A Yes
3 out of 5
AARP Medicare Advantage Flex Plan 2 (HMO-POS) H1944: 011 $33 $0 $5,200 Yes
4 out of 5
AARP Medicare Advantage Choice Plan 1 (PPO) H2577: 021 $35 $0 $5,500 Yes
3 out of 5
AARP MedicareRx Saver Plus (PDP) S5921: 351 $37 $505 N/A Yes
3 out of 5
AARP MedicareRx Preferred (PDP) S5820: 005 $112 $0 N/A Yes
3.5 out of 5
WellCare Health Plans, Inc.

WellCare Health Plans, Inc. Medicare Advantage Plans in Allegheny County, PA

The following table includes cost information and other plan details for WellCare Health Plans, Inc. Medicare Advantage plans available in Pennsylvania in 2023.

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Plan Name Plan Code Monthly Premium Deductible Out of
Pocket Max
Prescription Drug Coverage Medicare
Star Rating
Wellcare No Premium Open (PPO) H2128: 002 $0 $160 $6,700 Yes
Plan too new to be measured
Wellcare Giveback Open (PPO) H2128: 004 $0 $350 $7,550 Yes
Plan too new to be measured
Wellcare Dual Access Open (PPO D-SNP) H2128: 005 $0 $0 $0 Yes
Plan too new to be measured
Wellcare Dual Access (HMO D-SNP) H2915: 002 $0 $0 $0 Yes
2.5 out of 5
Wellcare No Premium (HMO) H2915: 003 $0 $0 $6,700 Yes
2.5 out of 5
Wellcare Giveback (HMO) H2915: 012 $0 $0 $7,550 Yes
2.5 out of 5
Wellcare Patriot Giveback (HMO) H2915: 013 $0 N/A $7,550 No
2.5 out of 5
Wellcare Value Script (PDP) S4802: 141 $11 $505 N/A Yes
3 out of 5
Wellcare Assist (HMO) H2915: 011 $14 $445 $6,700 Yes
2.5 out of 5
Wellcare Assist Open (PPO) H2128: 001 $14 $395 $6,700 Yes
Plan too new to be measured
Wellcare Low Premium Open (PPO) H2128: 003 $29 $100 $5,000 Yes
Plan too new to be measured
Wellcare Classic (PDP) S4802: 080 $38 $505 N/A Yes
3 out of 5
Wellcare Medicare Rx Value Plus (PDP) S4802: 237 $71 $0 N/A Yes
3 out of 5
Wellcare Medicare Rx Value Plus (PDP) S4802: 209 $71 $0 N/A Yes
3 out of 5