Medicare Plans in
Allegheny County, PA

62 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, 62 private Medicare plans are available in Allegheny County, and coverage is provided through Medicare-approved private companies, following rules set by Medicare.

HelpAdvisor Editorial Team analysis of data from the 2024 MA Landscape Source Files and carrier-provided plan data supplied by SunFire, Inc., a private company that creates software solutions for agents and brokers to compare Medicare plans. For more information, visit www.sunfireinc.com.

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, 62 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.

The following is HelpAdvisor Editorial Team analysis of data from the 2024 MA Landscape Source Files as well as carrier-provided plan data supplied by SunFire Inc.

Average Cost of Medicare
Plans in Allegheny County

Average Cost of Medicare Advantage Plans in Allegheny County, Pennsylvania
Average Monthly Premium $72.65
Average in-network out-of-pocket spending limit $6,343.44
Average drug deductible in 2024 (weighted) $378.00
Percentage of plans rated 4 stars or higher 66.1%
Average Cost of Medicare Advantage Plans in Allegheny County, Pennsylvania
Average Monthly Premium
$72.65
Average in-network out-of-pocket spending limit
$6,343.44
Average drug deductible in 2021 (weighted)
$378.00
Percentage of plans rated 4 stars or higher
66.1%

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.

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 2024.

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Plan Name Plan Code Monthly Premium Deductible Out of
Pocket Max
Prescription Drug Coverage Medicare
Star Rating
Aetna Medicare Advantra Credit Value (PPO) H5522: 017 $0 $0 $7,550 Yes
4.5 out of 5
Aetna Medicare Value (PPO) H5521: 261 $0 $0 $6,400 Yes
4 out of 5
Aetna Medicare Advantra Silver (HMO-POS) H3959: 010 $0 $0 $5,500 Yes
4.5 out of 5
Aetna Medicare Advantra Cares (HMO D-SNP) H3959: 036 $0 $0 $8,850 Yes
4.5 out of 5
Aetna Medicare Advantra Eagle (HMO-POS) H3959: 041 $0 N/A $3,900 No
4.5 out of 5
Aetna Medicare Advantra Gold (HMO-POS) H3959: 001 $23 $0 $5,500 Yes
4.5 out of 5
Aetna Medicare Value Plus (PPO) H5522: 001 $29 $0 $5,500 Yes
4.5 out of 5
Aetna Medicare Silver (HMO-POS) H3931: 070 $37 $250 $7,550 Yes
4 out of 5
Aetna Medicare Gold Plan (PPO) H5521: 122 $145 $250 $7,550 Yes
4 out of 5

Centene Corporation

Centene Corporation Medicare Plans in Allegheny County, PA

The following table includes cost information and other plan details for Centene Corporation private Medicare plans available in Pennsylvania in 2024.

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Plan Name Plan Code Monthly Premium Deductible Out of
Pocket Max
Prescription Drug Coverage Medicare
Star Rating
Wellcare No Premium (HMO) H2915: 003 $0 $0 $6,700 Yes
3.5 out of 5
Wellcare Dual Access (HMO D-SNP) H2915: 002 $0 $0 $8,850 Yes
3.5 out of 5
Wellcare Patriot Giveback (HMO) H2915: 013 $0 N/A $7,550 No
3.5 out of 5
Wellcare Dual Access Open (PPO D-SNP) H2128: 005 $0 $0 $8,850 Yes
2.5 out of 5
Wellcare Giveback Open (PPO) H2128: 004 $0 $545 $7,550 Yes
2.5 out of 5
Wellcare No Premium Open (PPO) H2128: 002 $0 $160 $6,700 Yes
2.5 out of 5
Wellcare No Premium (HMO) H2915: 016 $0 $0 $7,000 Yes
3.5 out of 5
Wellcare Assist (HMO) H2915: 011 $21 $435 $7,550 Yes
3.5 out of 5
Cigna

Cigna Medicare Plans in Allegheny County, PA

The following table includes cost information and other plan details for Cigna private Medicare plans available in Pennsylvania in 2024.

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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 $6,400 Yes
3 out of 5
Cigna True Choice Savings Medicare (PPO) H7849: 111 $0 $0 $6,400 Yes
3 out of 5
Cigna Preferred Medicare (HMO) H3949: 047 $0 $0 $5,500 Yes
3.5 out of 5
Cigna True Choice Courage Medicare (PPO) H7787: 002 $0 N/A $5,700 No
3 out of 5
Cigna TotalCare Plus (HMO D-SNP) H3949: 009 $0 $0 $8,850 Yes
3.5 out of 5
Cigna Preferred Plus Medicare (HMO) H3949: 048 $20 $0 $4,200 Yes
3.5 out of 5
Cigna True Choice Plus Medicare (PPO) H7849: 107 $27 $0 $5,500 Yes
3 out of 5

Highmark Health

Highmark Health Medicare Plans in Allegheny County, PA

The following table includes cost information and other plan details for Highmark Health private Medicare plans available in Pennsylvania in 2024.

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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 $6,500 Yes
4.5 out of 5
Together Blue Medicare HMO Signature (HMO) H3957: 048 $0 $0 $5,900 Yes
5 out of 5
Freedom Blue PPO Valor (PPO) H3916: 042 $0 N/A $6,000 No
4.5 out of 5
Community Blue Medicare HMO Signature (HMO) H3957: 047 $0 $0 $6,200 Yes
5 out of 5
Complete Blue PPO Distinct (PPO) H3916: 035 $27 $0 $5,500 Yes
4.5 out of 5
Community Blue Medicare HMO Prestige (HMO) H3957: 039 $41 $0 $5,500 Yes
5 out of 5
Complete Blue PPO Premier (PPO) H3916: 044 $46 $0 $4,900 Yes
4.5 out of 5
Security Blue HMO-POS ValueRx (HMO-POS) H3957: 031 $48 $0 $5,500 Yes
5 out of 5
Security Blue HMO-POS Basic (HMO-POS) H3957: 043 $48 N/A $5,900 No
5 out of 5
Freedom Blue PPO ValueRx (PPO) H3916: 032 $64 $0 $5,500 Yes
4.5 out of 5
Freedom Blue PPO Select (PPO) H3916: 022 $158 $0 $5,000 Yes
4.5 out of 5
Security Blue HMO-POS Standard (HMO-POS) H3957: 045 $182 $0 $5,000 Yes
5 out of 5
Security Blue HMO-POS Deluxe (HMO-POS) H3957: 046 $245 $0 $4,500 Yes
5 out of 5
Freedom Blue PPO Classic (PPO) H3916: 001 $271 $0 $4,500 Yes
4.5 out of 5
Humana Inc.

Humana Inc. Medicare Plans in Allegheny County, PA

The following table includes cost information and other plan details for Humana Inc. private Medicare plans available in Pennsylvania in 2024.

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Plan Name Plan Code Monthly Premium Deductible Out of
Pocket Max
Prescription Drug Coverage Medicare
Star Rating
HumanaChoice H5525-051 (PPO) H5525: 051 $0 $0 $7,800 Yes
4 out of 5
HumanaChoice H5525-058 (PPO) H5525: 058 $0 $505 $7,000 Yes
4 out of 5
Humana USAA Honor with Rx (PPO) H5525: 059 $0 $250 $7,850 Yes
4 out of 5
HumanaChoice R0923-001 (Regional PPO) R0923: 001 $0 N/A $4,500 No
4 out of 5
HumanaChoice H5216-116 (PPO) H5216: 116 $0 N/A $3,900 No
4.5 out of 5
Humana USAA 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 $8,850 Yes
4.5 out of 5
HumanaChoice H5525-060 (PPO) H5525: 060 $0 $0 $8,050 Yes
4 out of 5
HumanaChoice H5525-017 (PPO) H5525: 017 $26 $0 $6,300 Yes
4 out of 5
Humana Value Plus H5216-117 (PPO) H5216: 117 $40 $545 $7,800 Yes
4.5 out of 5
HumanaChoice R0923-002 (Regional PPO) R0923: 002 $46 $0 $6,700 Yes
4 out of 5
Humana Gold Choice H8145-163 (PFFS) H8145: 163 $75 N/A N/A No
4 out of 5
HumanaChoice H5216-120 (PPO) H5216: 120 $123 $0 $7,600 Yes
4.5 out of 5
UnitedHealthcare

UnitedHealthcare Medicare Plans in Allegheny County, PA

The following table includes cost information and other plan details for UnitedHealthcare private Medicare plans available in Pennsylvania in 2024.

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Plan Name Plan Code Monthly Premium Deductible Out of
Pocket Max
Prescription Drug Coverage Medicare
Star Rating
UHC Dual Complete PA-S002 (HMO-POS D-SNP) H3113: 009 $0 $0 $8,850 Yes
3.5 out of 5
AARP Medicare Advantage from UHC PA-0002 (HMO-POS) H1944: 010 $0 $0 $5,900 Yes
3.5 out of 5
UHC Dual Complete PA-V001 (HMO-POS D-SNP) H3113: 014 $0 $0 $6,700 Yes
3.5 out of 5
UHC Dual Complete PA-S001 (PPO D-SNP) H1889: 007 $0 $0 $8,850 Yes
4.5 out of 5
AARP Medicare Advantage from UHC PA-0012 (PPO) H2406: 101 $0 $295 $8,300 Yes
4 out of 5
AARP Medicare Advantage Patriot No Rx PA-MA01 (HMO-POS) H1944: 030 $0 N/A $6,700 No
3.5 out of 5
AARP Medicare Advantage from UHC PA-0017 (PPO) H2406: 117 $0 $0 $6,500 Yes
4 out of 5
UHC Nursing Home Plan EX-F002 (PPO I-SNP) H0710: 017 $32 $545 $1,800 Yes
5 out of 5
UHC Care Advantage PA-E001 (PPO I-SNP) H0710: 067 $36 $0 $1,600 Yes
5 out of 5
AARP Medicare Advantage from UHC PA-0003 (HMO-POS) H1944: 011 $39 $0 $5,200 Yes
3.5 out of 5
AARP Medicare Advantage from UHC PA-0014 (PPO) H2577: 021 $40 $0 $5,500 Yes
3.5 out of 5