Medicare Supplement plans, also known as Medigap, help pay for out‑of‑pocket costs that Original Medicare (Parts A and B) does not cover. These costs can include copayments, coinsurance, and deductibles after Medicare pays its share.
In Pennsylvania, Medigap plans are sold by private insurance companies but must follow federal and state rules to ensure the same basic benefits for the same lettered plan, no matter who sells it. Medigap plans work with Original Medicare and cannot be used with a Medicare Advantage plan.
Pennsylvania residents who turn 65 years old and enroll in Medicare Part B can purchase a Medigap policy during a six‑month Medigap Open Enrollment Period without medical underwriting.
If they buy a plan after this period, insurers can require health questions and charge higher premiums based on health history.
Calculate Your 2026 COLA Increase →How Do Medicare Supplement Plans Work in Pennsylvania
When you have a healthcare bill, Original Medicare pays first. Then your Medigap plan pays its share of the remaining costs, such as coinsurance and deductibles. All Medigap plans of the same letter offer the same core benefits, though premiums can vary by insurer and location.
Medigap plans do not cover prescription drugs, so Pennsylvanians often enroll in a separate Medicare Part D drug plan if they want drug coverage.
Pennsylvania offers 10 standardized Medigap plan types, labeled with letters like A, B, G, K, L, and N. Some older plans like C and F are only available to beneficiaries who were already enrolled before federal changes in 2020.
What Are the Most Common Medicare Supplement Plans in Pennsylvania
The most popular Medigap plan options in Pennsylvania for 2026 are Plan G and Plan N. Plan G is the most common choice for new enrollees because it covers almost all out‑of‑pocket costs except the Part B deductible.
Plan N is another strong option with lower premiums but some copayments for doctor and emergency visits. Plan F remains comprehensive but generally is not available to people who became eligible for Medicare on or after January 1, 2020.
Other plans, such as Plan A, B, D, K, and L, are available but cover fewer benefits or require higher cost‑sharing. Pennsylvania has dozens of insurers selling Medigap plans, allowing beneficiaries to compare prices and service quality before choosing.
What Do Medicare Supplement Plans Cover
Every Medigap plan in Pennsylvania is standardized. That means a Plan G policy from one company pays the same basic benefits as a Plan G policy from another. Plans help cover:
- Part A hospital coinsurance and hospital costs up to an extra 365 days after Medicare pays
- Part B coinsurance or copayment
- Blood (first three pints)
- Part A hospice care coinsurance
- Skilled nursing facility care coinsurance
- Part A deductible for most plans
- Foreign travel emergency care up to plan limits for certain plan types
Medigap plans do not cover dental, vision, hearing aids, routine care, or long‑term care. Prescription drugs must be purchased through a separate Part D plan.
How Much Do Medigap Plans Cost in Pennsylvania
Costs vary by plan type, insurer, age, gender, and ZIP code. According to recent data, average monthly premiums for Pennsylvania Medigap plans range widely.
For example, Plan G averages about $325 per month for a 65‑year‑old, while Plan N might average around $254, with variation by provider and location. Some plans like Plan K or L often have lower premiums but higher cost‑sharing when care is needed.
Insurers such as State Farm, AARP/UnitedHealthcare, HealthSpring (formerly Cigna), Mutual of Omaha, and Wellabe are among the top‑rated companies offering Medigap plans in Pennsylvania, based on pricing and complaint data.
These companies sell multiple plan types, and Pennsylvanians are encouraged to compare quotes before enrolling.
When Should You Buy a Medigap Plan
The best time to buy a Medicare Supplement plan is during your Medigap Open Enrollment Period. This starts the first month you both:
- Are age 65 or older
- Have Medicare Part B coverage
This six‑month period ensures guaranteed issue rights, meaning insurers must sell you a Medigap policy without medical underwriting and cannot charge higher premiums due to health conditions. If you miss this window, insurers can consider your health when setting your price or even deny coverage.
How to Compare Medigap Plans in Pennsylvania
Pennsylvanians can compare Medigap plans and costs using the official Plan Finder on Medicare’s website. This tool shows pricing in your ZIP code and helps you review the benefits of each plan type. Comparing multiple companies and policies can help you find the best coverage and cost balance.
Besides cost, compare insurer complaint rates, customer service quality, and premium increases over time. A plan that starts with a low premium might increase significantly as you age, especially if it is attained‑age rated rather than community‑rated.
Who Qualifies for Medigap in Pennsylvania
Generally, you must have Original Medicare Part A and Part B to buy a Medigap policy. You cannot have both a Medigap plan and a Medicare Advantage plan at the same time. If you already have Medicare Advantage, you must first return to Original Medicare before you can buy a Medigap policy.
Pennsylvanians who qualify due to disability or certain health conditions can also get Medigap, but specific eligibility rules can vary. Contact the Pennsylvania state health insurance assistance program, PA MEDI, for personalized help.
How to Enroll in a Medigap Plan in Pennsylvania
You enroll in a Medicare Supplement plan by contacting an insurance company or licensed agent directly or by using Medicare’s online comparison tools.
Enrollment typically requires proving your Medicare Part B coverage. During the initial six‑month enrollment period, insurers cannot refuse you coverage or charge more based on health status.
