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More than 2.7 million Pennsylvania residents receive Medicare benefits. That’s approximately 21% of the state’s population who are enrolled in some form of Medicare. HealthMarkets can help you learn about Medicare eligibility in Pennsylvania to access the coverage you need.

Am I Eligible for Medicare in Pennsylvania?

Medicare eligibility applies to:

  • People aged 65 and older.
  • People under 65 with certain disabilities.
  • People who have been diagnosed with End-Stage Renal Disease (ESRD).
  • People who receive regular dialysis treatments or who had a kidney transplant.
  • People who have Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s disease.
  • People who are eligible for and/or receive Social Security or Railroad Retirement Board benefits.

Understanding Medicare

There are four parts to Medicare in Pennsylvania:

Part A – This is hospital insurance, and it generally covers inpatient hospital care, skilled nursing facilities (not custodial or long-term care) and hospice care.

Part B – Also known as medical insurance, this covers regular doctor appointments and visits to specialists. Parts A and B together are known as Original Medicare.

Part CMedicare Advantage allows enrollees to receive healthcare coverage through a private insurance company. Medicare Advantage bundles Part A and Part B coverage into a single plan, and it is an alternative to Original Medicare. Plans often include prescription drug coverage, plus other benefits such as vision and dental. Nearly 1.1 million Pennsylvania residents are enrolled in Medicare Advantage. 

Part D– This is prescription drug coverage, which is sold through private insurance companies.You can add a standalone drug plan to Original Medicare if you have Part A and/or Part B. Based on your Medicare eligibility in Pennsylvania, you may be able to get help with your prescription drug costs.

Another option Pennsylvanians have is Medicare Supplement, also known as Medigap. Plans are generally used to help pay your Original Medicare Part A and Part B out-of-pocket costs, such as your deductibles, copays, and coinsurance. You can get Medicare Supplement plans in Pennsylvania in one of 10 standardized options. 

Get Help With Medicare Eligibility in Pennsylvania

HealthMarkets can help you learn more about the various Medicare options that are available.

In 2019, more than half of Pennsylvania applicants who applied qualified for Extra Help, which helps you pay less for prescription drug coverage. Find out if you qualify.

HealthMarkets can help you assess your Medicare eligibility in Pennsylvania, while comparing Medicare plans and enrolling online.


HMIA008135 4-2020

References:
https://www.kff.org/medicare/state-indicator/total-medicare-beneficiaries/ | https://www.kff.org/medicare/state-indicator/medicare-beneficiaries-as-of-total-pop/ | https://www.medicare.gov/sign-up-change-plans/how-do-i-get-parts-a-b | https://www.ssa.gov/open/data/Data-about-Extra-Help-with-Medicare-Prescription-Drug-Plan-Cost.html

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