Medicare Advantage Plans in Pennsylvania

Medicare Advantage Plan Eligibility and Enrollment in Pennsylvania

Qualifying for a Medicare Advantage plan is not too different from qualifying for Original Medicare, also referred to as Medicare Part A and Part B.

You must begin by enrolling in Original Medicare. If you’re an American citizen (or have been a permanent resident for at least five years) who is 65 or older, you’re eligible for Parts A and B. You can also qualify due to disability even if you’re under age 65.

In most cases, eligibility for Medicare Advantage is simple. First, you must be enrolled in Medicare Part A and Part B, or be eligible to enroll. Second, you must live in the area covered by the plan that you want. This is an essential detail because Medicare Advantage plans cover specific areas and are not portable. You may be able to see an out-of-network provider, but it will typically cost more.

You will have the opportunity to enroll in Medicare Advantage when you are initially enrolled in Medicare Parts A and B — called your Initial Coverage Election Period. Alternatively, if you’re already enrolled in Parts A and B, you can switch to a Medicare Advantage during the Medicare Open Enrollment Period, also called the Annual Enrollment Period, which runs from October 15 to December 7 each year. When you enroll in a new Medicare Advantage plan at this time, your coverage will begin January 1.

Medicare releases a Star Rating of Medicare plans no later than October 8. Their ratings system takes into account many factors, including customer reviews and complaints. If you’d like to see what plans are offered in your area, and what they cover, a GoHealth licensed insurance agent can assist you.