Medicare Insurance in Pennsylvania

Pennsylvania's Insurance Department has approved several different plans to supplement Medicare. Residents can choose from Medicare alone, Medigap plans (also known as Medicare supplements), Medicare Advantage plans, or original Medicare or a Medigap with a Part D plan. The options vary both in monthly premiums and in out-of-pocket costs, and you can typically only make plan changes once each year, so it's critical to make an informed decision.

Original Medicare

• Original Medicare is made up of Parts A and B. Part A is Medicare's coverage for hospitalization. It also covers hospice care and limited skilled nursing care and home health care. There is typically no monthly premium for Part A. Part B is Medicare's coverage for other medically necessary services, like doctor's visits, lab tests and durable medical equipment. Part B does have a monthly premium, and the premium varies depending on your income level. If you have other health insurance, like through a former employer or the Department of Veterans Affairs, you may not need to take Part B of Medicare. If you're uncertain about whether to take Medicare Part B, ask your insurance provider.

Medicare Supplements

• As of 2011, 46 different companies offer Medigap, or Medicare Supplement, plans in Pennsylvania. Medicare Supplement plans are regulated by the Federal Government so that the benefits offered are the same from company to company. For example, a Medicare Supplement Plan M offers the same benefits no matter what company you buy it from. Medicare Supplements are secondary to Medicare, so they pay after Medicare does. They also offer additional benefits, like foreign travel emergency coverage (Medicare only covers you in the United States). You may also want to consider a Part D prescription plan to go with your Medigap plan.

Medicare Advantage Plans

• Medicare Advantage plans, or MA plans, are offered through private companies, and also have to be approved by the Pennsylvania Insurance Department. MA plans have a monthly premium and are the primary payer, rather than Medicare. Most plans also include prescription coverage. There are several companies that offer MA plans, and each company offers a few plans to choose from, each with different premiums, co-pays and deductibles.

Medicare Part D

• Medicare Part D offers prescription coverage. There are standalone Part D plans that can be paired with Original Medicare or Original Medicare with a Medicare Supplement plan. Standalone plans have a monthly premium, co-pays and may have deductibles. Sixteen companies were approved by Pennsylvania to sell standalone Part D plans as of 2011, with each company offering multiple plans. Pennsylvania also offers prescription assistance, or PACE, to those 65 and older with a limited income. You can also apply for extra help with prescription coverage through Social Security; this is also based on your total income and savings.