Medicare in Pennsylvania: 2026 Guide
Pennsylvania Medicare at a Glance
Pennsylvania bans Part B excess charges — relevant when comparing Plan G vs Plan N.
| Metric | Value (2026) |
|---|---|
| Medicare enrollees | 2.72 million |
| Medicare Advantage penetration | 54% |
| Typical Plan G (65 yo nonsmoker) | $150/month |
| Nursing homes (Medicare-certified) | 690 |
| 5-star nursing homes | 23% |
| Median SNF semi-private room | $11,500/month |
| Median assisted living | $4,700/month |
Your Medicare Choices in Pennsylvania
Every Medicare-eligible resident chooses between two paths:
- Original Medicare + Medigap + Part D — any-doctor access, stable benefits, higher premium.
- Medicare Advantage (Part C) — bundled benefits, often $0 premium, but networks and prior auth.
About 54% of Pennsylvania's Medicare enrollees choose Advantage. Your best path depends on your doctors, travel patterns, health, and budget.
Medigap in Pennsylvania
Medigap is federally standardized across all states except Massachusetts, Minnesota, and Wisconsin — so Plan G in Pennsylvania is the same coverage as Plan G anywhere else in the country. What differs is premium and carrier availability.
- Typical 65-year-old nonsmoker Plan G: $150/month
- Plan N averages 20–30% less
- Your one-time Medigap Open Enrollment is the 6 months beginning when you're 65+ AND enrolled in Part B
Nursing Home Quality in Pennsylvania
Pennsylvania has 690 Medicare-certified nursing homes; 23% carry a 5-star Overall CMS rating. Before choosing a facility, check its Medicare Care Compare listing, read the most recent state inspection report, and visit in person on both a weekday meal and a weekend shift. Oversight agency: Pennsylvania Department of Health.
- SHIP (free Medicare counseling): 1-800-783-7067
- State long-term care ombudsman: 1-717-783-8975
Related Resources
- Nursing homes in Pennsylvania
- Assisted living in Pennsylvania
- Medicare Supplement (Medigap) guide
- Medicare Advantage vs Medigap
- Medicare cost calculator
Disclaimer: Figures are approximate 2026 benchmarks. Not affiliated with the U.S. government or the federal Medicare program. Consult a licensed agent or SHIP counselor before making decisions.