Pennsylvania Medigap plans (also called Medicare Supplement plans) cover the gaps in Original Medicare, including deductibles, copays, and coinsurance that would otherwise come out of your pocket. This comprehensive Pennsylvania Medigap guide covers available plans, average premiums, top carriers, the birthday rule, guaranteed issue rights, and how to choose between Plan G, Plan N, and other options. Whether you are approaching your initial Medigap Open Enrollment or considering a plan switch, understanding Pennsylvania Medigap rules helps you make a confident decision.
All information verified against CMS data and state sources as of April 2026.
In This Pennsylvania Medigap Guide:
Medigap Plans Available in Pennsylvania
Standardized plans: A, B, C, D, F, G, K, L, M, N
Every Medigap plan with the same letter provides identical benefits regardless of which carrier sells it. Plan G from one company covers the exact same medical costs as Plan G from another company. The only difference is the premium and the customer service experience. This standardization makes comparison shopping straightforward.
Plan F: Still available in Pennsylvania for beneficiaries who became eligible for Medicare before January 1, 2020. Plan F covers all gaps including the Part B deductible. New enrollees after 2020 cannot purchase Plan F.
High-Deductible Plan G: Available in Pennsylvania. You pay a higher annual deductible before benefits kick in, but monthly premiums are significantly lower than standard Plan G.
Pennsylvania Medigap Rates: Plan G & Plan N
| Plan | Age 65 | Age 70 | Age 75 |
|---|---|---|---|
| Plan G | $175/mo | Varies | Varies |
| Plan N | $125/mo | Varies | Varies |
These are approximate averages. Your actual premium depends on your carrier, zip code, age, gender, and tobacco use. Always compare quotes from at least three carriers before choosing.
How Pennsylvania Medigap Pricing Works
Pennsylvania uses attained-age-rated Medigap pricing. Your premium increases as you age. This means your Medigap costs will rise over time, making it especially important to compare rates annually and switch carriers during open enrollment windows if available.
Household discount: Many Medigap carriers in Pennsylvania offer 5-12% household or spousal discounts when two people in the same household both have Medigap policies.
Tobacco surcharge: Tobacco users in Pennsylvania typically pay approximately 15 to 50 percent depending on carrier more in Medigap premiums.
Plan G vs Plan N in Pennsylvania
Plan G and Plan N are the two most popular Medigap plans in Pennsylvania. Here is how they compare:
| Feature | Plan G | Plan N |
|---|---|---|
| Part B Deductible | Not covered (you pay $240/year in 2026) | Not covered |
| Part B Copay | Covered (no copays) | Up to $20 copay for office visits, up to $50 for ER visits not resulting in admission |
| Part B Excess Charges | Covered | Not covered |
| Monthly Premium | Higher | Lower (typically 15-25% less than Plan G) |
| Best For | Predictable costs, no copays | Lower premiums, okay with small copays |
Bottom line: If you want the most comprehensive coverage with no copays at the doctor, choose Plan G. If you prefer lower monthly premiums and do not mind occasional $20 copays, Plan N offers strong coverage at a lower cost.
Top Medigap Carriers in Pennsylvania
Top Medigap carriers in Pennsylvania:
- AARP/UnitedHealthcare
- Highmark
- Mutual of Omaha
- Aetna
- State Farm
Capital BlueCross (regional — central PA only at approximately 124 per month); State Farm is cheapest among nationally available carriers at approximately 159 per month typically offers among the lowest Plan G premiums in Pennsylvania. However, the cheapest carrier varies by zip code and age bracket.
When comparing Medigap carriers, the benefits are identical for the same plan letter. Focus on premium cost, AM Best financial strength rating (A or higher is strong), customer service reputation, and rate increase history.
Rate increase trend: Pennsylvania Medigap carriers have historically had Average to above average — national Medigap trend is 3-8 percent annually but nearly half of carriers implemented double-digit increases in recent years; PA-specific historical data UNVERIFIED rate increases compared to the national average.
Pennsylvania Medigap Switching Rights
Pennsylvania does not have a Medigap birthday rule. Your primary opportunity to buy or switch Medigap plans without medical underwriting is during your initial 6-month Medigap OEP.
Guaranteed Issue Rights in Pennsylvania
Federal law provides guaranteed issue rights in specific situations where you can buy a Medigap plan without medical underwriting:
- Losing employer/union coverage
- Your Medicare Advantage plan leaves your area
- You joined an MA plan when first eligible and want to switch back within 12 months (trial right)
- Your Medigap carrier goes bankrupt
Pennsylvania-specific guaranteed issue protections: Loss of employer or retiree group coverage, Medicare Advantage plan leaves service area or stops coverage, Medigap insurer bankruptcy or involuntary termination, Medicaid loss during unwinding, trial right return from Medicare Advantage within 12 months
Additional Pennsylvania Medigap rules: All three pricing methods allowed (attained-age most common); no birthday rule yet (pending legislation); Medicaid unwinding guaranteed issue right added; Independence Blue Cross stopped selling new Medigap policies effective January 1 2026 reducing competition in southeastern PA; PA MEDI program through Department of Aging offers free unbiased Medicare counseling; pre-existing condition waiting period of up to 6 months may apply outside open enrollment and guaranteed issue periods; PA Insurance Department must approve all rate increases but no statutory cap exists
Common Medigap Mistakes in Pennsylvania
- Missing your OEP: Your 6-month Medigap Open Enrollment Period is your best window. After it closes, carriers can deny you or charge higher premiums based on health.
- Choosing by carrier name alone: Medigap plans are standardized. A well-known brand’s Plan G costs more but covers the exact same benefits as a smaller carrier’s Plan G.
- Ignoring rate increase history: Some carriers offer low introductory rates then raise premiums aggressively. Ask for 5-year rate increase history before buying.
- Not comparing at least 3 carriers: Premium differences of 30-50% between carriers for the same plan letter are common.
- Confusing Medigap with Medicare Advantage: They are different products. You cannot have both simultaneously (except during limited trial rights).
Compare Pennsylvania Medigap Rates
Ready to compare Medigap plans in Pennsylvania? Use the official Medicare Plan Finder or contact your local SHIP counselor.
Official Sources & Resources
- Medicare.gov: medicare.gov
- Pennsylvania Insurance Department: https://www.pa.gov/agencies/insurance
- NAIC Medigap Shopping Guide: naic.org
- CMS Medicare & You Handbook: Medicare & You (PDF)
Last verified April 2026. Contact us if you notice outdated information.