Medicare Advantage PPO plans in Pennsylvania
There are 137 Medicare Advantage PPO plans in Pennsylvania from 13 carriers, averaging 4.20 out of 5 stars across the 137 plans CMS has rated. 48% of those with a published premium charge $0 a month (67 of 137); beyond the premium, what separates them is network, drug coverage and how much you could owe in a bad year.
Across the 137 PPO plans in Pennsylvania that publish one, the in-network out-of-pocket maximum has a median of $7,150 and tops out at $9,850 — the ceiling on what you pay in a year for covered in-network care. The mean is $7,450, which sits above the median — the spread is not symmetric, so the median is the better guide.
Pennsylvania has 5 five-star Medicare Advantage PPO plans.
Of the 137 PPO plans here, 5 carry CMS's top overall rating of 5 stars and 125 rate 4 or above. That matters beyond quality: a 5-star plan can be joined at almost any point in the year through a special enrollment period, rather than only during the autumn window.
Most PPO plans in Pennsylvania rate 4 stars or better.
125 of 137 plans here carry an overall rating of at least 4 stars. Where ratings cluster this high they stop being a useful way to sort plans — network, drug coverage and out-of-pocket limits will separate these more than the star count will.
Not sure whether Medicare Advantage suits you at all? Medicare Advantage vs Original Medicare covers the trade in plain language.
Top-rated PPO plans in Pennsylvania
| Plan | Stars | Out-of-pocket max | Premium / mo |
|---|---|---|---|
| Peak Advantage Summit (PPO)Peak Health | 5★ | $5,500 | $25 |
| Peak Advantage Vista (PPO)Peak Health | 5★ | $5,900 | $0 |
| Clover Health Choice (PPO)Clover Health | 5★ | $9,850 | $0 |
| Clover Health Valor (PPO)Clover Health | 5★ | $9,850 | $0 |
| UHC Nursing Home Plan EX-F002 (PPO I-SNP)UnitedHealthcare · Institutional SNP | 5★ | $9,850 | $12.50 |
Showing 5 of 137. See all PennsylvaniaMedicare Advantage plans →
PPO plans by carrier
| Carrier | Plans | Avg stars | SNPs |
|---|---|---|---|
| Highmark Blue Cross Blue Shield or Highmark Blue SHighmark Health | 42 | 4.5 | — |
| Capital Blue CrossCAPITAL BLUE CROSS | 24 | 4.0 | — |
| HumanaHumana Inc. | 19 | 4.0 | 4 |
| Aetna MedicareCVS Health Corporation | 12 | 4.4 | — |
| UPMC for LifeUPMC Health System | 10 | 4.5 | — |
| UnitedHealthcareUnitedHealth Group, Inc. | 9 | 4.1 | 2 |
| Devoted HealthDevoted Health, Inc. | 5 | 3.0 | — |
| Geisinger GoldRisant Health, Inc. | 4 | 4.0 | — |
| Independence Blue CrossIndependence Health Group, Inc. | 4 | 4.0 | — |
| Clover HealthClover Health Holdings, Inc. | 2 | 5.0 | — |
| HealthSpringHealth Care Service Corporation | 2 | 3.0 | — |
| Jefferson Health PlansThomas Jefferson University | 2 | 3.0 | — |
How PPO compares
States with similar PPO star ratings
Pennsylvania Medicare Advantage PPO plans, answered
How much do Medicare Advantage PPO plans cost in Pennsylvania?
What are the star ratings for Pennsylvania PPO plans?
How many Medicare Advantage PPO plans are available in Pennsylvania?
Do Pennsylvania PPO plans include prescription drug coverage?
What is a Special Needs Plan, and are there any in Pennsylvania?
A $0 premium is not the whole cost.
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