Pennsylvania
Medicare help in Pennsylvania
Free, unbiased counseling, help paying premiums and drug costs, how to check an agent before you talk to one, and the Pennsylvania rules that affect your Medigap choices.
Free counseling
PA MEDI
Pennsylvania Medicare Education and Decision Insight (PA MEDI) is Pennsylvania's State Health Insurance Assistance Program. Trained counselors answer Medicare questions, compare plans with you and help you apply for savings programs, at no cost. They don't sell insurance.
Help paying for Medicare in Pennsylvania
If your income and savings are limited, these programs can lower your premiums and drug costs. Many people who qualify never apply.
Medicare Savings Programs
Medical Assistance (Pennsylvania Medicaid) runs Pennsylvania's Medicare Savings Programs. They pay your Part B premium, and the fullest one (QMB) also pays Part A premiums, deductibles and copays. You don't need to qualify for full Medicaid.
The 2026 federal minimum limits: income up to $1,350 a month single or $1,824 married for full help (QMB), or up to $1,816 single or $2,455 married for help with the Part B premium, and savings up to $9,950 single or $14,910 married. Your home and one car don't count. States can be more generous.
Pennsylvania uses the federal income limits. Pennsylvania also calls QMB "Healthy Horizons-Medicare Cost-Sharing".
Extra Help with drug costs
Extra Help is a federal program, run by Social Security, that lowers Part D premiums, deductibles and copays. In 2026 you may qualify with income up to $23,940 a year single or $32,460 married, and resources up to $18,090 single or $36,100 married. If you get a Medicare Savings Program, Medicaid or SSI, you get Extra Help automatically. Apply with Social Security.
Pennsylvania drug assistance programs
PACE and PACENET
Who qualifies: Pennsylvania residents 65 or older, living in the state at least 90 days, with last year's income up to $33,500 single or $41,500 married.
What it pays: Low copays ($6 to $15 a prescription, depending on income and the drug), and it may help pay your Part D premium and late enrollment penalty.
Call 1-800-225-7223
Chronic Renal Disease Program (CRDP)
Who qualifies: Pennsylvania adults with end-stage kidney disease who meet the program's income guidelines.
What it pays: Help with dialysis, transplant care and drugs, including the Part D premium for plans that work with the program.
Call 1-800-225-7223
Sources: Medicaid.gov state contacts, Pennsylvania's own Medicaid pages and Medicare.gov's state program list, checked October 27, 2026. Limits change every year; confirm with Medical Assistance (Pennsylvania Medicaid) before you apply. How Extra Help and savings programs work.
Check an agent's license in Pennsylvania
The Pennsylvania Insurance Department licenses insurance agents in Pennsylvania. Before you share personal information, look the agent up by name or National Producer Number (NPN) and make sure their license is active and includes health insurance.
Medigap rules in Pennsylvania
Switching plans later
Pennsylvania has no yearly switching window. After your first 6-month Medigap Open Enrollment Period, insurers can ask health questions before selling you a different policy, unless you have a federal guaranteed issue right. How switching works.
If you're under 65
Insurers in Pennsylvania must offer Medigap to people under 65 who have Medicare. Plans and prices can be limited. More on Medigap under 65.
Source: NAIC state Medigap chart, May 11, 2026. Confirm with the Pennsylvania Insurance Department before changing coverage.
Dates that apply everywhere
- October 15 to December 7: Open Enrollment, when you can change Medicare Advantage and drug plans. All enrollment periods
- January 1 to March 31: people in Medicare Advantage can switch plans or go back to Original Medicare once.
- Around your 65th birthday: your 7-month window to sign up. Turning 65
Common questions in Pennsylvania
Where can I get free Medicare help in Pennsylvania?
Pennsylvania Medicare Education and Decision Insight (PA MEDI) is Pennsylvania's State Health Insurance Assistance Program. Its counselors help with Medicare questions for free and don't sell insurance. Call 1-800-783-7067.
How do I check a Medicare agent's license in Pennsylvania?
The Pennsylvania Insurance Department licenses insurance agents. Use its license lookup to search by the agent's name or National Producer Number (NPN), or call 1-877-881-6388.
How do I get help paying Medicare premiums in Pennsylvania?
Apply for a Medicare Savings Program through Medical Assistance (Pennsylvania Medicaid) (1-800-692-7462). These programs pay your Part B premium, and sometimes your deductibles and copays. Pennsylvania uses the federal income limits. Pennsylvania's free SHIP counselors (1-800-783-7067) can help you apply.
Does Pennsylvania help pay for prescriptions?
Pennsylvania has state drug assistance programs: PACE and PACENET and Chronic Renal Disease Program (CRDP). Extra Help, a federal program run by Social Security, also lowers Part D premiums and copays for people with limited income.
Does Pennsylvania have a Medigap birthday rule?
Not as of the NAIC's May 11, 2026 chart. Outside your first 6-month Medigap window and federal guaranteed issue rights, insurers in Pennsylvania can ask health questions before selling you a different policy.
Can I buy Medigap under 65 in Pennsylvania?
Insurers in Pennsylvania must offer Medigap to people under 65 who have Medicare. Plans and prices can be limited.
State contacts checked against official Pennsylvania sites on October 26, 2026. General information, not advice about a specific plan. How we check facts.