Medicare Advantage Plans in Philadelphia County, PA:
Your Complete 2026 Guide
For 2026, residents of Philadelphia County, PA can choose from 66 Medicare Advantage plan options. Of these, 42 cost nothing beyond the Part B premium. Enrollment in the County stands at approximately 81,399, with 52% of plans achieving 4 stars or better. This page and its statistics exclude Special Needs Plans (SNPs). See Medicare Special Needs Plans available in Philadelphia County, PA.
Last update: . Enrollment data last updated: March 12, 2026
* CMS rates Medicare Advantage plans annually using a 5-star system. Data sources
Medicare Advantage PPO Plans
Preferred Provider Organization (PPO) plans allow members to choose care from both in-network and out-of-network providers. While using out-of-network doctors or hospitals usually means higher costs, PPOs may appeal to people who want more flexibility in how they access their healthcare.
- Total PPO Plans
- 34
- Average Premium
- $37.13/mo
- Beneficiaries Enrolled
- 17,542
- $0 Premium PPOs
- 20
- Average MOOP
- $6,979
- Most Popular PPO
- Personal Choice 65 Achieve Rx (PPO) with 2,255 enrollees
- PPOs Without Drug Coverage
- 7
What is the average monthly premium for PPO plans in Philadelphia?
On average, PPO plans in Philadelphia cost $37.13 per month.
Which PPO plan has the highest enrollment in Philadelphia?
The most popular PPO in Philadelphia is Personal Choice 65 Achieve Rx (PPO), covering 2,255 beneficiaries.
How many PPO plans in Philadelphia do not include prescription drug coverage?
7 PPO plans available in Philadelphia do not include Part D benefits.
Medicare Advantage HMO Plans
Health Maintenance Organization (HMO) plans generally require members to use doctors, hospitals, and other providers within the plan’s network, except in emergencies. Because of this structure, HMOs often come with lower premiums and out-of-pocket costs compared with other plan types.
- Total HMO Plans 18
- Average Premium $17.87/mo
- Beneficiaries Enrolled 46,519
- $0 Premium HMOs 13
- Average MOOP $6,947
- Most Popular HMO Keystone 65 Basic Rx (HMO) with 13,913 enrollees
- HMOs Without Drug Coverage 4
What is the top HMO by enrollment in Philadelphia?
Keystone 65 Basic Rx (HMO) is the most popular HMO plan in Philadelphia, with 13,913 enrollees.
What is the number of HMO plans without Part D coverage in Philadelphia?
4 HMO plans in Philadelphia do not include prescription drug coverage.
Medicare Advantage HMO-POS Plans
HMO-POS plans are structured like HMOs, requiring in-network care for the lowest costs, but they also permit some use of out-of-network doctors and hospitals. Those services are generally more expensive, but the added access can be valuable for people who don’t want to be fully limited to a single network.
- Total HMO-POS Plans
- 13
- Average Premium
- $19.18/mo
- Beneficiaries Enrolled
- 17,315
- $0 Premium HMO-POS
- 8
- Average MOOP
- $6,831
- Most Popular HMO-POS
- Keystone 65 Focus Rx (HMO-POS) with 3,830 enrollees
- HMO-POS Without Drug Coverage
- 2
| Plan Name | Rating* | Premium | MOOP | Rx Ded. | Plan-ID |
|---|---|---|---|---|---|
| AARP Medicare Advantage Essentials from UHC PA-5 | $0 | $6,700 | $520 | H5253-154-0 | |
| AARP Medicare Advantage Extras from UHC PA-18 | $0 | $6,700 | $600 | H5253-203-0 | |
| AARP Medicare Advantage from UHC PA-0001 | $49 | $5,400 | $440 | H5253-145-0 | |
| AARP Medicare Advantage Patriot No Rx PA-MA01 | $0 | $6,700 | N/A | H5253-152-0 | |
| Aetna Medicare Advantra Prime Plus | $0 | $6,900 | $615 | H3959-053-0 | |
| Aetna Medicare Advantra Signature | $0 | $7,500 | $615 | H3959-052-0 | |
| Aetna Medicare Value Care | $33 | $7,500 | $615 | H3959-033-0 | |
| Keystone 65 Essential Rx | $31 | $8,500 | $0 | H3952-060-0 | |
| Keystone 65 Focus Rx | $0 | $6,750 | $0 | H3952-053-0 | |
| Wellcare Assist | $33 | $5,500 | $475 | H2915-011-0 | |
| Wellcare Patriot Giveback | $0 | $7,550 | N/A | H2915-013-0 | |
| Wellcare Simple | $0 | $6,200 | $615 | H2915-003-0 | |
| Aetna Medicare Premier | $104 | $6,900 | $615 | H3931-004-0 |
What is the typical premium for HMO-POS plans in Philadelphia?
On average, HMO-POS plans in Philadelphia cost $19.18 per month.
Which HMO-POS plan has the most members in Philadelphia?
The leading HMO-POS in Philadelphia is Keystone 65 Focus Rx (HMO-POS), with 3,830 members.
How many HMO-POS options are offered without prescription drug coverage in Philadelphia?
There are 2 HMO-POS plans in Philadelphia without Part D benefits.
Medicare Advantage PFFS Plans
PFFS, or Private Fee-for-Service plans, allow access to any Medicare-approved doctor or hospital that accepts the plan’s terms. They provide wide flexibility in choosing providers, but it’s essential to verify that your preferred healthcare professionals agree to the plan’s payment rules before scheduling care.
| Plan Name | Rating* | Premium | MOOP | Rx Ded. | Plan-ID |
|---|---|---|---|---|---|
| Humana Gold Choice H8145-163 | $0 | $1,500 | N/A | H8145-163-0 |
What is the total number of PFFS plans in Philadelphia?
In 2026, Philadelphia has 1 PFFS plans with 23 members.
How much do PFFS plans cost on average in Philadelphia?
The mean monthly PFFS premium is $0.00, and 1 have no premium.
The table below shows the quality ratings for Medicare Advantage plans offered in Philadelphia County, PA for 2026.
| Rating Category | Number of Plans | Percent of Plans |
|---|---|---|
| 5 Stars | No 5-star plans available. | 0% |
| 4 Stars (includes 5 Stars) | 32 | 52% |
| 3 Stars | 29 | 48% |
| Below 3 Stars | 0 | 0% |
| Not Rated | 5 | 8% |
| Average Rating | 3.79 | |
Medicare Advantage comes with strict enrollment windows. By knowing when and how to sign up, you’ll avoid missed deadlines and keep your healthcare coverage aligned with your needs.
Key Medicare Enrollment Periods
- Initial Enrollment Period (IEP): This seven-month window starts three months before the month you turn 65 and ends three months after. It’s the first time you can sign up for Medicare and, if you choose, a Medicare Advantage plan. Learn more
- Medicare Advantage Open Enrollment Period (MA OEP): Each year from January 1 through March 31, you may change to another Medicare Advantage plan or drop your plan and return to Original Medicare. Learn more
- Annual Enrollment Period (AEP): This yearly window, running October 15 to December 7, gives you the opportunity to join, switch, or drop Medicare Advantage and Part D plans. Learn more
- Special Enrollment Periods (SEPs): Certain qualifying events, such as a change in residence or loss of existing coverage, may allow you to enroll in or change Medicare Advantage plans outside of the usual enrollment windows. Learn more
Enrollment Options Explained
- Talk with a Licensed Agent: Licensed agents at HealthCompare can explain your Medicare Advantage choices. Reach them at 1-833-748-3201 (TTY 711), Monday–Friday 5am–6pm and Saturday 6am–5pm PST.
- Contact the Plan Provider Directly: You may enroll through a plan provider’s website or speak with their customer support staff to complete your application.
- Use Medicare.gov: Visit Medicare.gov to shop for plans, review benefits, and submit your enrollment electronically.
The MA and MAPD plans on this page are available to people on Medicare enrolled in both Medicare Part A and Part B living in Philadelphia, and all other areas of Philadelphia County, Pennsylvania.
Plans Offered for Enrollment through Medicare.org
Medicare Advantage and Part D plans and benefits offered by the following carriers: Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Baylor Scott & White Health Plan, Capital Blue Cross, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, GlobalHealth, Health Care Service Corporation, HealthSpring℠, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint
- CMS.gov, Landscape Source Files — Last accessed September 26, 2025
- CMS.gov, Medicare Part C & D Performance — Last accessed October 10, 2025
- CMS.gov, Plan Benefits Package — Last accessed October 13, 2025
- CMS.gov, Medicare Advantage/Part D Contract and Enrollment Data — Last accessed March 12, 2026
Some facts and percentages shown on this page (such as average premiums, distribution of plan types, and percentage of $0 premium plans) are calculated by Medicare.org using data from the CMS Landscape file, Plan Benefits Package (PBP) files and Part C & D Performance files. All underlying values originate from CMS, and calculations are refreshed whenever CMS issues updated data. Enrollment counts and rankings (such as Top 3 plans by enrollment) are derived from CMS monthly enrollment files and aggregated at the county level.
Medicare.org separates Medicare Advantage (MA/MAPD) plans and Special Needs Plans (SNPs) into different pages for clarity. As a result, plan counts, percentages, and other calculations shown here may differ from the aggregate totals published in the CMS Landscape files. All plan availability and benefit details originate from CMS.
Learn more about how we use CMS data.
- Medicare.gov, "Understanding Medicare Advantage Plans" — Last accessed 25 May, 2025
- Medicare.gov, "Compare Original Medicare & Medicare Advantage" — Last accessed 25 May, 2025
- NCOA.org, "5 Steps to Choosing the Right Medicare Plan for You" — Last accessed 25 May, 2025
Some facts and percentages shown on this page (such as average premiums, distribution of plan types, and percentage of $0 premium plans) are calculated by Medicare.org using data from the CMS Plan Benefits Package (PBP) files and Part C & D Performance files. All underlying values originate from CMS, and calculations are refreshed whenever CMS issues updated data.
To explore how 2026 Medicare Advantage plans available in Philadelphia County compare with plans offered elsewhere, you can search the Medicare Advantage plan directory to review options nationwide using the same authoritative data sources.
Medicare.org is owned and operated by Health Network Group, LLC, an Allstate company. Medicare.org provides information only and is not connected with or endorsed by the U.S. Government or the federal Medicare program.
Data provenance documentation is maintained in alignment with the U.S. Core Data for Interoperability (USCDI) Provenance standard.
Page content independently curated and maintained by David W. Bynon, Medicare Technical Operator, using a standardized, data-driven methodology designed for accurate, non-commercial Medicare plan interpretation and resolution.