Understanding Medicare Special Needs Plans in Fayette County, Pennsylvania
In Fayette County, PA, Medicare beneficiaries have access to 23 Special Needs Plans (SNPs) in 2026. Among them, 4 are available at a $0 premium. About 5,342 people in the County are enrolled, with 68% of SNPs rated 4 stars or higher. These plans are designed for individuals with specific healthcare needs, including dual eligibility for Medicare and Medicaid, chronic conditions, or long-term care requirements.
To see how SNPs fit with your other Medicare choices, explore all Medicare coverage options in Fayette County, PA.
Page last revised:
Enrollment data refreshed: September 9, 2026
* Each year CMS evaluates Medicare Advantage plans on a 5-star scale. Data sources
Dual Eligible Special Needs Plans (D-SNPs)
Dual Eligible Special Needs Plans (D-SNPs) are designed for people who qualify for both Medicare and Medicaid. These plans coordinate benefits to reduce costs and provide access to additional support services.
| Health Plan Name | CMS Rating* | Premium Per Mo | Network | CMS Plan ID |
|---|---|---|---|---|
| Geisinger Gold Secure Rx | $33 | HMO D-SNP | H3954 097 0 | |
| HumanaChoice SNP-DE H7617-048 | $12 | PPO D-SNP | H7617 048 0 | |
| Aetna Community HealthChoices | $16 | HMO D-SNP | H3959 071 0 | |
| Aetna Medicare Advantra Dual | $14 | HMO D-SNP | H3959 036 0 | |
| AmeriHealth Caritas VIP Care | $33 | HMO D-SNP | H4227 002 0 | |
| Highmark Wholecare Medicare Assured Diamond | $16 | HMO D-SNP | H5932 001 0 | |
| Highmark Wholecare Medicare Assured Ruby | $18 | HMO D-SNP | H5932 009 0 | |
| UHC Dual Complete PA-S001 | $33 | PPO D-SNP | H1889 007 0 | |
| UPMC for Life Complete Care | $27 | HMO D-SNP | H4279 001 0 | |
| HumanaChoice SNP-DE H5216-227 | $0 | PPO D-SNP | H5216 227 0 | |
| UHC Dual Complete PA-S002 | $7 | HMO-POS D-SNP | H3113 009 0 | |
| UHC Dual Complete PA-S3 | $19 | HMO-POS D-SNP | H3113 016 0 | |
| UHC Dual Complete PA-V001 | $30 | HMO-POS D-SNP | H3113 014 0 | |
| Wellcare Dual Liberty Sync | $33 | HMO-POS D-SNP | H2915 002 0 | |
| Wellcare Dual Select | $33 | HMO-POS D-SNP | H2915 018 0 |
What is the total number of D-SNP options in Fayette County?
Fayette County has 15 D-SNP options for 2026, serving 4,756 members.
How much do D-SNP plans cost on average in Fayette County?
The mean monthly D-SNP premium in Fayette County is $21.38, with 1 at no cost.
Institutional Special Needs Plans (I-SNPs)
These plans cater to individuals residing in long-term care facilities, such as nursing homes, or those requiring extended skilled nursing facility care at home. The CMS website provides more information about I-SNPs and their coverage details.
- Total I-SNP Plans
- 5
- Average Premium
- $26.16/mo
- Beneficiaries Enrolled
- 88
- $0 Premium I-SNPs
- 1
- Average MOOP
- $15,840
- Most Popular I-SNP
- Provider Partners Pennsylvania Advantage Plan (I-SNP) with 73 enrollees
- I-SNPs Without Drug Coverage
- 0
| Health Plan Name | CMS Rating* | Premium Per Mo | Network | CMS Plan ID |
|---|---|---|---|---|
| Aetna Medicare Longevity | $33 | HMO I-SNP | H3959 066 0 | |
| American Health Advantage of Pennsylvania | $33 | HMO I-SNP | H9968 001 0 | |
| Provider Partners Pennsylvania Advantage Plan | $33 | HMO I-SNP | H4093 001 0 | |
| Provider Partners Pennsylvania Community Plan | $0 | HMO I-SNP | H4093 004 0 | |
| Provider Partners Pennsylvania Essential Plan | $33 | HMO I-SNP | H4093 008 0 |
What is the total number of I-SNP options in Fayette County?
There are 5 I-SNP plans in 2026, covering 88 beneficiaries.
How much do I-SNP plans cost on average in Fayette County?
The average I-SNP premium is $26.16, with 1 costing $0.
What I-SNP plan has the highest enrollment in Fayette County?
Provider Partners Pennsylvania Advantage Plan (I-SNP) is the most popular I-SNP in Fayette County, with 73 enrollees.
What is the total number of I-SNP options in Fayette County?
There are 5 I-SNP plans in 2026, covering 88 beneficiaries.
Chronic Condition Special Needs Plans (C-SNPs)
These plans are designed for individuals with severe or disabling chronic conditions. C-SNPs excel at coordinating your care among different medical specialists and often include extra benefits like prescription drug plans.
- Total C-SNP Plans 3
- Average Premium $9.60/mo
- Beneficiaries Enrolled 498
- $0 Premium C-SNPs 2
- Average MOOP $15,133
- Most Popular C-SNP Aetna Medicare Chronic Care Value (C-SNP) with 195 enrollees
- C-SNPs Without Drug Coverage 0
| Health Plan Name | CMS Rating* | Premium Per Mo | Network | CMS Plan ID |
|---|---|---|---|---|
| Aetna Medicare Chronic Care | $0 | HMO C-SNP | H3959 076 0 | |
| Aetna Medicare Chronic Care Value | $29 | HMO C-SNP | H3959 075 0 | |
| UHC Complete Care PA-17 | $0 | HMO-POS C-SNP | H5253 192 0 |
- What is the average premium for C-SNP plans in Fayette County?
- On average, C-SNP plans in Fayette County cost $9.60 per month.
- Which C-SNP is the most popular in Fayette County?
- The leading C-SNP in Fayette County is Aetna Medicare Chronic Care Value (C-SNP), with 195 members.
- How many C-SNP plans are available in Fayette County?
- In 2026, Fayette County offers 3 C-SNPs with 498 enrollees.
Medicare Special Needs Plans have 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): Between January 1 and March 31, people already enrolled in Medicare Advantage can make a one-time change—switch to another plan or return to Original Medicare. Learn more
- Annual Enrollment Period (AEP): Each fall, from October 15 to December 7, Medicare beneficiaries can review their coverage and make changes for the next plan year. Learn more
- Special Enrollment Periods (SEPs): Life events like moving to a new service area, losing other health coverage, or becoming eligible for assistance may open a Special Enrollment Period to adjust your Medicare coverage. Learn more
Ways to Enroll in Medicare Advantage Special Needs Plans
- Consult a Licensed Agent: Call a licensed insurance agent at HealthCompare 1-833-748-3201 (TTY 711), available Monday through Friday 5am–6pm and Saturday 6am–5pm PST, for help reviewing your Medicare options.
- Contact the Plan Provider Directly: Start enrollment by reaching out to the plan provider through their website or by phone with their member services team.
- Use Medicare.gov: At Medicare.gov, you can compare Medicare Advantage plans side by side and enroll securely online.
The D-SNP, C-SNP, and I-SNP plans listed on this page are available to qualifying individuals enrolled in Medicare Part A and Part B living in Belle Vernon, Uniontown, Brownsville, Connellsville, Dawson, Dunbar, Fairchance, Farmington, Fayette City, Grindstone, Hopwood, La Belle, Lemont Furnace, Mc Clellandtown, Markleysburg, Masontown, Mill Run, New Salem, Normalville, Perryopolis, Point Marion, Republic, Smithfield, Smock, Vanderbilt, Everson, and all other areas of Fayette County, Pennsylvania. For a broader statewide overview, see Medicare plan options in 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 — Version: 202608
- CMS.gov, Medicare Part C & D Performance — Version: 2026
- CMS.gov, Plan Benefits Package — Version: 2026
- CMS.gov, Medicare Advantage/Part D Contract and Enrollment Data — Version: 2026-08
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 SNP plans available in Fayette County compare with plans offered elsewhere, you can search the Special Needs Plan directory to review options nationwide using the same authoritative data sources.
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, "Compare types of Medicare Advantage Plans" — Last accessed 25 May, 2025
- Medicare.gov, "Your coverage options" — Last accessed 23 May, 2025
- AARP.org, "The Big Choice: Original Medicare vs. Medicare Advantage" — Last accessed 20 May, 2025
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, Editorial Steward, using a standardized, data-driven methodology for accurate Medicare coverage interpretation and resolution.