Medicare Advantage Plans in Rouzerville, Pennsylvania

2025 Medicare Advantage Plan Facts for Rouzerville

• 42.52% of Medicare beneficiaries are enrolled in a Medicare Advantage plan in Rouzerville.

• All Medicare beneficiaries in Rouzerville have access to a $0 premium plan.

• There are 34 $0 premium Medicare Advantage plans available in Rouzerville.

• For those that pay a premium, the average is $73.74 per month.

• The average out-of-pocket maximum is $6,571.20 per year.

• The average prescription drug plan deductible (for plans that include Part D) is $350.71 per month.

• There are 57 plans available in Rouzerville that Medicare rated four stars or higher.

• There are 4 Medicare Advantage plan types you can choose from, including: Local HMO, Local PPO, PFFS, Regional PPO.

Why Choose a Medicare Advantage Plan?

There are three primary reasons you may choose to enroll in a Medicare Advantage plan:

• Low or no-cost monthly premiums.

• Lower out-of-pocket costs.

• Additional benefits such as comprehensive dental, vision, hearing, and more.

1. Low or no-cost monthly premiums

You have access to a Medicare Advantage plan as low as $0 monthly. If you don't qualify for a $0 premium plan, the average is $73.74 per month. This premium is low, especially compared to a Medicare Supplement plan or your Part B premiums.

2. Lower out-of-pocket costs

Original Medicare doesn't cap their out-of-pocket costs, so you could end up with unexpectedly high medical bills. With Original Medicare Part B, you must pay the premium, deductible, and 20% coinsurance for Medicare-approved services and procedures. The 20% can add up.

3. Additional benefits not available with Original Medicare

Want routine dental coverage? Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) don't offer comprehensive dental, vision, or hearing coverage. These services would be entirely out-of-pocket for you.

Medicare Advantage Companies in Rouzerville

7 insurance companies offer Medicare Advantage plans in Rouzerville.

Top 5 Medicare Advantage Insurance Companies in Rouzerville

These 5 Medicare Advantage insurance companies enroll the largest amount of Medicare beneficiaries in Rouzerville. They offer the most popular plans.

2025 Rouzerville Medicare Advantage Plans

There are 62 Medicare Advantage plans to choose from in Rouzerville. Below are the many available options. Click on any of the links to review additional plan details.

Top 57 Medicare Advantage Plans with the Highest Star Ratings in Rouzerville

The Centers for Medicare and Medicaid Services (CMS) rates all Medicare Advantage plans on a scale of 1 to 5 stars. Plans with one star are considered “poor,” while those with five stars are considered “excellent.” Any plan that is four stars and higher is a “top-rated” plan. These are the plans with the highest star ratings in Rouzerville.

Types of Medicare Advantage Plans Available in Rouzerville

There are 4 Medicare Advantage plan types you can choose from in Rouzerville. These include: Local HMO, Local PPO, PFFS, Regional PPO. Not sure which is the best plan for your health needs and budget? We'll walk you through the most popular plan types: Local HMO, Local PPO, PFFS, Regional PPO. At the end of this section, you'll understand the difference between these three most popular plan types.

Medicare Advantage HMO Plans

You have 18 Medicare Advantage HMO plans to choose from in Rouzerville. An HMO, or Health Maintenance Organization, is a type of health plan that limits coverage to in-network care from doctors who work for or contract with the HMO. Typically, HMO plans won't cover out-of-network care except in an emergency.

Medicare Advantage PPO Plans

There are 41 Medicare Advantage PPO plans in Rouzerville. A PPO, or Preferred Provider Organization, is a type of health plan where you pay less to use doctors in the plan's network. Unlike an HMO, you can see doctors and specialists and use a hospital outside the network without a referral for an additional cost.

Medicare Advantage Special Needs Plans (SNPs)

Special Needs Plans, or SNPs, are a type of Medicare Advantage plan. There are two types of Special Needs Plans that may be available to you: Chronic Special Needs Plans (C-SNP) and Dual Special Needs Plans (D-SNP).

Chronic Special Needs Plans (C-SNP) are limited to people with specific illnesses or characteristics. For example, you may qualify for a C-SNP if you have diabetes, End-Stage Renal Disease (ESRD), HIV/AIDS, dementia, chronic heart failure, or other qualifying illness. Medicare C-SNPs tailor benefits, provider choices, and drug formularies to meet the needs of the special needs groups they serve.

You may qualify for a Dual Special Needs Plan (D-SNP) if you are eligible for Medicare and Medicaid. With a D-SNP, the State of Pennsylvania may cover your Medicare costs, depending on your eligibility.

Veteran Benefits & Medicare

If you or your spouse are veterans, you likely have VA benefits. However, the U.S. Department of Veteran Affairs encourages you to sign up for Medicare as soon as you are eligible. Here are three reasons you should speak to a local licensed agent about how VA benefits and Medicare work together:

• Having Medicare means you're covered when you need care from a non-VA hospital or doctor, which also offers you greater health options.

• VA benefits and health care could change in the future, so you should enroll in every health care benefit that you are eligible for.

• If you lose VA benefits and aren't enrolled in Medicare, you could face Medicare Part B and Part D lifetime late enrollment penalties.

When to Enroll in a Medicare Advantage Plan in Rouzerville

Knowing when to enroll or make plan changes can help you save money.

Enrolling in a Medicare Advantage plan for the first time, or are you interested in making a plan change? Skip to the section that applies to you - and mark the dates in your calendar.

Enroll for the First Time

If you're new to Medicare, the best time to enroll in a Medicare Advantage plan is during your Initial Enrollment Period. If you miss that, you can still enroll during the General Enrollment Period (January 1 - March 31) or Special Enrollment Period, but likely with penalties.

Make a Plan Change

The best time to make a plan change is during the Medicare Annual Enrollment Period (October 15 - December 7). During this time, anyone enrolled in Medicare can review their plan options for the coming year and ensure that their plan choice meets their health and budget needs.

If you need to make a plan change because you moved to a new service area or lost coverage, among other reasons, you could qualify for a Special Enrollment Period.

Whether you're enrolling for the first time or making a plan change, a Medicare Advantage plan could fit your health and budget needs. Medicare in Pennsylvania can be confusing, and you don't have to sift through your options alone.

Medicare Advantage Special Needs Plans (SNPs)

Special Needs Plans, or SNPs, are a type of Medicare Advantage plan. There are two types of Special Needs Plans that may be available to you: Chronic Special Needs Plans (C-SNP) and Dual Special Needs Plans (D-SNP).

Chronic Special Needs Plans (C-SNP) are limited to people with specific illnesses or characteristics. For example, you may qualify for a C-SNP if you have diabetes, End-Stage Renal Disease (ESRD), HIV/AIDS, dementia, chronic heart failure, or other qualifying illness. Medicare C-SNPs tailor benefits, provider choices, and drug formularies to meet the needs of the special needs groups they serve.

You may qualify for a Dual Special Needs Plan (D-SNP) if you are eligible for Medicare and Medicaid. With a D-SNP, the State of Pennsylvania may cover your Medicare costs, depending on your eligibility.

Veteran Benefits & Medicare

If you or your spouse are veterans, you likely have VA benefits. However, the U.S. Department of Veteran Affairs encourages you to sign up for Medicare as soon as you are eligible. Here are three reasons you should speak to a local licensed agent about how VA benefits and Medicare work together:

• Having Medicare means you're covered when you need care from a non-VA hospital or doctor, which also offers you greater health options.

• VA benefits and health care could change in the future, so you should enroll in every health care benefit that you are eligible for.

• If you lose VA benefits and aren't enrolled in Medicare, you could face Medicare Part B and Part D lifetime late enrollment penalties.

Medicare Doctors Near Me in Rouzerville, Pennsylvania

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