Pennsylvania

Going Strong

Medicare Advantage plans that keep you going strong

Jefferson Health Plans offers Medicare Advantage plans with more benefits than Original Medicare. Our HMO and PPO plans include robust medical and prescription drug coverage, and added benefits, including a Flex Card, over-the-counter spending benefit, and allowances for dental, vision, and hearing services.

If you have Medicare and Medicaid benefits, you can enroll in one of our D-SNP plans. With $0 copays on all medical services and Flex Card benefits for food and utilities, our D-SNP plans help with your everyday needs without compromising coverage.

Our Medicare Advantage plans are available in select Pennsylvania counties.

Complete (HMO)

A $0 premium HMO plan with prescription drug coverage and additional benefits. Complete has a low Maximum Out-of-Pocket and is one of our best-selling plans.

$0 monthly plan premium
$0 primary care and $25 specialist visits
$125 quarterly allowance for over-the-counter health products
$2,250 Flex Card for additional dental, vision and hearing spending
$0 copay for three routine dental visits plus $2,000 annual allowance for other dental services
$250 eyewear allowance
Coverage for hearing aids
SilverSneakers® fitness membership

An enhanced HMO plan that features a $140 Part B giveback. This popular plan includes prescription drug coverage for a $0 monthly premium.

$0 monthly plan premium
$140 Part B giveback
$0 primary care and $40 specialist visits
$30 quarterly allowance for over-the-counter health products
$2,250 Flex Card for additional dental, vision and hearing spending
$0 copay for three routine dental visits plus $2,000 annual allowance for other dental services, including implant coverage
$200 eyewear allowance
Coverage for hearing aids
SilverSneakers® fitness membership

An enhanced HMO plan with a $32.70 monthly premium. Prime is a perfect plan for individuals with a Low Income Subsidy.

$32.70 monthly plan premium
$0 primary care and $20 specialist visits
$130 quarterly allowance for over-the-counter health products
$2,250 Flex Card for additional dental, vision and hearing spending
$0 copay for three routine dental visits plus $2,000 annual allowance for other dental services
$300 eyewear allowance
Coverage for hearing aids
SilverSneakers® fitness membership

A $0 premium PPO plan with prescription drug coverage. Flex provides more flexibility in where you can go for care while still offering more benefits, including:

$0 monthly plan premium
$0 primary care and $25 specialist visits
$160 quarterly allowance for over-the-counter health products
$3,500 Flex Card for additional dental, vision and hearing spending
$0 copay for three routine dental visits plus $1,000 annual allowance for other dental services
$200 eyewear allowance
Coverage for hearing aids
SilverSneakers® fitness membership

A mid-priced PPO plan with prescription drug coverage for an $18 monthly premium. Flex Pro offers doctor visits with $0 copays and additional benefits, including:

$18 monthly plan premium
$0 primary care and specialist visits
$150 quarterly allowance for over-the-counter health products
$5,000 Flex Card for additional dental, vision and hearing spending
$0 copay for three routine dental visits plus $2,000 annual allowance for other dental services
$300 eyewear allowance
Coverage for hearing aids
SilverSneakers® fitness membership

An enhanced PPO plan with prescription drug coverage for a $32.70 monthly premium. Flex Plus offers flexibility in where you go for care and low copays for medical services.

$32.70 monthly plan premium
$0 primary care and $20 specialist visits
$165 quarterly allowance for over-the-counter health products
$5,000 Flex Card for additional dental, vision and hearing spending
$0 copay for three routine dental visits plus $2,000 annual allowance for other dental services
$200 eyewear allowance
Coverage for hearing aids
SilverSneakers® fitness membership

Our flagship SNP plan, Special features a $0 monthly premium and $0 copays for medical services and many covered prescription drugs. Special offers rich additional benefits designed for individuals with Medicare and full Medicaid.

$0 monthly plan premium*
$0 copay for medical services
$0 copay for many prescription drugs
$250 quarterly allowance for over-the-counter health products
$330 Flex Card to spend on food and utilities per quarter**
$0 copay for three routine dental visits plus $5,000 annual allowance for other dental services
$250 eyewear allowance
Coverage for hearing aids
SilverSneakers® fitness membership

*If your level of “Extra Help” changes, you may be responsible for a $32.70 monthly premium.

**The benefits mentioned are a part of special supplemental program for the chronically ill. Not all members qualify.

Select is a new $0 premium plan with $0 copays for medical services. Select offers $700 each quarter for food and utilities, as well as $800 annually for additional dental, vision, and hearing needs.

$0 monthly plan premium*
$0 copay for medical services
$0 copay for many prescription drugs
$700 Flex Card to spend on food and utilities per quarter and $800 for additional dental, vision and hearing needs**
$300 quarterly allowance for over-the-counter health products

*If your level of “Extra Help” changes, you may be responsible for a $32.70 monthly premium.

**The benefits mentioned are a part of special supplemental program for the chronically ill. Not all members qualify.

Dual Pearl is a $0 premium plan with $0 copays for medical services and added dental coverage. Dual Pearl also covers prescription drugs and offers additional benefits for individuals with Medicare and full Medicaid.

$0 monthly plan premium*
$0 copay for medical services
$0 copay for many prescription drugs
$235 Flex Card to spend on food and utilities per quarter**
$200 quarterly allowance for over-the-counter health products
$0 copay for three routine dental visits plus $10,000 annual allowance for other dental services, including implant coverage
$200 eyewear allowance
Coverage for hearing aids
SilverSneakers® fitness membership

*If your level of “Extra Help” changes, you may be responsible for a $32.70 monthly premium.

**The benefits mentioned are a part of special supplemental program for the chronically ill. Not all members qualify.

Do you need help choosing the right plan for you? Our licensed representatives are available to answer your questions and help you make an informed decision.

Our Pennsylvania plans offer more benefits than Original Medicare, including*:

Low-cost doctor visits: $0 copays for primary care, plus low or no copays for specialist visits
Rx Drugs: All plans provide Part D coverage
Flex Card: Debit card that gives you flexibility
Dental: Coverage for cleanings, x-rays and more
Vision and Hearing: includes eyewear allowance and hearing aid coverage
JeffConnect: 24/7 virtual care with a Jefferson doctor

*Benefits vary by plan.

Need help choosing the right plan for you?

Our licensed representatives are available to answer your questions and help you make an informed decision.

Y0170_MCE-810MR-7391_M | Updated 10/01/2025

Going Strong

Medicare Advantage plans that keep you going strong

Select a Plan

Complete (HMO)

Do you need help choosing the right plan for you? Our licensed representatives are available to answer your questions and help you make an informed decision.

Our Pennsylvania plans offer more benefits than Original Medicare, including*: