Plan vs plan · Carbon County, PA · 2027 plan year
UPMC for Life HMO Rx Choice (HMO) vs Aetna Medicare Advantra Signature (PPO)
Medicare.gov compares Medicare Advantage plans with each other. This page also shows Original Medicare, so you can see the full trade-off: premiums, copays, the yearly limit, extra benefits, and the rules about doctors and approvals.
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UPMC for Life HMO Rx Choice (HMO)
- Plan premium
- $40 a month
- Yearly limit, in network
- $6,000
- 2027 star rating
- 4.5 of 5
- Prior authorization needed for
- 16 services
Aetna Medicare Advantra Signature (PPO)
- Plan premium
- $0 a month
- Yearly limit, in network
- $9,250
- 2027 star rating
- 4.5 of 5
- Prior authorization needed for
- 19 services
In most states, including Pennsylvania, you cannot count on getting Medigap later
You can buy any Medigap plan with no health questions in the 6 months that start when you are 65 or older and have Part B. After that, a Medigap company in Pennsylvania can ask about your health. It can say no, or it can charge you more. So if you join a Medicare Advantage plan now, you may not be able to get Medigap later.
One exception is the trial right. If you joined Medicare Advantage when you first got Medicare at 65, or you left a Medigap plan to try Medicare Advantage for the first time, you can switch back within 12 months. Then you can buy a Medigap plan with no health questions.
Read about Medigap rights on Medicare.govYour yearly cost, side by side
Move the controls to match your year. Totals include premiums, the Part B premium, copays, and drug costs.
Want to check your exact drugs? Medicare.gov lets you enter each drug and shows what each plan charges for it. Enter your drugs on Medicare.gov
We have no Medigap Plan G price for a 65-year-old woman in Carbon County. Enter the monthly price from your quote, or check Medigap prices for ZIP 18235 on Medicare.gov.
Original Medicare
We have no Medigap Plan G price for a 65-year-old woman here, so we cannot show this total yet. Enter your quote above to see it. Check Medigap prices on Medicare.gov
UPMC for Life HMO Rx Choice (HMO)
HMO from UPMC for Life
$6,444 a year
- Premiums
- $2,994
- Medical costs
- $1,275
- Drugs
- $2,175
Most you can pay in a bad year, before drugs: $8,994.
Aetna Medicare Advantra Signature (PPO)
PPO from Aetna Medicare
$5,482 a year
- Premiums
- $2,514
- Medical costs
- $1,265
- Drugs
- $1,703
Most you can pay in a bad year, before drugs: $11,764.
With these settings, Aetna Medicare Advantra Signature (PPO) costs about $962 less a year than UPMC for Life HMO Rx Choice (HMO).
These are estimates, not quotes. Check every number with Medicare (Medicare.gov or 1-800-MEDICARE) and with the plan before you choose. What you pay depends on your doctors and hospitals, your drugs and pharmacy, and the care you use. Drug costs use typical prices for generic and brand-name drugs. Original Medicare amounts are 2027 projections from the 2026 Medicare Trustees Report. CMS sets the final amounts in November.
Text us about this comparisonWhat you pay each time you get care
In-network costs for one visit or one stay. The Original Medicare amounts follow your Medigap choice above: Plan G.
Primary doctor visit
Original Medicare + Medigap Plan G
$0
after the $292 yearly Part B deductible
UPMC for Life HMO Rx Choice (HMO)
$0 copay
Aetna Medicare Advantra Signature (PPO)
$0
Specialist visit
Original Medicare + Medigap Plan G
$0
after the $292 yearly Part B deductible
UPMC for Life HMO Rx Choice (HMO)
$35
Aetna Medicare Advantra Signature (PPO)
$40
Lab tests
Original Medicare + Medigap Plan G
$0
most Medicare-covered tests
UPMC for Life HMO Rx Choice (HMO)
$5
Prior authorizationAetna Medicare Advantra Signature (PPO)
$0
Prior authorization
MRI or CT scan
Original Medicare + Medigap Plan G
$0
after the $292 yearly Part B deductible
UPMC for Life HMO Rx Choice (HMO)
$220
Prior authorizationAetna Medicare Advantra Signature (PPO)
$0-$295
Prior authorization
Emergency room
Original Medicare + Medigap Plan G
$0
after the $292 yearly Part B deductible
UPMC for Life HMO Rx Choice (HMO)
$130
Aetna Medicare Advantra Signature (PPO)
$115
Urgent care
Original Medicare + Medigap Plan G
$0
after the $292 yearly Part B deductible
UPMC for Life HMO Rx Choice (HMO)
$50
Aetna Medicare Advantra Signature (PPO)
$40
Outpatient surgery
Original Medicare + Medigap Plan G
$0
after the $292 yearly Part B deductible
UPMC for Life HMO Rx Choice (HMO)
$225-$275
Prior authorizationAetna Medicare Advantra Signature (PPO)
$0-$285
Prior authorization
Ground ambulance
Original Medicare + Medigap Plan G
$0
after the $292 yearly Part B deductible
UPMC for Life HMO Rx Choice (HMO)
$50-$270
Prior authorizationAetna Medicare Advantra Signature (PPO)
$275
Prior authorization
Hospital stay, 5 days
Original Medicare + Medigap Plan G
$0
Plan G pays the $1,788 Part A deductible
UPMC for Life HMO Rx Choice (HMO)
$400
for a 5-day stay
Prior authorizationAetna Medicare Advantra Signature (PPO)
$1,675
for a 5-day stay
Prior authorization
See every cost in one table
| What you pay in network | Original Medicare + Medigap Plan G | UPMC for Life HMO Rx Choice (HMO) | Aetna Medicare Advantra Signature (PPO) |
|---|---|---|---|
| Monthly premium | Part B $209.50 + Medigap Plan G at the price of your quote + drug plan $5.30 | $40 + Part B $209.50 | $0 + Part B $209.50 |
| Yearly limit on what you pay | You pay the $292 Part B deductible. Plan G pays the rest. | $6,000 in network | $9,250 in network; $11,300 in and out of network |
| Medical deductible | $292 Part B. Plan G pays the $1,788 Part A deductible. | $0 | $0 |
| Primary doctor visit | $0, after the $292 yearly Part B deductible | $0 copay | $0 copay |
| Specialist visit | $0, after the $292 yearly Part B deductible | $35 copay | $40 copay |
| Lab tests | $0, most Medicare-covered tests | $5 copayPrior authorization | $0 copayPrior authorization |
| MRI or CT scan | $0, after the $292 yearly Part B deductible | $220 copayPrior authorization | $0-$295 copayPrior authorization |
| X-rays | $0, after the $292 yearly Part B deductible | $25 copayPrior authorization | $30 copayPrior authorization |
| Emergency room | $0, after the $292 yearly Part B deductible | $130 copay | $115 copay |
| Urgent care | $0, after the $292 yearly Part B deductible | $50 copay | $40 copay |
| Outpatient hospital | $0, after the $292 yearly Part B deductible | $275 copayPrior authorization | $0-$335 copayPrior authorization |
| Surgery center | $0, after the $292 yearly Part B deductible | $225-$275 copayPrior authorization | $0-$285 copayPrior authorization |
| Ground ambulance | $0, after the $292 yearly Part B deductible | $50-$270 copayPrior authorization | $275 copayPrior authorization |
| Hospital stay | $0, Plan G pays the $1,788 Part A deductible | $400 per stayPrior authorization | $335 per day for days 1-7; $0 per day for days 8-90Prior authorization |
| Skilled nursing facility | $0, Plan G pays days 21-100 | $10 per day for days 1-20; $221 per day for days 21-100Prior authorization | $0 per day for days 1-20; $221 per day for days 21-100Prior authorization |
| Mental health visit | $0, after the $292 yearly Part B deductible | $35 copay | $40 copayPrior authorization |
| Physical therapy | $0, after the $292 yearly Part B deductible | $35 copayPrior authorization | $25 copay |
| Home health care | $0, Medicare-covered home health | $0 copayPrior authorization | $0 copayPrior authorization |
| Medical equipment | $0, after the $292 yearly Part B deductible | 20% coinsurancePrior authorization | 20% coinsurancePrior authorization |
| Part B drugs | $0 after the $292 Part B deductible | 0%-20% coinsurancePrior authorization | 0%-20% coinsurancePrior authorization |
| Drug deductible (Part D) | $700 with Wellcare Value Script (PDP) | $700 | $700 |
| Drug tiers (one month, retail) | Generic: $0 copayPreferred Brand: 25% coinsuranceNon-Preferred Drug: 49% coinsuranceInjectable Drugs: 15% coinsuranceSpecialty Tier: 25% coinsuranceSelect Care Drugs: $11 copay | Preferred Generic: $0 copayGeneric: $0 copayPreferred Brand: 25% coinsuranceNon-Preferred Drug: 28% coinsuranceSpecialty Tier: 25% coinsurance | Preferred Generic: $0 copayGeneric: $5 copayPreferred Brand: 17% coinsuranceNon-Preferred Drug: 28% coinsuranceSpecialty Tier: 25% coinsurance |
Not sure which of these costs apply to you?
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A higher drug plan premium is not, by itself, a reason to switch
With Original Medicare, you buy a separate drug plan. In Pennsylvania, 8 drug plans are for sale for 2027, from $5.30 to $184.40 a month. Half of them cost $65.05 a month or less.
- Every 2027 drug plan limits what you pay for covered drugs to $2,400 a year. The drug coverage in Medicare Advantage plans has the same limit.
- The premium is one part of your yearly cost. The calculator above adds premiums, medical costs, and drug costs, so you can see the whole year.
- A Medicare Advantage plan can cost less in a light year. But you also take on its network and prior authorization rules, and you may not be able to get Medigap later.
- If your income is limited, Extra Help can pay most of your drug plan premium and drug costs. Check Extra Help at SSA.gov
Doctors, referrals, and prior authorization
Cost is one side. The other side is how you get care. These rules come from the CMS plan files. Prior authorization means the plan must approve a service before you get it.
Original Medicare
- Any doctor or hospital in the U.S. that takes Medicare
- No referrals
- Prior authorization only for a short list of services
UPMC for Life HMO Rx Choice (HMO)
HMO
- You use doctors and hospitals in the plan network. Outside the network, the plan pays for emergencies and urgent care.
- No referral needed to see a specialist.
Prior authorization for 16 services
Diagnostic tests, MRI or CT, Radiation therapy, Outpatient hospital, Observation stay, Surgery center, Ambulance, Physical therapy, Occupational therapy, Home health, Medical equipment, Prosthetics, Diabetic supplies, Hospital stay, Skilled nursing, Part B drugs
Aetna Medicare Advantra Signature (PPO)
PPO
- The plan has a network. You can go outside it, but you pay more.
- No referral needed to see a specialist.
Prior authorization for 19 services
Diagnostic tests, MRI or CT, Radiation therapy, Outpatient hospital, Observation stay, Surgery center, Ambulance, Mental health visits, Psychiatrist visits, Home health, Partial hospitalization, Medical equipment, Prosthetics, Diabetic supplies, Dialysis, Substance use care, Hospital stay, Skilled nursing, Part B drugs
Extra benefits
| Extra benefit | Original Medicare | UPMC for Life HMO Rx Choice (HMO) | Aetna Medicare Advantra Signature (PPO) |
|---|---|---|---|
| Dental | No | Comprehensive, up to $3,000 a year | Comprehensive, up to $500 a year |
| Eye exam | No | Yes | Yes |
| Glasses or contacts | No | Yes, $200 allowance | Yes, $100 allowance |
| Hearing aids | No | Yes, copays from $690 | Yes, up to $500 |
| Over-the-counter allowance | No | $120 a year | No |
| Fitness benefit | No | Yes | Yes |
| Rides to care | No | No | No |
| Meals after a hospital stay | No | Yes | No |
| Emergency care abroad | Plan G and Plan N pay 80% after a $250 deductible | Yes | Yes |
| Part B premium giveback | No | No | No |
What changed for 2027
UPMC for Life HMO Rx Choice (HMO)
Renewal Plan with SAR · 2026 plan H3907-057-4
- Drug deductible up from $175 to $700
- Outpatient hospital: $250 copay to $275 copay
- Inpatient hospital: $395 per stay to $400 per stay
- Skilled nursing facility: $10 per day for days 1-20; $218 per day for days 21-100 to $10 per day for days 1-20; $221 per day for days 21-100
- Dental maximum down from $5,000 to $3,000
- Yearly OTC allowance down from $150 to $120
Aetna Medicare Advantra Signature (PPO)
Renewal Plan · 2026 plan H5522-004-0
- Drug deductible up from $615 to $700
- Specialist visit: $0-$40 copay to $40 copay
- Outpatient hospital: $0-$350 copay to $0-$335 copay
- Inpatient hospital: $350 per day for days 1-7; $0 per day for days 8-90 to $335 per day for days 1-7; $0 per day for days 8-90
- Skilled nursing facility: $0 per day for days 1-20; $218 per day for days 21-100 to $0 per day for days 1-20; $221 per day for days 21-100
- Meals after a hospital stay removed
More 2027 plans in Carbon County
- UPMC for Life HMO Premier Rx (HMO), H3907-059 (page for Lancaster County, PA)
- UPMC for Life HMO Rx (HMO), H3907-058 (page for Allegheny County, PA)
- Geisinger Gold Preferred Complete Rx (PPO), H3924-065 (page for Bucks County, PA)
- Aetna Medicare Signature Giveback (PPO), H5522-022 (page for Lancaster County, PA)
- Geisinger Gold Classic Complete Rx (HMO), H3954-158 (page for Bucks County, PA)
- Freedom Blue PPO ValueRx (PPO), H3916-018 (page for Lancaster County, PA)
- Community Blue Medicare HMO Signature (HMO), H3957-042 (page for Northampton County, PA)
- Humana Essentials Plus Giveback (PPO), H5525-085 (page for Philadelphia County, PA)
County guide: 2027 plans in Carbon CountyState guide: Pennsylvania
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Sources and method
Plan data comes from the CMS 2027 Plan Benefit Package and landscape files. The data is from 2026-10-10. We checked a sample of plans field by field against Medicare.gov. Original Medicare amounts are the 2027 projections in the 2026 Medicare Trustees Report (Tables V.E1 and V.E2). CMS sets the final amounts in November. We do not have a Medigap price for Carbon County, PA. So the Original Medicare total needs your own Medigap quote. You can look up prices for ZIP 18235 on Medicare.gov. Totals use typical Medicare-allowed amounts for each service and typical drug prices.
- UPMC for Life HMO Rx Choice (HMO) on Medicare.gov · plan website · drug list · doctor directory
- Aetna Medicare Advantra Signature (PPO) on Medicare.gov · plan website · drug list · doctor directory
- Medigap prices for ZIP 18235 on Medicare.gov
- CMS Plan Benefit Package files, 2027
- CMS 2027 landscape files (premiums and limits)
- CMS 2027 plan crosswalk
- CMS 2027 Star Ratings
- 2026 Medicare Trustees Report: projected 2027 Part A and Part B amounts (Tables V.E1 and V.E2)
- CMS 2026 Part A and Part B amounts
- Medicare.gov: Medigap guaranteed issue rights
These are estimates, not quotes, and they are for education only. Check every number with Medicare and with the plan before you choose. What you pay depends on your doctors and hospitals, your drugs and pharmacy, and the care you use. Plans can change their benefits, premiums, drug lists, and networks each year.
Pinnie is not an insurance agent or broker and does not sell Medicare plans. Pinnie is not connected with or endorsed by the U.S. government or the federal Medicare program. For all your options, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048.