Plan vs plan · Dauphin County, PA · 2027 plan year
UPMC for Life HMO Rx Choice (HMO) vs Community Blue Medicare PPO 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
Community Blue Medicare PPO Signature (PPO)
- Plan premium
- $0 a month
- Yearly limit, in network
- $7,150
- 2027 star rating
- 4.5 of 5
- Prior authorization needed for
- 17 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 Dauphin County. Enter the monthly price from your quote, or check Medigap prices for ZIP 17032 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.
Community Blue Medicare PPO Signature (PPO)
PPO from Highmark Blue Cross Blue Shield or Highmark Blue Shield
$5,868 a year
- Premiums
- $2,514
- Medical costs
- $1,415
- Drugs
- $1,939
Most you can pay in a bad year, before drugs: $9,664.
With these settings, Community Blue Medicare PPO Signature (PPO) costs about $576 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
Community Blue Medicare PPO Signature (PPO)
$0 copay
Specialist visit
Original Medicare + Medigap Plan G
$0
after the $292 yearly Part B deductible
UPMC for Life HMO Rx Choice (HMO)
$35
Community Blue Medicare PPO Signature (PPO)
$35
Lab tests
Original Medicare + Medigap Plan G
$0
most Medicare-covered tests
UPMC for Life HMO Rx Choice (HMO)
$5
Prior authorizationCommunity Blue Medicare PPO Signature (PPO)
$0-$20
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 authorizationCommunity Blue Medicare PPO Signature (PPO)
$300
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
Community Blue Medicare PPO Signature (PPO)
$130
Urgent care
Original Medicare + Medigap Plan G
$0
after the $292 yearly Part B deductible
UPMC for Life HMO Rx Choice (HMO)
$50
Community Blue Medicare PPO 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 authorizationCommunity Blue Medicare PPO Signature (PPO)
$25-$275
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 authorizationCommunity Blue Medicare PPO Signature (PPO)
$325
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 authorizationCommunity Blue Medicare PPO Signature (PPO)
$1,250
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) | Community Blue Medicare PPO 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 | $7,150 in network; $10,750 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 | $35 copay |
| Lab tests | $0, most Medicare-covered tests | $5 copayPrior authorization | $0-$20 copayPrior authorization |
| MRI or CT scan | $0, after the $292 yearly Part B deductible | $220 copayPrior authorization | $300 copayPrior authorization |
| X-rays | $0, after the $292 yearly Part B deductible | $25 copayPrior authorization | $20 copayPrior authorization |
| Emergency room | $0, after the $292 yearly Part B deductible | $130 copay | $130 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 | $75-$350 copayPrior authorization |
| Surgery center | $0, after the $292 yearly Part B deductible | $225-$275 copayPrior authorization | $25-$275 copayPrior authorization |
| Ground ambulance | $0, after the $292 yearly Part B deductible | $50-$270 copayPrior authorization | $325 copayPrior authorization |
| Hospital stay | $0, Plan G pays the $1,788 Part A deductible | $400 per stayPrior authorization | $250 per day for days 1-5; $0 per day for days 6-90Prior 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 | $35 copayPrior authorization |
| 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 | 0%-50% 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: 21% coinsuranceNon-Preferred Drug: 25% coinsuranceSpecialty Tier: 25% coinsurance |
Not sure which of these costs apply to you?
Text us what you have now. We will help you read this comparison and check it with Medicare.gov.
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
Community Blue Medicare PPO 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 17 services
Diagnostic tests, MRI or CT, Radiation therapy, Outpatient hospital, Surgery center, Ambulance, Mental health visits, Physical therapy, Occupational therapy, Home health, Partial hospitalization, Medical equipment, Prosthetics, Diabetic supplies, Hospital stay, Skilled nursing, Part B drugs
Extra benefits
| Extra benefit | Original Medicare | UPMC for Life HMO Rx Choice (HMO) | Community Blue Medicare PPO Signature (PPO) |
|---|---|---|---|
| Dental | No | Comprehensive, up to $3,000 a year | Comprehensive, up to $2,000 a year |
| Eye exam | No | Yes | Yes |
| Glasses or contacts | No | Yes, $200 allowance | Yes, $150 allowance |
| Hearing aids | No | Yes, copays from $690 | Yes, up to $500 |
| Over-the-counter allowance | No | $120 a year | $140 a year |
| 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
Community Blue Medicare PPO Signature (PPO)
Renewal Plan · 2026 plan H3916-037-6
- In-network out-of-pocket maximum down from $7,950 to $7,150
- Drug deductible up from $615 to $700
- Part B giveback down from $11 to $0
- Emergency care: $115 copay to $130 copay
- Diagnostic radiology (MRI, CT): $195 copay to $300 copay
- Outpatient hospital: $350 copay to $75-$350 copay
- Ground ambulance: $260 copay to $325 copay
- Inpatient hospital: $175 per day for days 1-5; $0 per day for days 6-90 to $250 per day for days 1-5; $0 per day for days 6-90
- 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
- Dental maximum down from $2,500 to $2,000
- Yearly OTC allowance down from $200 to $140
- Eyewear allowance down from $350 to $150
- Rides to care removed
More 2027 plans in Dauphin 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)
- Aetna Medicare Advantra Signature (PPO), H5522-004 (page for Lancaster County, PA)
- Geisinger Gold Preferred Complete Rx (PPO), H3924-065 (page for Bucks County, PA)
- Aetna Medicare Value Plus (PPO), H5522-013 (page for Lancaster County, PA)
- Aetna Medicare Advantra Signature Giveback (PPO), H5522-017 (page for Allegheny 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)
County guide: 2027 plans in Dauphin 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 Dauphin County, PA. So the Original Medicare total needs your own Medigap quote. You can look up prices for ZIP 17032 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
- Community Blue Medicare PPO Signature (PPO) on Medicare.gov · plan website · drug list · doctor directory
- Medigap prices for ZIP 17032 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.