Pennsylvania

Landscape insights this AEP

Pennsylvania: The Growth Story

While most states contract, Pennsylvania adds 92 plans in 4 years.

Plans Added

+92

Since 2022

Active Payers

17

+2 from 2025

Counties

67

Full Coverage

Plans in Lancaster

114

Most in USA

4-Year Expansion Trajectory

Sustained growth every year

+38% Total Growth

Geographic Moves

County-level changes

Devoted Health

+25 Counties Added

Now in 53 of 67 counties

Universal Coverage

5 Major Payers

Plan Type Mix

2026 Distribution

HMO +27%

186

56%

PPO -14%

141

42%

SNP +20.4%

59

18%

HMO Surge

+39 Plans

Fastest growing segment

Market Leaders

By plan count

Highmark Health

80

Optimizing

CVS Health

39

Selective Focus

UPMC Health

35

+5 Plans

Member Costs

2026 Averages

Average Premium

$30.40

Monthly

Max Out-of-Pocket

$6,850

Annual

Cost Distribution

Part C

$11.50

Part D

$20.50

Drug Deductibles

Sharp increase

HMO Surge

$423 average

+81% from $233

18%

$0 Deductible Plans

Down from 48%

153

Plans Over $600

253 non-zero-drug deductible

Why It Matters

Pennsylvania's unique market dynamics

#3 Growth State

+16 plans in 2026 alone

HMO Dominance

186 plans, +27% growth

Premium Market

$30.40 average monthly

While most states see contraction, Pennsylvania proves growth is still possible with the right strategy