How Much Does Medicare Really Cost Each Month in Blair County, PA? (From a Local Medicare Expert)
As a licensed insurance broker specializing in Medicare insurance in Blair County, PA, one of the most common questions people ask when exploring Medicare plans is: “How much does Medicare really cost each month?”
The honest answer is that Medicare costs are NOT the same for everyone. Your monthly Medicare costs depend on:
The type of Medicare coverage you choose
How often you use healthcare
Your prescription medications
Which Medicare plans in Blair County, Pennsylvania are available to you
Let’s break it all down in a clear, easy-to-understand way so that you know what to expect!
Tara Saltzburg, Care Compass Owner & Licensed Insurance Broker, at the Blair County Home, Garden and Healthy Living Showcase.
The Main Factors That Affect Monthly Medicare Costs
Most Medicare beneficiaries will see their costs come from four main areas:
Medicare Part B premium
Medicare Advantage or Medicare Supplement (Medigap) plan premium
Prescription premium and drug costs
Out-of-pocket healthcare expenses (copays / coinsurance)
Understanding how these pieces work together makes it much easier to compare Medicare Advantage plans in Blair County, PA as well as other Medicare options.
Medicare Part B Premium
Most people pay a monthly Medicare Part B premium, no matter which Medicare plan they choose. The Part B premium is:
$202.90 for most beneficiaries in 2026, although this can be higher if you are considered a high-income earner
Usually deducted directly from Social Security (you will receive a quarterly bill if you are not yet collecting Social Security benefits)
Applies whether you choose Medicare Advantage or Original Medicare with a Medicare supplement
This cost exists for nearly everyone and should always be included when budgeting for Medicare.
Medicare Advantage Plan (Part C) Premiums in Blair County, PA
Many Medicare Advantage plans in Blair County, PA offer low or even $0 monthly premiums. Here’s what that means:
You will still pay your Medicare Part B premium
Healthcare costs are typically paid as copays/coinsurance when you receive care
Costs vary based on the plan, provider network, and how often you use healthcare
For people who don’t go to the doctor often, these plans can be very affordable on a monthly basis.
For more information on Medicare Advantage Plans, visit Exploring Medicare Advantage (Part C): A Beginner’s Guide.
Medicare Supplement (Medigap) Plans in Blair County, PA
Medicare Supplement plans - also known as “Medigap” plans - usually have higher monthly premiums, but much lower out-of-pocket costs when you receive care. Medicare supplements provide:
Secondary coverage to “Original Medicare”
More predictable expenses
No network restrictions
These plans are often a good fit for people who want flexibility, travel frequently, or prefer fewer surprise medical bills. They do NOT include Rx coverage so if you opt for a supplemental insurance, enrollment into a standalone Prescription Drug Plan (PDP) is needed.
For more information on Medicare Supplements, visit Understanding Medicare Supplements: Bridging the Gaps in Coverage with Plans G, N, and HDG.
Looking for Medicare assistance in Blair County, PA? Come to one of our FREE upcoming seminars!
Prescription Drug Coverage Costs
Prescription drug costs are one of the most unpredictable parts of Medicare and a major reason people seek help comparing Medicare coverage in Blair County, PA.
Your costs depend on:
The medications you take
Whether they are generic or brand-name
How your plan categorizes them (drug tiers)
How Drug Costs Typically Work
Generic medications or lower-tiered drugs (usually considered Tier 1 and Tier 2)
often cost $0 or a very low copay
are usually not subject to a deductible
Example: On a particular insurance plan, a common blood pressure medication is considered Tier 1. There is no deductible on Tier 1 medications and the copay is $0.
Brand-name or higher-tiered drugs (usually considered Tier 3-6 medications)
usually cost more than generic/lower-tiered medications
are often subject to a deductible
may require that you pay a coinsurance (a percentage of the drug’s cost) after the deductible
Example: On a particular insurance plan, a name-brand inhaler is considered a Tier 3 medication. The plan requires the enrollee to pay the first $615 (deductible) early in the year, then 25% of the medication’s cost after that.
The Annual Prescription Drug Cap
Out-of-pocket prescription drug costs are capped at $2,100/year in 2026. This means:
Some people pay $0 all year for medications, while others may reach the cap quickly due to expensive prescriptions
Once you reach $2,100, covered medications cost $0 for the rest of the year
In practical terms, your prescriptions at the pharmacy can cost anywhere from $0 to $2,100 annually, depending on your medications.
This is why reviewing your prescriptions is one of the most important steps when comparing Medicare Advantage plans available in Blair County, PA or standalone Part D plans.
Out-of-Pocket Costs to Consider
Even with Medicare coverage, out-of-pocket costs can play a major role in what you actually spend each year. These are the expenses that often catch people by surprise if they’re not reviewed carefully.
Depending on your plan, you may pay:
Copays for physician visits, which can add up quickly if you see doctors regularly
Hospital copays or daily hospital charges, especially for multi-day stays
Coinsurance for services such as imaging, outpatient procedures, therapies, etc.
Costs for services not fully covered, including certain tests, treatments, or out-of-network care
For someone who rarely uses healthcare, these costs may be minimal. But for someone who sees multiple doctors, has hospital visits, or receives ongoing treatment, out-of-pocket expenses can become one of the largest contributors to total Medicare costs.
This is why reviewing more than just the monthly premium is so important when comparing Medicare Advantage plans in Blair County, PA or other Medicare plans in Blair County, Pennsylvania. An annual review helps ensure your coverage still aligns with your health needs, budget, and how you actually use healthcare.
So, What Does Medicare Really Cost Each Month in Blair County, PA?
Monthly Medicare costs can look very different depending on how much healthcare you use.
Example 1: Low Healthcare Utilizer
This might be someone who:
Is generally healthy
Only sees their primary care doctor and an occasional specialist
Takes no medications / generic medications
Enrolls in a $0 premium Medicare Advantage Prescription Drug plan
Typical monthly costs:
Medicare Part B premium - $202.90/month for most individuals in 2026
Medicare Advantage premium - $0/month
Very low or $0 prescription costs
Occasional copays (e.g. $35 to visit a specialist)
➡️ Overall monthly costs are on the lower end, with most expenses only occurring when care is used.
Example 2: High Healthcare Utilizer
This might be someone who:
Sees doctors and specialists frequently
Takes multiple expensive medications and hits the $2,100 Rx cap
Wants predictable healthcare costs
Chooses a Medicare Supplement plan with a standalone Part D (Rx) plan
Typical monthly costs:
Medicare Part B premium - $202.90/month for most individuals in 2026
Medigap monthly premium - $130/month
Monthly Rx premium and Rx costs - $175/month
Minimal out-of-pocket costs when receiving care (few/no copays)
➡️ Monthly costs are higher, but medical bills are more predictable throughout the year.
The Key Takeaway: Why Medicare Costs Vary and Why Local Help Matters
When it comes to Medicare in Blair County, PA, the “cheapest” plan on paper isn’t always the least expensive over the course of the year. Some Medicare plans have lower monthly premiums but higher costs when you use care. Others cost more each month but offer greater predictability and lower out-of-pocket expenses. The right choice depends on your doctors, medications, health needs, and budget - not just the premium.
That’s why working with a licensed, local Medicare broker in Blair County, PA can help you avoid costly surprises and choose coverage that truly fits your situation. I’m Tara Saltzburg, Owner of Care Compass, a licensed insurance broker specializing in Medicare. I have a physical office in Duncansville, PA, making it easy to meet in person, ask questions face-to-face, and work with someone local who understands Medicare coverage in Blair County and the surrounding area.
With so many Medicare Advantage plans available in Blair County, Pennsylvania - and plan changes happening every year - understanding how much Medicare really costs can feel overwhelming. This is where working with an independent Medicare broker makes a real difference.
As a local Medicare broker, I can help you:
Compare Medicare plan options in Blair County, PA
Review Medicare Advantage plans available in Blair County
Evaluate prescription drug costs and out-of-pocket expenses
Confirm your doctors and medications are covered
Avoid unexpected costs during the year
With over 130 five-star reviews, my goal is to provide clear, honest Medicare guidance without pressure, confusion, or sales tactics. And the best part? These is NO CHARGE to use my services!
If you’d like help comparing Medicare options or reviewing your current coverage, I invite you to contact me for your Care at No Cost Consultation! Whether you prefer to meet in person or speak by phone, I’m here to help you feel confident in your Medicare decisions!
Care Compass is an independent insurance agency that helps seniors navigate the complexities of Medicare and other Senior Products. Our services are offered at NO COST! Care Compass is proudly owned and operated in Blair County, Pennsylvania. We provide Medicare insurance assistance to the residents of Altoona, Hollidaysburg, Duncansville and the surrounding region. If you need assistance with Medicare, contact Care Compass today!