HMO · Special Needs Plan · Contract H9968 · 2026
American Health Plan OF Pennsylvania Inc
American Health Plan OF Pennsylvania Inc is a HMO Medicare Advantage plan from American Health Advantage of Pennsylvania, available in 1 state. Here is its CMS quality rating, drug coverage, and benefits.
- N/R
- Overall CMS rating
- $32.70
- Premium/mo
- 1
- States available
American Health Plan OF Pennsylvania Inc plan score
A single 0-100 verdict combining American Health Plan OF Pennsylvania Inc's nationwide standing on 3 of 4 CMS-filed measures: quality, affordability, cost protection, and supplemental-benefit richness, each from its own CMS source file. A missing filing drops out and redistributes its weight rather than deflating the score.
33/100
Percentile-weighted across 3 of 4 measures
- CMS quality (star rating)
- N/A not on file
- Affordability (premium)
- D 32.7 $/mo
45th percentile nationwide
- Cost protection (deductible)
- F 615 $/yr
0th percentile nationwide
- Benefit richness (supplemental coverage)
- D 4 benefits
43th percentile nationwide
Benchmarked live against every plan or plan-county row reporting each measure in the current CMS extract (CY2026 Star Ratings, Landscape file, and Plan Benefit Package). Not a CMS-endorsed score; PlainMedicare's own weighting (quality 40%, affordability 25%, cost protection 15%, benefit richness 20%).
What the CMS Data Shows About American Health Plan OF Pennsylvania Inc
American Health Plan OF Pennsylvania Inc operates under CMS contract H9968, issued by American Health Advantage of Pennsylvania (parent organization Mitchell Family Office). The contract is classified as a HMO product, which governs how enrollees access care: HMOs require in-network providers and referrals for most specialist care, trading network flexibility for lower cost-sharing. This contract is also flagged in CMS data as a Special Needs Plan (SNP), meaning enrollment is restricted to beneficiaries meeting specific eligibility criteria, chronic condition, dual Medicare-Medicaid status, or institutional residence. Service area spans 1 state (PA) and 29 counties, a geography set at the CMS service-area definition level.
The overall CMS Star Rating for this contract is not yet published by CMS. This rating synthesizes 2 individual quality measures spanning 1 CMS domain, including clinical outcomes, patient experience (CAHPS), member complaints and appeals, and plan operations. Ratings at 4+ stars trigger federal Quality Bonus Payments that insurers typically reinvest in supplemental benefits.
On costs, this contract lists a monthly plan premium of $32.70 (Part C + D combined) and an annual Part D drug deductible of $615.00, from the CMS CY2026 Landscape file; every enrollee also pays the standard Part B premium. Beyond standard Medicare Parts A and B, the contract documents 4 supplemental benefits in the CMS benefits file, coverage extras such as dental, vision, hearing aids, fitness programs, and OTC allowances that Original Medicare does not provide. Before enrolling, verify that your preferred providers participate in the plan's network for your specific county, review the current Summary of Benefits, and confirm that your prescriptions appear on the plan formulary. All figures shown come from CMS public-use files for the 2026 contract year; this page is informational only and is not personalized Medicare counseling advice.
Quality Measures by Domain
Customer Service
2 measuresCall Center – Foreign Language Interpreter and TTY Availability
Call Center – Foreign Language Interpreter and TTY Availability
Supplemental Benefits
| Benefit | Covered | Max Benefit |
|---|---|---|
| Hearing Aids | ✓ Yes | - |
| Hearing Exam | ✓ Yes | - |
| Vision, Eye Exam | ✓ Yes | - |
| Vision, Eyewear | ✓ Yes | - |
County Availability
Medicare Advantage Guides
Official Medicare resources
Frequently Asked Questions
What is the star rating for American Health Plan OF Pennsylvania Inc?
American Health Plan OF Pennsylvania Inc (Contract H9968) by American Health Advantage of Pennsylvania has an overall CMS star rating of Not yet rated out of 5. Star ratings are based on quality measures including preventive care, chronic disease management, and member satisfaction.
How much does American Health Plan OF Pennsylvania Inc cost per month?
American Health Plan OF Pennsylvania Inc has a monthly plan premium (Part C + D combined) of $32.70, with an annual Part D drug deductible of $615. Every enrollee also pays the standard Part B premium (about $202.90/month in 2026). Premiums are from the CMS CY2026 Landscape file and can vary by county; confirm current costs on Medicare.gov.
What type of plan is American Health Plan OF Pennsylvania Inc?
American Health Plan OF Pennsylvania Inc is a HMO Medicare Advantage plan offered by American Health Advantage of Pennsylvania. This is also a Special Needs Plan (SNP) designed for beneficiaries with specific diseases, characteristics, or care needs. HMO plans generally require you to use in-network providers and get referrals for specialists.
Where is American Health Plan OF Pennsylvania Inc available?
American Health Plan OF Pennsylvania Inc is available in 1 state (PA) across 29 counties. Coverage area can vary, check with the insurer or Medicare.gov for exact availability in your ZIP code.
What supplemental benefits does American Health Plan OF Pennsylvania Inc offer?
American Health Plan OF Pennsylvania Inc covers 4 supplemental benefits beyond standard Medicare, including hearing aids, hearing exam, vision eye exam, vision eyewear. Many Medicare Advantage plans include dental, vision, and hearing coverage not available under Original Medicare.
How is American Health Plan OF Pennsylvania Inc rated on quality measures?
CMS evaluates American Health Plan OF Pennsylvania Inc across 2 individual quality measures spanning 1 domain, including HD5: Health Plan Customer Service. These measures cover clinical outcomes, patient experience, and plan operations.
Data Source
Data from CMS Medicare Advantage 2026 Star Ratings and Plan Finder datasets. Contract ID: H9968. Last updated: 2026 plan year.
Nationwide Medicare Advantage plans with similar county footprint or CMS star rating
Data-derived peers across the CMS Landscape file: nearest county inventory and nearest overall CMS star rating at the contract level. Not parent-org containment or same-state overlap.
Similar county footprint
- Pacificsource Community Health Plans 29 counties
- First Health Life & Health Insurance Company 29 counties
- Wellcare Health Insurance Company OF Oklahoma, Inc 30 counties
- Usable HMO, Inc. 30 counties
- Bluecross AND Blueshield OF South Carolina 30 counties
- Kaiser Foundation HP, Inc. 30 counties
Related
Before you enroll in American Health Plan OF Pennsylvania Inc
Star rating and network fit matter more than the premium alone.
- This contract's premium is $32.70/mo (Part C + D) - compare it against other plans before enrolling. Browse all plans
- Check that your doctors and drugs are in-network before you enroll, and confirm the plan on Medicare.gov. Medicare Plan Compare
- This plan documents 4 supplemental benefits beyond Original Medicare - see how it stacks up against Original Medicare's coverage. MA vs Original Medicare
Figures are from CMS CY2026 public files for this contract; benefits and premiums can vary by the specific plan you enroll in and your county.
PlainMedicare is rendered directly from CMS Medicare Advantage and Part D public files, no number is typed in by an editor. See our editorial standards & corrections policy, the methodology behind these numbers, or report a correction. Data current as of 2026-09-01.
CMS lists 131,985 Medicare Advantage and Part D plan records in the current public files. PlainMedicare refreshes this registry with each annual release.