Pennsylvania Health Insurance

You can find a variety of reasonably priced health insurance options in Pennsylvania that will meet your specific needs. The majority of these plans will allow for the addition of dental and vision insurance. The lowest-priced health insurance plans start at $340 per month, dental add-ons at $58 per month, and vision plans at $20 per month. Coverage and costs vary depending on your age, location, household size, and other factors, but a full-coverage health insurance plan will cost Pennsylvania residents an average of $516 per month, with some people even being eligible for free plans.

Pennsylvania Health Insurance Options

When it comes to health insurance, Pennsylvania is one of the states with the most options, with over a dozen companies offering plans in the state. We’ve highlighted some of the most popular companies that you can choose from:

Highmark Inc.

Highmark offers a range of products for your health and financial needs, like the newly launched Medicare Advantage plans from Highmark Blue Cross Blue Shield. This range of products, along with numerous others, is intended to give customers more options at reasonable prices.

Oscar

Oscar offers health insurance plans for individuals and families in the Platinum, Gold, Silver, and Bronze metal categories. These plans offer benefits including no-cost doctor visits, no-cost generic medications, and more than 75 free preventive care services like flu vaccines, immunizations, and pregnancy tests. Aside from these money-saving features, Oscar plans also offer financial incentives for reaching fitness objectives, as well as brand-name prescription and urgent care visit discounts.

Capital Blue Cross

Health insurance provider Capital Blue Cross is based in Harrisburg, the state’s capital. More than 18,000 healthcare professionals and 40 hospitals are accessible through their plans’ networks. Individual and family health insurance plans, including Preferred Provider Organization (PPO) choices, are available to residents of the Capital Blue Cross coverage area both on and off the exchange.

 

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Health Insurance Marketplace in Pennsylvania

If you’re looking for health insurance in Pennsylvania, the health insurance Marketplace is a good place to start. Marketplace health insurance, which was created by the Affordable Care Act, offers certain consumer protections, guarantees coverage for pre-existing conditions, and includes coverage for what are known as the “10 essential health benefits”:

  • Ambulatory patient services (outpatient care)
  • Emergency services
  • Hospitalization
  • Pregnancy, maternity, and newborn care (both before and after birth)
  • Mental health and substance use disorder services, including behavioral health treatment (including counseling and psychotherapy)
  • Prescription drugs
  • Rehabilitative and habilitative services and devices
  • Laboratory services
  • Preventive and wellness services and chronic disease management
  • Pediatric services, including oral and vision care (but adult dental and vision coverage aren’t essential health benefits)

The ACA-compliant plans offered on the Marketplace are divided into different types, known as metal tiers: Bronze, Silver, and Gold. These tiers do not signal a difference in quality of care, though. The tiers differ in your out-of-pocket costs versus what your plan covers. 

It’s important to remember that the Marketplace only offers the plans of participating providers. So unfortunately, while the Marketplace is a great tool, you may not be able to compare every plan available to you.

Whether you want a Marketplace plan, or a plan from a private insurer, an EZ agent can help. We work with all carriers in your state in order to compare all options available.

 

Pennsylvania’s Short Term Health Insurance Guidelines

If you’ve missed the health insurance Open Enrollment Period (OEP), or if you need health insurance for a short amount of time, short-term plans are a great option. It’s important to note, though, that these policies tend to only cover the basics, and you can be denied one of these plans if you have a pre-existing condition. 

There are some rules around short-term plans, both at the federal and the state level. Some states choose to have their own guidelines separate from federal guidelines, or to not offer short-term plans at all, when it comes to short-term health insurance, Pennsylvania abides by federal regulations. That means one year is the maximum initial period of coverage, and plans may be renewed 3 times for a maximum of 36 months. 

 

Pennsylvania Health Insurance Resources

There are resources at your disposal to help you get good health insurance coverage. One of these resources is actually your employer, so speak to them about any group healthcare plans they might offer. These plans are usually less expensive than individual plans, since your employer gets discounts for buying group coverage.

Another priceless resource for finding great coverage is Pennie, the state’s exchange for health insurance. It can be used to compare plans that are available to you, and you can even use it to check if you qualify for a government-funded program. Citizens 65 and older, or those with specific disabilities are eligible for Medicare. For low-income households, Medicaid offers affordable or even free insurance policies.

Another excellent resource is an insurance agent. With the assistance of an EZ agent, you can look into all options available to you on and off the Marketplace. They can guarantee that your insurance will give you the coverage you need at a price you can afford.

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How to Get the Most Savings

In terms of per capita healthcare spending, Pennsylvania is ranked 45th out of the 50 states, making it an affordable state for healthcare, with an average per capita cost of $11,229 per year. Even being in a state on the more affordable end of the spectrum, you can still find ways to lower your health insurance costs.

Your health is a big factor in determining your rates. If your body mass index (BMI) is excessively high or even too low, your premium may increase. In Pennsylvania, the obesity rate is 33.20 %, so if you’re in this group, know that you can save money by maintaining a healthy BMI.

Using tobacco is considered a significant risk by insurance companies. That means a smoker’s premiums may actually be up to 50% higher than those of a nonsmoker. If you’re among the 14.4% of Pennsylvanians who smoke, consider quitting to save money! Not only will you save money on tobacco products, but you’ll lower your insurance costs and stay healthier, cutting your healthcare costs in general.

But there’s a way to save money that’s even simpler! Work with an EZ agent, who can compare all of the plans available to you that fit your budget, as well as find any local discounts you might be eligible for. Your annual savings on health insurance could be hundreds thanks to the experts at EZ, and we don’t charge for any of our services!

 

Pennsylvania Health Insurance FAQS

  • Does Pennsylvania require you to have health insurance?

No, health insurance is not required in Pennsylvania. Although the Affordable Care Act technically requires all Americans to have health insurance, there is no longer a federal tax penalty for not having it, and Pennsylvania is not one of the states that has a state mandate.

  • What is the cheapest health insurance in Pennsylvania?

The cheapest health plan will be a Bronze plan, which can start as low as $340 a month. Remember, though, health insurance plan prices can vary depending on age, zip code, gender, and other factors. More than half of Pennsylvania residents who qualify for a Marketplace plan can actually get a Bronze plan for free.

  • How much does health insurance cost in Pennsylvania?

The average monthly premium for health insurance in Pennsylvania is $516, or $6,192 per year. With plans as low as $340 a month to as high as $1,102. But some residents may be eligible for free health insurance if they meet certain income requirements.

  • Which insurers offer plans in Pennsylvania?

The top 15 insurers in Pennsylvania are Capital Advantage Assurance Company​, ​Capital Advantage Insurance Company, Cigna Life & Health Insurance Company, ​First Priority Health HMO, Geisinger Health Plan, Geisinger Quality Options, ​​Highmark Benefits Group, ​Highmark Coverage Advantage, Highmark, Inc., QCC Insurance Company, Keystone Health Plan Central​, ​Keystone Health Plan East, Oscar Health Plan of Pennsylvania​, Pennsylvania Health & Wellness, and UPMC Health Coverage Inc.

 

How to Enroll in Health Insurance in Pennsylvania

In Pennsylvania, there are various options for signing up for a health insurance plan. Including the health insurance Marketplace, insurance companies’ websites, or through your employer.

Pennsylvania has its own state-run health insurance exchange, Pennie, which works just like the federal Marketplace but only offers plans from Pennsylvania carriers. 

Health insurance companies all have websites that allow you to search through their specific plans and enroll online if you want to. 

If your employer offers a group healthcare plan, you can speak to your HR department for instructions on how to enroll.

Whatever you decide, enrolling can be difficult and time-consuming, but EZ has you covered! We can assist you with the enrollment process and answer any questions you may have. We’ll assess each of your options based on the details you give us, making an extra effort to consider your financial and medical circumstances, as well as any potential financial aid you might be eligible for. Using this data, we will evaluate each plan on and off the Marketplace and present you with a variety of options. We are able to do this with no additional fees or obligation.

If you still have questions, feel free to give us a call at 877-670-3557. When you call, you will be directly connected to a local insurance agent who can answer all of your questions and help you find the health insurance plan that works best for you.

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