Group Health Insurance In Pa

Employer-sponsored medical coverage is very popular. Big companies, such as PPG, Comcast, Heinz, Cigna and US Steel offer comprehensive  benefits and very affordable prices. Of course, once you leave, it might be different, depending on your situation. Typically, you can’t take your group benefits with you unless you retire before age 65. And even then, the benefits may not be the same.

Large company plans typically feature very comprehensive coverage with rich benefits and low out of pocket expenses on large hospital claims. Often, deductibles are as low as $250 or $500. If the policy is an HMO, there may be no deductibles to meet. Primary care physician and specialist visits may also be covered with very low copays…perhaps $10 or $15. And sometimes there are no copays, which is very costly to the employer.

And a few specific benefits such as maternity and mental illness, may be either completely covered or have very small out of pocket costs to the group policyholder. Other unusual coverage such as chiropractor visits may have no limitations and there may be very small copays on ER visits.

Of course, Pa group  insurance plans are more expensive than private coverage because of the excess benefits. If the employer is paying all or most of the premiums, it’s a great situation for the employee. However, if very little (or none) of the expense is paid by the employer, it can be quite expensive.

Private Health Insurance In Pa

Personal medical plans are easily purchased from many of the biggest and most reputable companies. Large insurers, such as Aetna, UnitedHealthcare and Highmark, along with smaller carriers, such as Geisinger and Celtic, offer multitudes of policies for Pa residents with or without coverage. Most plans are underwritten, which means rates will be lower for persons with very few or no health issues. A group plan will accept just about all applicants, which is part of the reason rates can be so high. Keystone is one of the few companies that offers a private policy with virtually no underwriting. This “Personal Choice” plan is available in Southeastern Pennsylvania.

When you purchase your own family coverage, the selection process is a bit harder than an “Open Enrollment” through an employer. The main reason is that there are hundreds of different plan variations with different coverage, deductibles, copays and out of pocket limits. So obviously, utilizing a website like ours is a must, so we can easily help you compare the best plans and ensure you are applying for the most appropriate and affordable policy.

Private medical policies allow you to customize your benefits to meet your individual or family requirements. You can pick a plan with a high deductible or purchase an HSA to keep premiums low.  If you need specialized coverage, such as extra accidental benefits, dental coverage or vision insurance, more than likely it can be added to your package.

And very importantly, when you own your own policy, it becomes portable. Whether you remain employed with a company or leave them, your own benefits are not impacted. This can be a big factor if you develop a serious condition, since you would not have to utilize COBRA, which would likely be extremely expensive.  And you can keep your policy until you become eligible for Medicare.

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It also provides more authority to local government and less for the federal government which is what most consumers prefer. Although it is likely rates will continue to increase, the increases may be more modest. This law does not impact individual health insurance rates in Pennsylvania since premium increases are already reviewed by the PDOI. Consumers are always notified in advance of when premiums are going to increase (or decrease).

Because small group health insurance rates have been substantially increasing, many individuals and families are purchasing their own private medical plans which are offered by the top companies such as Highmark BCBS, Aetna, UnitedHealthOne, Capital Blue Cross, Keystone and Independence Blue Cross. Rates are often substantially lower than group plans and a wide variety of coverage and benefits is available so you can easily customize your own policy. Cheap large deductible or expensive no copay policies can be easily purchased. If you only want to buy a policy for a few months…that’s OK too.

In many situations, small group medical plans may be the best option (compared to private coverage). For example, if a major conditions exists, such as insulin-dependent diabetes, severe obesity, cancer or severe heart disease, often, acceptance is guaranteed on group plans. Therefore in these instances, it is the best choice. Of course, each situation is different so enrollment options should be discussed with an experienced broker.

This website is Pennsylvania’s trusted online source for up-to-date issues pertaining to Pa health insurance rates, information or the Exchange. Our “one-stop” approach combines live experienced broker assistance with the best available rates to bring consumers an easy comparison and application process without paying any fees. The rates you view are “live” and are constantly updated for accuracy.

The PDOI may be setting up the “Pennsylvania Health Insurance Exchange” if future Supreme Court rulings are favorable to recent proposed changes to our health care system. Currently, the Exchange is on a holding pattern since it is expensive to implement and may actually turn out to be less helpful to consumers than originally planned.  However, with brokers and the PDOI working together, we believe that ultimately the consumer will be rewarded.

Currently, small business group and individual medical coverage is available through many different carriers and experienced broker websites (such as this one) that provide the means to purchase coverage. Hundreds of plans are offered and the process works well. The proposed Exchanges will limit choices and may force insureds to work with inexperienced “Navigators.” But for now, the concept has not been implemented.

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1. Pennsylvania Private Vs. Group Health Insurance Options

We can help. Our website was created with two things in mind. First, we wanted to provide the most accurate and current  information regarding a wide range of topics including rate information, policies, health care reform information, applying for coverage, pre-existing conditions and many more. Second, we wanted to give you the ability to easily apply for a Pennsylvania health insurance policy and pay the absolute lowest rate that every company offered. And that’s exactly what we have done.

Of course, the “choosing the right plan” part may be the most important step in the process. After you’re presented with all of the  options, now what do you do? We use our 31 years of experience to guide and recommend the right plan. If your main concern is minimizing potential out of pocket costs, we’ll find the policies with the lowest deductibles and copays. If you’re willing to take on a little bit of risk, a plan with a high deductible on hospital-type claims will save you a bunch of money.

Choosing the maximum monthly premium you want to pay should be one of the first things you decide. By developing an effective budget, you’ll drastically reduce the number of available plans, and make the process of picking the best plan much easier. As an example, if you wanted to keep your monthly premium below $400, instead of comparing 150 plans, approximately 10-15 plans might be in that price range. That’s a lot easier to compare isn’t it? And after asking a few questions, we can select the 3-5 options that are best for you.

Now that you have decided on the premium, what type of Pennsylvania medical coverage would you want? A plan that covers office visits with low copay or simply a basic high deductible plan that provides catastrophic benefits? We would review with you the advantages (and disadvantages) of each option, and research which providers would be the best choice. It might be a Highmark plan if you live in the Pittsburgh area, a Geisinger plan if you live in Harrisburg, or possibly a Keystone Health Plan East policy if you live in Southeastern Pennsylvania. And of course, Aetna and UnitedHealthcare may provide the best combination of rate and coverage.

Essentially, that’s what we do best. We help you choose the right health insurance plan by listening to you and understanding the type of health care policy you want and the premium you want to pay. Then, we find those policies and help you pick out the policy that fits best. And finally, we simplify the application process so it’s quick and takes as little time as possible. Small business and dental benefits are also available.

So browse the website, enjoy the content and view your free quotes. We’ll be available if you need expert guidance when comparing or applying for your policy.

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And guess who might pay for these services? You.  Health rates in Pennsylvania will probably increase as the insurers pass the cost to the consumers. Now, don’t get me wrong. I think preventive benefits are important for men and women and medical plans should cover most of the expense. But it seems as if paying for birth control is going a bit too far. And covering the “morning after pill” was also a very controversial decision made by the Obama administration. As was Obama’s announcement that he now supports gay marriages. (By the way, I do not have strong feelings for either side on these controversial subjects).

Regardless of whether you practice (or don’t practice) birth control, it seems a bit odd that the federal government is forcing insurance carriers to cover this. It’s not an option. It’s the law. You begin to wonder what will be next. Mandatory replacement of toothbrushes every 60 days?  Free earmuffs for residents of Allegheny County?

The groups of insureds that are likely to see the biggest increases are females between the ages of 15 and 50, although the amount of the increase will vary, depending on the company. I believe the increases will be in the 2%-7% range. But that is my opinion. It could end up being closer to 9%.

But one of the unintended consequences of this change could be positive. Maternity health insurance rates  should reduce, since it’s safe to assume the number of unplanned pregnancies will decrease. Highmark, Keystone (Independence Blue Cross) and Aetna offer maternity benefits in many of their plans, so we’ll monitor the rates when all of these changes transpire.

UnitedHealthacare and HealthAmerica do not offer maternity options or riders, so it will be interesting to see if they will add this coverage to their Pa portfolio. Actually, UnitedHealthcare offered a maternity coverage rider for many years, but suspended the product in 2010.

We update daily any rate or coverage change on our website. So feel free to view current rates. We’ll assist in the application process and don’t worry…you never pay any fees.

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Pahealthinsurancecoverage.com proudly represents Geisinger Choice plans along with all of the other major companies in Pennsylvania. We offer individual and family health insurance plans at the lowest available rates and never charge any fees. Geisinger has recently added two new plans to their portfolio and we’ll be happy to explain why they may be right for you. The quoting and application process is very easy and we are available to assist you at any time.

One of the most popular Geisinger medical plans is the “PPO Plan 4,” which features a $20 copay on primary doctor office visits and $45 for specialist office visits. Covered office visits are not subject to a deductible. Also, qualified preventive expenses (routine annual physicals, OB-GYN exams and well-baby care visits) are covered at 100%. A $150 Emergency Room charge is waive if you are admitted to the hospital.

We recommend adding an optional prescription benefit rider that is typically very inexpensive. Copays  are $5 (generic), $35 (brand) and $55 (non-formulary mail order). A $100/$300 deductible will also apply to this rider. An optional maternity rider is also available at a very reasonable cost. Outpatient mental health benefits are also covered, which is unusual for private plans.

Perhaps the most popular feature of the “PPO Plan 4” is the low $250 major medical deductible, which is not often available with most other PPO plans from major Pennsylvania health insurers. Once this deductible is met, the policy pays 80% of all covered expenses (the coinsurance is 20%) until the maximum out-of-pocket limit of $1,500 is reached. Higher deductibles are offered through other plans, Rates will be lower, but most office visit and prescription coverages remain unaffected.

There is no lifetime maximum for paid benefits and many additional benefits are included, such as mental health coverage, no fees when applying for coverage and electronic signatures allowed during the application process. Basic dental and vision benefits are available through the “MyChoice Essential” plan, which was just introduced in 2012. This plan contains most of the important benefits of “Plan 4,” but is much less expensive since the deductible for larger claims is $2,500 instead of $250.

We’ll be happy to review additional Plan 4 specifics along with details on the other plans. At the same time, as an unbiased broker, we’ll also inform you if companies like Aetna, UnitedHealthcare, Blue Cross, HealthAmerica or Assurant offer better options.

For additional information or if you wish to apply for coverage, please call us at (888) 513 6446.

INSTANTLY VIEW GEISINGER RATES

SERVICE AREA

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This plan uses the “Personal Choice” Network so you pay much less for treatment when you utilize Network providers. You can also use your policy if you are outside of the state. The Keystone Health Plan East HMO is alternative to this plan, although premiums are higher.

An HSA (Health Savings Account) is a form of medical benefits that allows you to pay for current and future approved medical, dental and vision expenses with tax-deducible dollars. The HSA account works with a “High Deductible Health Plan” and you have complete control over the funds in your Pennsylvania HSA. Most companies will provide a debit card to conveniently pay for the expenses. I have had an HSA for many years and the debit card is a great free feature.  It’s important to remember to use it for all of your qualified purchases.

The Personal Choice plan covers all qualified preventive services at 100% without any waiting period or deductible. The most common preventive benefits are routine annual physicals, mammograms, pediatric immunizations, pap tests and routine gynecological exams. Six nutrition counseling visits are also included. A much broader list of benefits is available. Each year, you may see additional free benefits added.

Once the deductible has been met, Independence Blue Cross pays 100% of covered expenses. This would include all primary care office visits, specialist office visits, inpatient and outpatient hospital services, emergency room charges, ambulance services medical equipment and MRIs. Whether the amount is $1,000 or $1o million, there is no cap on covered benefits. There is also no annual upper limit.

Also covered at 100% after the deductible are generic formulary, brand formulary and non-formulary prescriptions. There is no  maximum benefit and mail-order is available. Also, occupational therapy, physical therapy and spinal manipulations are all covered benefits, subject to limitations on visits. The concept of this policy is to provide total coverage of your health care expenses after a specific stop-gap amount.

Many expenses that are subject to the deductible receive a negotiated network discount which will lower out-of-pocket expenses. Lab fees and X-rays often receive very substantial discounts…often as much as 80%. Even ER visits will be discounted.

Sample Personal Choice PPO 5000 HSA Monthly Rates in the Philadelphia Area:

$111 40 Year-Old Male

$130 40 Year-Old Female

$384 40 Year-Old Male & Female Plus Two Children (Family Of Four)

For additional information regarding this plan or any other Pennsylvania Independence Blue Cross plans, please contact us. We’ll be happy to review your options and help with the application process. You can also apply online or receive a free quote at the top of the page.

View Independence Blue Cross Personal Choice PPO 5000 HSA Plan Details

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1. Highmark Blue Cross Blue Shield High Deductible Rates

Pahealthinsurancecoverage.com is the recognized trusted website for Pennsylvania HSA rates and benefit information. We carefully created this website so you can easily view and compare HSA policies from the best health care providers in the state. But most importantly, with our 30 years of experience, you also have someone you can talk to individually that will provide expert advice and recommendations. We’ll carefully research all of your options and offer the choices that best fit within your budget.

An HSA is a high-deductible insurance policy with an optional tax-favored savings plan. Deposits into the savings plan can accumulate and pay the deductible (if needed) and other qualified medical, vision and dental expenses. Contributions are tax-deductible and qualified withdraws are not subject to taxes. All funds that accumulate in the HSA can be withdrawn at any time, and unused funds at the end of the year can be rolled to the next year. You don’t have to worry about losing money that you did not use.

Not everyone should consider a Pennsylvania Health Savings Account and HSA rates will vary, depending on which part of the state you live. But, generally, the best rates are available from Independence Blue Cross, Highmark, Aetna, UnitedHealthcare and Healthamerica. However, this is not an all-inclusive list so when we discuss your options, depending on which part of the state you reside, we may consider additional regional carriers. For example, Geisinger should be considered in the Harrisburg and surrounding area.

Many policies have an “embedded deductible,” which is a deductible on each person (usually capped at two). UnitedHealthcare and a few other companies have an “aggregate deductible, which is a larger family deductible that must be met before most benefits are paid. Each type of deductible option has its own advantages and we’ll be happy to review the effect they might have on your individual or family HSA.

These types of policies will remain popular for families and individuals. With the wide range of deductible and coinsurance options, it’s always a good idea to compare multiple plans to find the best fit. The free quotes you view from us will allow you to quickly and easily determine which Pennsylvania HSA plans are best for you.

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How to use these charts:

• For an individual: single male, age 25; no spouse or children; $3,500 deductible. Based on the individual’s gender, the rate is taken from the Male rate chart, $3,500 Individual Deductible, for age 25. This individual’s monthly rate is $57.10.

Monthly Rates Female

Monthly Rates Male

PPOBlue Preferred-Provider High-Deductible Program

$2,400 Family Annual Deductible

How to Apply the PPOBlue Family Deductible

For an Agreement covering more than one (1) family member, the ENTIRE family deductible must be met (within a benefit period) before Highmark will pay for covered services for ANY family member. The family deductible can be satisfied by an individual family member or a combination of one or more family members.

How to use these charts:

• For a family of four: father, age 51; mother, age 48; son, age 18; daughter, age 15. Based on the father’s gender and as the older spouse, the rate is taken from the Male rate chart for age 51. Under the Husband/Wife/Children category, this family’s monthly rate is $525.60.

Monthly Rates Female

.

Monthly Rates Male

PPOBlue Preferred-Provider High-Deductible Program

$5,200 Family Annual Deductible

How to Apply the PPOBlue Family Deductible

For an Agreement covering more than one (1) family member, the ENTIRE family deductible must be met (within a benefit period) before Highmark will pay for covered services for ANY family member. The family deductible can be satisfied by an individual family member or a combination of one or more family members.

How to use these charts:

• For a family of four: father, age 51; mother, age 48; son, age 18; daughter, age 15. Based on the father’s gender and as the older spouse, the rate is taken from the Male rate chart for age 51. Under the Husband/Wife/Children category, this family’s monthly rate is $450.20.

Monthly Rates Female

Monthly Rates Male

PPOBlue Preferred-Provider High-Deductible Program $7,000 Family Annual Deductible

How to Apply the PPOBlue Family Deductible

For an Agreement covering more than one (1) family member, the ENTIRE family deductible must be met (within a benefit period) before Highmark will pay for covered services for ANY family member. The family deductible can be satisfied by an individual family member or a combination of one or more family members.

How to use these charts:

• For a family of four: father, age 51; mother, age 48; son, age 18; daughter, age 15. Based on the father’s gender and as the older spouse, the rate is taken from the Male rate chart for age 51. Under the Husband/Wife/Children category, this family’s monthly rate is $418.80.

Monthly Rates Female

Monthly Rates Male

To apply for coverage, request an application by calling (888) 513 6446 or email us at eharris@pahealthinsurancecoverage.com

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1. Independence Blue Cross Personal Choice PPO 5000 HSA Plan

Here at Pahealthinsurancecoverage.com, we are the recognized resource for affordable Health Savings Accounts in Pennsylvania. The rates we publish are the lowest rates offered by each carrier and there are never any fees for our service. We feel it is important to find the health insurance policy that best matches your budget concerns, but that also provides the benefits that you need. And we will take the time to review all of the Highmark options with you.

The Highmark PPOBlue HSA offers three deductible options. They are $1,200, $2,600 and $3,500 for individuals and $2,400, $5,200 and $7,000 for families. Once the deductible has been met, benefits are payable at 90%. Once the designated coinsurance has been met, covered benefits are paid at 100%. Preventive services, such as routine physicals, mammograms, gynecological exams, pap tests and adult or pediatric immunizations are not subject to a deductible, copay or coinsurance and are covered immediately. Also, as a result of national health care reform, the lifetime cap has been removed.

Some of the additional benefits provided by the PPOBlue plan are occupational and speech therapy, spinal manipulations, and discounts on health related services such as fitness centers and spas, nutritional counseling and personal trainers.

Highmark Blue Cross Blue Shield negotiates lower member rates with doctors, hospitals and other facilities. So when you utilize network facilities, you’ll pay the lower negotiated rate for services and possibly prescriptions. Some of these discounts can be substantial, especially lab tests and x-rays. Highmark’s HSA provider network is one of the largest in Western Pennsylvania and we’ll be happy to find participating providers for you. There’s a high probability that there are many available physicians within a few miles of where you live or work.

An HSA is a low cost alternative to a traditional comprehensive health insurance policy. Although it is classified as a savings product, you are able to pay for current and future health care, dental and vision expenses on a tax-free basis. You also have complete control of the money in your account including the type of investments.

The HSA works with a “High Deductible Health Plan” (HDHP), and the combination of both accounts can provide substantial savings in premium dollars and taxes over many years. The deductible, which is the amount you pay out of pocket before benefits begin, is usually fairly high. Therefore, establishing the HSA account will save you money.

For additional information on the Highmark Blue Cross Blue Shield HSA plan, please feel free to call us at (888) 513 6446 or email eharris@pahealthinsurancecoverage.com. We’ll be happy to provide additional specific details regarding the plan, rates and how you apply. You can download the application and fax to (888) 513 6446.

View Highmark HSA Rates

View Highmark Plans

Highmark Application

Benefit Summary listed below for $2,600  Individual/$5,200 Family HSA:

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Pahealthinsurancecoverage.com is the trusted authority for the best Pennsylvania health insurance plans. Instantly, you can view, compare and apply for high quality health care from the top companies such as Independence Blue Cross, Keystone, Highmark Blue Cross Blue Shield, Aetna, UnitedHealthCare, Capital Blue Cross, HealthAmerica, Geisinger, Celtic and Assurant. The rates you view on this website are always the lowest published rates allowed and approved by the state and each carrier. And our free service continues even after your policy is approved.

If/when the Pennsylvania Health Insurance Exchange is active, we hope to play an active role in assisting Pennsylvania residents find low cost medical coverage that provides the coverage needed for each individual or family situation. We believe it is incomprehensible to consider hiring inexperienced and unlicensed workers to handle such a complicated task. Also, the process of eligibility determination for premium tax credits will be an important task for the Pennsylvania Exchange.

Since health insurance premiums will undoubtedly be higher than current rates, it is imperative that tax credits be quickly determined and applied to policies. And although our role is undefined at this time, we will offer our expertise and resources to ensure that policies are efficiently issued and most importantly, Pennsylvania residents have an experienced licensed broker to consult after the policy is approved.

We’ll keep you updated on the progress of the Pennsylvania Health Insurance Exchange. As events occur, we’ll post them here. Until that time, as previously mentioned, you can view, compare and apply for coverage here, and your rates are the lowest published by each company. And of course, feel free to call us at (888) 513 6446 if you would like to speak to a very live person.

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