Find the best central Pennsylvania health insurance plans in minutes. We provide unbiased information from all of the best carriers such as Highmark Blue Shield Blue Cross, Capital Blue Cross, Aetna, Geisinger, and UnitedHealthOne (UnitedHealthCare). We offer medical plans to individuals, families, the self employed and the uninsured of Central Pennsylvania. Harrisburg, Lancaster, Chambersburg, Lebanon, Hershey, and York are several cities in the area. Senior Medicare plans help persons that have reached age 65 secure quality benefits.
Although Geisinger is not one of the larger companies, their rates are very affordable, especially if you prefer more personable treatment. You can read about Geisinger here. They were also one of the original companies to offer deductible options as low as $250 without having to use an HMO. Their Network of providers also extends beyond the central part of the state. A very inclusive RX benefit is also available with most of their plans.
Geisinger's cheapest policies are the "catastrophic" HMO and POS plans, available only if you are under the age of 30, or you can show proof of financial hardship that meets the Department Of Health And Human Services (HHS) guidelines. However, these policies do not qualify for federal Obamacare subsidies, so they only should be considered if your household income is above 400% of the Federal Poverty Level and you have no major medical conditions.
Rates In Central Pa
Central Pennsylvania health insurance prices are fairly low compared to most parts of the state. Usually, prices in the Pittsburgh and Philadelphia areas tend to be approximately 10%-20% higher than Harrisburg, Lancaster and Lebanon area rates. Physician charges, hospital room rates and malpractice insurance premiums are generally lower than other parts of the state, accounting for some of the difference. Renegotiated network pricing also helps consumers pay lower medical costs. Although the number of available carriers has reduced for applicants under age 65, it is anticipated the additional companies will return to the market by 2020.
The Southeastern Pennsylvania area is served by Independence Blue Cross (IBX), who at one time was negotiating a merger with Highmark. Their Keystone plans provide PPO and HMO options to residents of that area. However, since you must reside in five local counties to qualify for a policy, residents outside of that area are excluded. These counties are Philadelphia, Montgomery, Chester, Bucks and Delaware.
Affordable And Popular Plans
Regardless which part of the area you reside in, each individual and family is different. Catastrophic coverage may be the best solution for certain situations, but not for others. That’s why we feel it is important to consider all of the available medical plans from all of the major companies, and not just a selected few.
For many consumers, the following options (below) have been quite popular. Each of these policies can be purchased through our website at the lowest available rates and with no fees. Each policy is eligible for the federal subsidy unless otherwise indicated. All qualified preventive expenses are fully covered.
Geisinger Marketplace Value - $7,350 deductible and 0% coinsurance. First three pcp office visits are covered at 100%.
Highmark my Direct Blue Major Events EPO 7350 - $7,350 deductible and 0% coinsurance. First three pcp office visits covered at 100%.
Geisinger Bronze HMO 30/60/6100 - $6,100 deductible with 0% coinsurance. Office visit copays are $30 and $60. All prescription drugs must meet the deductible.
Highmark my Direct Blue EPO 6950B - $6,950 deductible. $50 pcp office visit copay. All prescription drugs must meet the deductible.
Highmark my Direct Blue EPO 7000B - $7,000 deductible with 30% coinsurance. Office visit copays are $60 and $100. Tier 1, Tier 2, Tier 3, and Tier 4 prescription drugs subject to 15%, 25%, 35%, and 50% coinsurance respectively.
Capital BlueCross Bronze PPO 7350/60 - $7,350 deductible with 0% coinsurance. Office visit copays are $60 and $85. All prescription drugs must meet the deductible.
Flex Blue 2100 from Highmark - Reasonably low $2,100 deductible. However PCP and Specialist visits only subject to copay ($45 and $90). Most drugs don't require a deductible to be met. It is a "Community Blue" plan so check with us regarding network providers.
Marketplace Extra 3 from Geisinger - $2,000 deductible and $10 copay for PCP visits. Also a low $3 copay for generic prescriptions. A big money-saver if you take multiple generic drugs.
Marketplace Direct 10 from Geisinger - Somewhat similar to previous plan, although no coinsurance and lower out-of-pocket expenses if you have a major claim.
Comprehensive Care Blue PPO 1500 from Highmark - Low $1,500 deductible and copays on most prescriptions. $70 copay on mental/behavioral expenses, which is slightly less than many other Highmark policies.
Keystone Healthy Benefits Value HMO from Capital BlueCross - No deductible or coinsurance although there is a $750 per day inpatient service charge. It's a bit pricey compared to other options, but in some circumstances ( especially if you qualify for 94% cost-sharing), it's a lot of benefits for the price you are paying.
Flex Blue PPO 1000 from Highmark - Low $1,000 deductible with $25 and $50 copays on office visits. Similar to Flex Blue 2100, a Silver plan.
Marketplace Extra 2 from Geisinger - $500 deductible and $10 copay on pcp office visits minimizes out-of-pocket expenses. Specialist visit is also only a $40 copay.
Marketplace Solutions 5 from Geisinger - Higher deductible ($1,350) than Extra 2 plan, but lower out-of-pocket maximum $2,500 vs. $5,000).
Health Savings Blue PPO 1300 from Highmark - Low $1,300 deductible with only $2,300 maximum out-of-pocket expense (individual).
HealthAmericaOne Gold $5 Copay HMO from Coventry - $5 copay and $1,750 deductible makes this plan popular, although not cheap. If you qualify for a large subsidy, it can be a great option.
Marketplace Extra 1 from Geisinger - No deductible, $10 copay on office visits and maximum $2,000 out-of-pocket expense ($4,000 per family). This is a nice plan! Hospital stays re subject to a $250 inpatient copay and preferred brand drugs are only subject to a$35 copay. As a Platinum-tier plan, it isn't cheap, but the benefits are outstanding.
Comprehensive Care Blue PPO 500 from Highmark - $500 deductible and a very low $1,650 (per person) maximum out-of-pocket expense. Most non-preventive benefits except prescriptions are subject to deductible and 10% coinsurance. Typically, about 20%-30% more than Marketplace Extra 1 policy.
Cheapest Medicare Advantage Plans In Central Pennsylvania
Many Seniors utilize "Medicare Advantage" contracts for providing their medical benefits. These types of policies are issued by private carriers that receive direct reimbursement from Medicaid to offer Parts A and B benefits. Typically, drug coverage is included, although specific copays, premiums, and out-of-pocket expenses vary. Listed below are 10 inexpensive plans (and their monthly rate) available in Lancaster County and much of the surrounding area:
$0 - Cigna HealthSpring Advantage
$0 - Geisinger Gold Classic Complete RX
$0 - Advantra Silver
$0 - HumanaChoice R-5826-002
$0 - UPMC For Life HMO Deductible With RX
$20 - Cigna HealthSpring Preferred
$23 - AdvantraOne
$39 - HumanaChoice H5525-006
$50 - Capital BlueCross SeniorBlue - Option 2
$69 - Aetna Medicare Standard
NOTE: It is very important to consider many other variables (including network provider list) before selecting a plan.
Coverage For Your Pets
We're really not kidding! Capital BlueCross works closely with PetPlan, one of the largest pet insurers in the US. Coverage is available in the Lehigh Valley and outlying areas. Coverage is available for dogs and cats and three options (Gold, Silver, and Bronze) are available. Cap BC members receive a 10% lifetime premium discount.
The rate is based on a combination of factors, including the age and breed of your pet, and where you live. A dalmatian for example, will cost about 20% more than a poodle or golden retriever, but won't be as expensive as a pit bull. If you move, your policy does transfer with you, although your rate may change. For example, Allegheny rates are about 15% lower, while rates in the Eastern portion of the state are generally lower.
Bronze benefits (the most popular option) typically include coverage for veterinary exams, surgery, medications, diagnostic and cancer treatment, dental, behavioral, MRI, cat scans, and ultrasounds. The upgraded Silver and Gold plans may offer boarding fees, coverage from death/illness, and help with advertising and rewards for a lost pet.
October 2010 - National health care reform now mandates preventive benefits on most policies to be covered at 100% with no waiting period. Most plans (other than temporary) include these new provisions.
March 2013 - The State Exchange will open in October. Current rates and applications for coverage will continue through our website. We will also advise you of your eligibility for federal tax subsidies.
September 2014 - Capital BlueCross and the Health Care Improvement Foundation (HCIF) will be working together in the Lehigh Valley and Central portion of the state. Palliative care will be the initial focus of this joint initiative. Physicians, specialists and practitioners will focus on improving awareness and decision-making as it relates to patient care.
October 2014 - The State Senate may require "navigators" to undergo criminal background checks. These federally-certified counselors are often very inexperienced and can not match the comprehensive assistance that is available through brokers and top-rated websites such as ours. Currently, navigators are trained, but still lack the expertise offered by experienced agents. Currently,the proposed bill has not been voted on or passed.
May 2015 - Obtaining medical coverage in Central Pennsylvania for spouses is becoming increasingly difficult, according to a recent survey by Conrad Siegel Actuaries. More than 100 small and large companies were studied, and almost one-third did not offer spousal health insurance coverage in 2014. This was a significant increase from just two years ago.
Also, many companies that offered spousal medical benefits charged an extra premium (typically about $140 per month) for the extra coverage. Roughly 20% of group premiums were paid by the employer, and HSA and other reimbursement plans continued to grow in popularity, perhaps because of their lower rates and tax-favored features.
October 2017 - Highmark, Geisinger, and Capital BC continue to dominate the under-65 market. However, Senior coverage is offered by many additional companies, including Cigna, Aetna, and Humana.