Pa catastrophic (high deductible) health insurance plans are an affordable low-cost option to reduce rates, and still maintain major medical benefits. We specialize in helping Pa residents find the least expensive catastrophic coverage with top-ranked companies. The combination of high deductible plans and supplemental coverage is often a popular cost-saving option. After Open Enrollment ends, you can continue to buy qualified plans with an approved exception.
During Open Enrollment, Catastrophic plans are the cheapest policies offered to Pa residents. To be able to purchase these types of plans, you must be under age 30, or qualify for "economic hardship." If the cost of coverage is more than 8% of the household income, the "economic hardship" rule will apply. This will allow you to save money by selecting a cheap plan, and utilize negotiated network discounts offered by each carrier. However, in many situations, selecting a Bronze-tier plan will be more cost-effective, since a federal subsidy may apply. Expanded benefits may also be offered, including copays for an unlimited number of pcp (primary care physician) visits.
If you forgot to sign up during the OE period, you can apply for several economical options that concentrate on paying larger claims, instead of routine office visits and medications. Since these policies are not designated for long-term use, it's best to utilize them only until the next Open Enrollment, which typically occurs at the end of the calendar year. However, in the future, eligibility dates may change as Trump Administration plans become available. By 2018 0r 2019, several newer plans may be offered, that eliminate many benefits that most consumers do not utilize.
Many Companies Offer Plans
Individual and family plans are offered through large insurers such as Highmark Blue Cross Blue Shield, Capital Blue Cross, UPMC, Keystone, Independence Blue Cross, and Geisinger. The rates you view on this website are always the lowest issued by the carriers, and the exact rate that you would pay by going directly to the carrier. Therefore, by utilizing our 37 years of experience, you are always viewing the lowest offered premium. Note: HealthAmerica was purchased by Coventry...which was recently bought by Aetna.
Also, NE Blue Cross merged with Highmark, and Aetna and UnitedHealthcare may return to the under age-65 market in 2018 or 2019 (private individual coverage). Additional carriers, such as Cigna and Humana, offer Senior products, but not private (non-Group) plans to persons under age 65.
Pa Seniors covered by Medicare, if you have reached $4,950 in out-of-pocket prescription drug expenses, a catastrophic benefit begins, and generally only a small copay or coinsurance applies. Although Plan F is the most comprehensive Medigap option, a high-deductible Plan F is offered that features the same standard benefits, although a deductible must be met. Despite the high deductible, foreign travel and emergency care, hospice care, and a skilled nursing facility copay are included.
Catastrophic health insurance policies will insure major claims, such as hospital expenses (including semi-private room charges, surgery and fees charged by doctors, surgeons and nurses), outpatient surgery, and emergency room and facility charges. Also referred to as “high deductible” plans, this type of coverage typically has a high deductible (up to $7,150 for individuals and $14,300 for a family) that must be met before most non-preventative benefits are paid. Out-of-pocket expenses will depend on which deductible is selected, along with the coinsurance option that you choose.
Whether you are one person, a family, uninsured, self employed or on Cobra, this type of plan is always worth considering. The concept is simple: In the event of an emergency, protect yourself against unexpected illness, disease or an accident. Supplemental options are available for persons that already have existing benefits, but simply want to cover some of the "gaps" in their policy. A Medigap plan works the same way. Medicare covers most expenses and a secondary policy fills in the "gaps." Medigap plans are designed to help Seniors, while special supplemental options can help persons under age 65 cover many out-of-pocket expenses.
If you are in reasonably good health (or if you have chronic conditions), you can apply and get approved for a policy with more coverage, such as office visits and lower out of pocket charges. You should, however, consider what effect that will have on your current and future situation. Having office visit copay benefits is always a great feature. But it's important to determine if you are paying thousands of dollars per year for a coverage that only provides a few hundred dollars of coverage in return.
The Best Catastrophic Health Insurance Plans In Pennsylvania For 2017
UPMC Catastrophic $7,150/$0 - Available in Partner, Select, and Premium Networks. $7,150 deductible with 0% coinsurance. Deductible must be met before non-preventative expenses are covered. Available in Western Pa, and other area counties.
Highmark Major Events Blue PPO 7150 - One of the least expensive plans available, it features a $7,150 deductible with no coinsurance. Similar to prior plan although three pcp office visits are included at no cost.
Geisinger Marketplace Value - $7,150 deductible with 0% coinsurance. Like UPMC plan, deductible must be met before non-preventative expenses are covered. Only available in central Pennsylvania and various surrounding counties.
Independence Blue Cross Personal Choice Catastrophic - $7,150 deductible with 0% coinsurance.Similar to other plans although first three pcp office visits are subject to $50 copay. Available in the Philadelphia area.
Best Plans Prior To 2014 (No...You Can't Buy These Any More!)
After researching hundreds of different options, three of our favorite Pennsylvania catastrophic policies were HealthAmerica’s “QHDHP”, UnitedHealthcare’s “Saver 80” and Aetna’s “Preventive & Hospital Care” plans.
The HealthAmerica “QHDHP” policy is a catastrophic contract with a few features that normally aren’t found on this type of plan. For example, preventive benefits are NOT subject to the deductible. Well child and adult physicals, routine mammograms, gynecological exams and preventive immunizations are covered with no out-of-pocket cost. And once the deductible has been met, primary care and specialty office visits are covered with a copay along with some prescription coverage. It is also an eligible HSA plan.
UnitedHealthCare’s “Saver 80” policy is a no-frills policy that has been a top cheap plan for many years. Most major medical expenses are covered and subject to the deductible. Typical covered expenses are inpatient and outpatient hospital fees, emergency room charges, fees charged by doctors, surgeons and nurses, and radiation/chemotherapy treatments. Additionally, facility charges, CAT scans, MRIs, inpatient physician visits and prescriptions, and standard operating room and recovery room charges are also covered. This plan may lack some of the benefits of the “QHDHP” policy, but in many parts of Pennsylvania, it’s the lowest cost health plan available.
Aetna’s “Preventive & Hospital Care” policy is a budget plan with a $3,000 deductible. It’s an HSA-eligible contract that provides comprehensive preventive benefits that are not subject to the deductible. Premiums are especially competitive in Central and Western Pennsylvania. If having low premiums is a major priority, this plan should be considered. However, it does place a limitation on RX benefits.
We’re committed to finding the plan that best matches your specific budget and needs. You can apply online for coverage or we can assist you. Please feel free to email or call us at (888) 513 6446. The top section of the website is where your free online quote is provided.
Updates From The Past:
October 2013 - Catastrophic coverage is available as Exchange plans. To qualify to purchase this type of policy, you must be under age 30 or have special "hardship" exemptions. Typically, major medical expenses are covered, and a deductible applies to most non-preventive expenses.
Some of the most popular catastrophic options for the Pa Exchange (you can get free quotes at the top of the page) include Highmark Major Events Blue, HealthAmerica HMO, UPMC Advantage Secure Select, Keystone Healthy Benefits Value HMO, Geisinger Marketplace Value, Aetna Basic, Independence Personal Choice and Blue Cross of NE Pa MyBlue.
January 2014 - The government is now allowing policyholders that have had their plan cancelled due to the implementation of Obamcare, to purchase catastrophic plans on the Exchange. Prior to this announcement (see above), only applicants under age 30 could qualify. A copy of the cancellation letter will be required by most companies to obtain this special low-cost policy.
April 2014 - If you qualify for an exception, you can still buy a plan that receives subsidies. There are about 10 situations that allow you to qualify for financial help after Open Enrollment has ended. Otherwise, there are additional low-cost options that we can discuss with you. Simply contact us with your information.