Pennsylvania Golden Rule health insurance plans are offered through this website, your one-stop shopping experience for medical coverage. Golden Rule (the brand name of UnitedHealthOne) offers affordable policies to single persons, single parents, children, families, the self employed, students and the uninsured. Whether your need is catastrophic, copay, short-term or long-term, we’ll help you compare all of the available plans and apply directly for benefits.
The personal and group rates you view on our website are the lowest prices provided to the public. We will also discuss with you the impact of healthcare reform and how you can utilize some of the changes to reduce your premium. Most importantly, we have devoted the top portion of the page for you to easily view your free quotes. You can have them emailed or you can view them live.
There are four available types of plans offered here in the Keystone state. They are Copay, HSA accounts, Select Saver, and Short-Term. All of these policies are Obamacare-compliant (off-Exchange) with the exception of the "short-term" plans. These temporary contracts, however, are ideal for providing inexpensive benefits for less than 12 months, especially if you missed Open Enrollment. A description of all four options is provided below:
Perhaps the most competitively-priced Pennsylvania Golden Rule plan is the “Copay.” This policy utilizes the extensive UHC Network of doctors, hospitals, X-ray and lab facilities and other related providers. Premiums are reduced by approximately 40% compared to non-Network coverage, and the policy is designed to provide benefits similar to traditional employer plans. It is considered the "Cadillac" of their plan offerings.
The policy is available through all four Metal Exchange options (Bronze, Silver, Gold and Platinum). The Silver plans offer the most deductible options (three). A $5,000, $3,500 or $2,500 deductible may be selected. The maximum out of pocket expense (per person) is $6,350 on all policies except the Platinum, which offers a $1,500 maximum. The Platinum plan also has lower copays on office visits and specialists ($15 and $30).
The HSA (Health Savings Account) features lower premium payments than the Copay plans. You also have more control over how much you spend on your medical treatment and the types of procedures and tests you elect to have done.
It uses a flexible spending account feature without the "use it or lose it" provision that forces you to buy benefits you don't need. As a result, any unused funds continue to roll over to the next year.You also get a tax deduction for depositing funds, even if the money has not yet been spent on qualified expenses.
The Bronze HSA 100 and Silver HSA 100 are the two featured plans in the state. The Bronze option has a $6,350 deductible while the Silver option offers a lower $3,650 deductible. There is no coinsurance on either policy so 100% of your expenses are covered once the deductible has been met.
Also known as a "catastrophic" plan, this type of policy is typically available to applicants under age 30, or if you receive a certificate exemption for not being able to afford the required essential benefits.
The concept is fairly straightforward and simple. There is no coinsurance, so once the deductible is met, 100% of covered expenses are paid. Premiums are very affordable since only three primary-care physician visits are included per year for each person. Of course, preventive benefits continue to be covered with no waiting period or applicable copay, coinsurance or deductible.
Specialist and Urgent-Care charges are subject to the deductible, although the negotiated price will save you some money. Prescriptions are handled the same way and a "Preferred Price Card" will lower your portion of the drug cost while the deductible has not been met.
Without question, short-term plans are the cheapest form of medical coverage. Often less than one-fourth of the premium of more comprehensive policies, temporary contracts place a deductible on all claims (including preventive) to keep rates low.For example, a 40 year-old male could purchase coverage for one month for about $50. Of course, prices will vary depending which county you reside in.
The four available temporary plans are Copay, Plus Elite, Plus, and Value. The Copay option is the only policy that offers office visit benefits (two visits per person per term with $50 copay). Also, drug coverage is much higher on this plan compared to the three others, which feature a "preferred Price Card," as mentioned above.
The "Value" option is perhaps the most popular, mainly due to its low cost. The maximum amount of expenses covered is $250,000 per person per term. The other three policies cover at least $1 million. Also, the coinsurance is 30%, instead of the standard 20%. Benefit period are your choice, although they must be between 1 month and 11 months.
Maternity benefits are now covered on all Metal plans, including delivery expenses, inpatient services and postpartum care. Any applicable coinsurance and deductible will apply. However, prenatal benefits are covered at 100%. Typically, uncomplicated standard deliveries allow 48 hours of coverage and 96 hours for an uncomplicated caesarean delivery.
Rates are extremely competitive in the Pittsburgh and Philadelphia areas. In the Reading, Johnstown and Harrisburg areas, the temporary policies are priced well. In Dauphin, Cumberland and some of the centrally-located areas, Highmark and Capital Blue Cross have strong rates that we would also review with you. When benefits are only needed for less than 180 days, the short-term option is not only cheap and most appropriate, but can be approved the same day.
When a Network physician is used for an office visit, 100% of history and exam fees are covered at 100% after a $35 copay. X-rays and lab tests receive a negotiated fee reduction (for Network providers) that substantially reduces your out-of-pocket cost. Adult and child preventive care benefits are also provided with no waiting period or copay. Some of the included benefits are child immunizations, preventive mammograms, Pap Smears and PSA screenings.
Referrals are not required and comprehensive prescription coverage is a covered benefit. Both generic and brand drugs are covered with no annual or lifetime caps. Regardless if your prescription costs are $10 or $10,000 per month, you will not run out of benefits.
One of the best low cost policies is UnitedHealthCare’s “Saver 80” plan. Premiums are generally half the cost of a comparable comprehensive plan, while providing catastrophic coverage in the event of a major medical claim. The lifetime maximum benefit is unlimited and deductibles from $500 to $12.500 are available. There is also an additional coinsurance that applies.
This plan is a "grandfathered" policy, so it is not available for new purchase. However, many consumers are able to keep their existing policy, depending on the original effective date. If you are not able to maintain the policy because of legislative changes, you will be notified in writing.
Generally, prices increase less for high deductible policies when compared to other more expensive plans. And yes...sometimes premiums actually decrease! This policy has been often used for young persons that are on a tight budget, or healthy families that don't want to pay for coverage that is not utilized.
The “Saver 80” plan is ideal for early retirees wanting a policy to carry them to Medicare or anyone wanting low-cost health care coverage in exchange for paying routine medical expenses out-of-pocket. Larger benefits are covered, including room and board, professional fees of medical personnel, intensive care unit, operating room and recovery room. Additional outpatient expense benefits are also provided such as outpatient surgery and emergency room fees for sickness and injury.
The "vanishing deductible" reduces every year if you don't meet it. That can make a big difference in what you pay. For example, you may start out with a $5,000 deductible, that gradually reduces to $2,500. And you are not charged a fee for this feature. Although not available on Exchange plans, this rider was popular on grandfathered policies.
UHC plans in Pennsylvania are offered through “Golden Rule Insurance Company.” GR is rated “A” by A.M. Best and “A+” by “Standard and Poors.” UnitedHealthCare processes the vast majority of their claims within 9-14 days and offers one of the largest US Networks with more than 580,000 physicians and care professionals and 4,900 hospitals nationwide. So if you are traveling outside of Pennsylvania, you’ll still be able to use your coverage. If you move to another state, there's a good chance you can keep coverage since more than 25 million persons are already covered with UHC.
Upon request, we’ll be happy to provide a list of local doctors and hospitals in any area of the country. This can be helpful, especially if you are going to be out of the area. And of course, the quotes are free. Simply enter your zip code at the top of the page. We'll help you calculate your subsidy.