Pennsylvania health insurance providers offer comprehensive, catastrophic, student and short-term temporary coverage to Pa residents. Many plans are available at very low rates. As one of the state’s leading authorities for providing affordable healthcare coverage, we represent all of the large companies. Our unbiased information, advice and online quotes are free, and allow you to view the best prices in minutes.
We help you find the carriers that offer the least expensive prices, while maintaining the services you need most. The most important factors include the type of benefits you need, your budget, the networks of your personal physicians and what level of federal subsidy you are likely to receive from the federal Exchange. We have listed below details and important information about many of these carriers.
Although a limited number of companies participate in the State Marketplace, additional companies offer small-group and Senior products. It is also possible that in certain years, individual and family coverage may be available, but not small business coverage. And of course, vice versa. "Off-Marketplace" policies can also be purchased, but they are not eligible for federal tax credits. These options are often ideal for households with income above $100,000 that would not otherwise qualify for federal aid. Tax-favored HSAs should always be considered by upper-income households.
Aetna offers an extensive combination of PPO and HMO Pennsylvania insurance plans. As the first national, full-service health insurer to offer individual consumer contracts, Aetna also features various competitively-priced Senior Medigap plans. Private coverage for persons under age 65 consists of employer-sponsored coverage (see below) and various ancillary products.
Policies are available for Group benefits and "off-Exchange" since individual Marketplace plans are no longer offered. In 2017, Aetna made the decision to offer plans in only four states - Virginia, Delaware, Iowa, and Nebraska. Heavy underwriting losses contributed to the decision.
The Premier 2000 PD Gold PPO policy is the most comprehensive private contract available. It features a $10 copay on office visits along with a $30 copay on visits to a specialist. Generic drugs are subject only to a $4 copay. The deductible is also just $2,000.
Also, Aetna’s dental rates, if added to the policy, are typically only $15-$20 per person (per month). That cost is substantially lower than most other full-service rates. A stand-alone policy can also be purchased. Senior Medigap plans are available for applicants that have reached age 65, and are receiving Parts A and B benefits.
UnitedHealthcare (UHC) is one of the largest US insurers and provides plans through UnitedHealthOne and Golden Rule. Private individual comprehensive coverage is not currently available, although small and large group plans are offered in the Keystone State. Senior Medigap products are also available, and are typically very affordable. UHC and AARP jointly offer many plans.
The “Bronze Compass 6500” policy is the most popular comprehensive plan in their portfolio. Rates are low because of the higher ($6,500) deductible. The Silver Compass 4500 is also popular, especially for applicants that qualify for a federal subsidy. Their temporary rates are also excellent. Short-term contracts can be bought throughout the entire year, regardless of Open Enrollment periods.
Currently, they do not offer options through the Marketplace. This means that if you qualify for an Obamacare tax credit subsidy, you would not be able to buy a UHC plan (unless you forfeit the subsidy). However, for upper-income households, there are some excellent selections offered.
Policies are marketed under the "Golden Rule" brand. "FACT" membership is required, which provides discount eye and dental benefits. UHC did not offer plans in many states in 2014 as they chose to "sit out" and watch to see how Obamacare works out. We assume that in 2015, UHC will offer both "on" and "off" Exchange coverage.
The “Bronze HSA 100” plan is one of the most popular catastrophic coverage options in the state. With 100% preventive benefits and no lifetime cap included, this policy is a great way to reduce your premiums.Because it is classified as a Health Savings Account (and "High Deductible Health Plan), tax-deductible deposits of up to $3,300 per year may be made. The policy has a simple concept - all qualified medical expenses are covered at 100% after the deductible is met.
HealthAmerica, was recently purchased by Coventry, who was subsequently bought by Aetna. So very shortly, all plans will feature Aetna's name. HealthAmerica was previously recognized as one of the 20 best health plans in the country by “The US News". Their $2500 and $5,000 deductible HSA plans are extremely competitively priced and the “Rewards” plan is a unique catastrophic policy that also provides preventive benefits. Some office visit and prescription benefits are included. And many policies automatically include some basic dental benefits.
HealthAmerica is one of the companies you don’t often hear about, but they are a well-respected organization. Recently, they lowered rates on their copay plans, and came out with a low-priced comprehensive policy.Because of the Aetna takeover, obviously, our website will not be focusing on their plans after 2014.
Highmark Blue Cross Blue Shield handles Pittsburgh and the 29 counties of Western Pennsylvania and has one of the largest provider Networks in the region. The Shared Cost Blue (A Community Blue contract) and Health Savings Blue plans are the most popular Bronze Marketplace policies and are available with deductibles of $5,500 and $3,400. Rates are generally extremely competitive and preventive benefits are always covered in full. Major medical expenses are paid (after the deductible with out-of-pocket limit) and federal subsidies can be applied to these plans.
Silver "Metal" options offer the unique cost-sharing feature that lowers the deductible and out-of-pocket expenses. For example, a family of four (parents in their 40s) would qualify for this feature if the household income is below $58,000. Three of the most affordable options offered are the Health Savings Blue 2750, Shared Cost Blue 2650 and Shared Cost Blue PPO 3200.
The "Advance Blue" plan is a policy that was initially offered in late 2011. It was one of the most sought-out options for consumers that were willing to pay higher out-of-pocket costs for specific items in return for a more budget-friendly price. If you still own this policy, you may have been able to keep it. However, it was discontinued since it did not comply with the new ACA legislation requirements.
Capital Blue Cross services 21 counties in the Central part of the state and the Lehigh Valley. PersonalBlue PPO was their popular medically underwritten individual policy that was replaced by the new compliant plans. Like all other companies, non-temporary plans are not subject to answering medical questions or taking a physical.
Bronze policies are the least expensive choices for budget-conscious customers. These include the Capital Blue Value HMO policies with $6,000 and $4,000 deductibles. The Healthy Benefits Value HMO 50 features no deductibles (both individual and family).The Gold PPO 1000 is the "Cadillac" Marketplace policy that is offered.
In the Harrisburg, Lancaster and Lebanon areas, they are very well-positioned on price. Geisinger and Highmark, however also must be included in comparisons in those areas. All three offer small business options that are very popular if the number of employees is less than 50.
Independence Blue Cross (IBC and IBX) is Southeastern Pennsylvania’s largest health insurer. The Keystone policies offer a wide variety coverages with low out-of-pocket costs. HMO Copay and HMO Deductible plans are popular choices for individuals and families.More than two million persons are covered in just the Philadelphia area (and surrounding counties). The five-county service area is Philadelphia, Montgomery, Bucks, Chester and Delaware.
When Marketplace plans became available in 2014, IBC's rates instantly became the most competitive in the area. Affordable options are found especially the Catastrophic, Bronze and Silver Metal tiers. The Personal Choice Guarantee-Issue plans were shelved, since underwriting is not required any longer.
The Personal Choice PPO Bronze Reserve and Keystone HMO Bronze plans are among the cheapest policies for individuals and families. The Personal Choice PPO Bronze is slightly more expensive but features a deductible that is $2,000 smaller. The Keystone HMO Silver Proactive and Personal Choice Silver plans have much lower deductibles, but still are reasonably-priced.
Blue Cross Of Northeastern Pennsylvania (BCNEPA) is based in Wilkes-Barre and serves northeastern and north central Pennsylvania. BCNEPA has merged with Highmark (announced in February 2014) and together, they serve the 13 Northeastern Pa counties. 14 plans are offered to consumers in allMetal categories including the catastrophic tier. However, "Multistate" policies can only be purchased as an Exchange plan, instead of outside the Marketplace.
The myBlue Choice LP and myBlue Access LP are the popular Bronze plans that are offered. They are low-cost options that feature 0% and 20% coinsurance ($5,500 and $4,500 deductibles), full preventive benefits and $25/$50/$75 copays on the different levels of prescriptions. Mail-order is available. First Priority Life underwrites these policies. Rates for children are below $100 per month for the myBlue Access policy.
Geisinger is based in Central Pennsylvania and offers extremely affordable options in Dauphin, Cumberland, Lancaster and surrounding counties. They feature plans with deductibles as low as $250 and are also one of many carriers to offer comprehensive maternity benefits. We feel Geisinger is one of the best options if you want a low deductible on the major expenses, assuming you live in the central part of the state. Recently, they have added dental and vision benefits to selected plans. Their high-deductible HSA policies compete very favorably to other companies, including Highmark and Capital BC.
As one of the participants on the Pa State Exchange, many policies are offered that are eligible for subsidies. The "Marketplace Solutions" 12 and 13 plans are the most affordable policies that are available to be purchased. They are "Bronze" tier plans with $4,000 and $6,000 deductibles respectively. The "Marketplace Direct" option is slightly more expensive.
The Marketplace Direct 1 is one of the most comprehensive contracts publicly available. As a "Platinum" plan, it features no deductibles and low $15 and $30 copays for visits to a family physician or specialist. The maximum out-of-pocket expense is $3,000 with a $500 per stay copay for hospital visits.
Assurant provides a wide range of financial services in the US including insurance to Keystone residents. Assurant offers competitive short-term temporary plans with many optional deductibles. In some areas, their high-deductible Health Savings Accounts feature fairly low rates. And their prices have been reducing in recent years.
The two major types of plan they market are "Minimum Essential Coverage" and "Not Minimum Essential Coverage" plans. Of course, the latter type of policy is cheaper, since it contains less mandated benefits. There are three "Non-Minimum" offerings.
For example, the "Value" policy pays fixed and predetermined cash amounts for hospital confinements, office visits and prescriptions. The "Fundamentals" plan is an upgraded version that covers four (instead of two) office visits at $75 each (instead of $50). Also, the daily hospitalization benefit is $2,000 instead of $1,000. The "Enhanced" version further upgrades benefits.
All three policies do not contain all 10 "Essential Health Benefits," as required by Obamacare, and therefore are more suited for purchasing outside of Open Enrollment.The special tax penalty of 1% of your income would apply with these contracts.
Assurant's major medical portfolio features options for all Metal plans - Bronze, Silver, Gold and Platinum. Preventive costs are covered in full and many combinations of copays and deductibles are offered.
Celtic Insurance Company is based in Chicago and offered individual short-term, comprehensive and HSA coverage before reorganization. The Celtic Indemnity Bronze policy is the top option offered to consumers. The deductible is $6,000 with 20% additional coinsurance. All four tiers of drugs are covered, although subject to deductible and coinsurance.
For additional information on any Pennsylvania health insurance company, please feel free to call us at (888) 513 6446. You can also contact us via email (see top of the page). We'll review which plans are most suitable for you and provide an easy method to apply for coverage. Your free quote takes only a few minutes and can be found in the quote boxes at the top of the page.