Affordable Pittsburgh health insurance plans are available from Pennsylvania's major companies, such as Highmark Blue Cross Blue Shield, Aetna, UPMC, HealthAmerica, Humana, Gateway, and UnitedHealthcare. We help residents of Western Pennsylvania compare multiple carriers, research and apply for the best available individual, family, Senior, and group medical coverage so they can pay lower rates quality benefits. UnitedHealthcare, Aetna, Humana, and several other carriers offer Group and Senior plan options, but not private single or family medical coverage.
There are no brokerage fees ever associated with our website, and we also assist you in Open Enrollment through the State Exchange and Marketplace. If you waited too long for Open Enrollment (OE), we will show you low-cost options that will cover you until the next OE period. There are numerous options that will keep premiums substantially below Obamacare plans. Open Enrollment for 2018 effective dates began on November 1st.
Senior healthcare coverage in Pittsburgh, Allegheny County, and Western Pennsylvania is offered by many large and small insurers. Medicare Supplements, Advantage, and Part D prescription drug plans are priced very competitively. Popular companies include Cigna-HealthSpring, Advantra (HealthAmerica), Humana, UPMC, Highmark, Keystone, Aetna, AARP (UnitedHealthcare), Geisinger, and Gateway.
Highmark Blue Cross Blue Shield serves the 29 counties of Western Pa, including the Pittsburgh area. Available private (non-employer-provided) plans include: my Direct Blue HMO 6950B, my Direct Blue HMO 7000B, my Direct Blue HMO 7150S, my Direct Blue HMO1000G, Major Events Blue PPO 7350, my Direct Blue EPO 6950B, my Direct Blue EPO 7000B, my Direct Blue EPO 7150S, my Direct Blue EPO 1000G, my Direct Blue Conemaugh EPO 6950B, my Direct Blue Conemaugh EPO 7000B, my Direct Blue Conemaugh EPO 7150S, and my Direct Blue Conemaugh EPO 1000G. "Off-Exchange" plans offered include: Major Events Blue PPO 7350, Shared Cost Blue PPO 7000, my Direct Blue HMO 2850SQE, my Direct Blue HMO 3750s, my Direct Blue EPO 2850SQE, my Direct Blue EPO 3750S, my Direct Blue Conemaugh EPO 2850SQE, and my Direct Blue Conemaugh EPO 3750S.
Rates and coverages vary, so we carefully determine which of the Highmark plans (if any) would be the perfect fit for you. Although popular with small business owners and the self-employed, anybody who pays for their own coverage, including students and retired persons, should also consider these options. By utilizing the Blue Cross nationwide network, coverage is offered throughout most of the US.
Senior Medicare Supplement plans offered in Allegheny County include Plans A, N, B, C, F, and F (HD). Two Part D prescription drug plans are also offered (Blue Rx PDP Plus and Blue Rx PDP Complete). The nine available Advantage plans are Community Blue Medicare HMO Signature, Freedom Blue PPO Classic, Security Blue HMO Deluxe, Security Blue HMO Standard, Security Blue HMO Basic, Security Blue HMO ValueRx, Freedom Blue PPO ValueRx, Freedom Blue PPO Select, and Community Blue Medicare HMO Prestige.
Pre-Exchange Highmark Plans No Longer Available
The Highmark DirectBlue and PPOBlue plans, which are no longer available, offered comprehensive coverages including preventive care services, prescription coverage, and complete access to the Highmark Blue Cross Blue Shield networks. Office visits, inpatient hospital services, diagnostic services and maternity care were just a few of the additional benefits of each plan.
The AdvanceBlue was a newer plan that provided a copay on office visits that the other two pans did not offer. It became a very popular plan in the Pittsburgh area for small business owners that wished like to provide inexpensive benefits at a cost that was within their budget. The "Shared Cost Blue" effectively accomplishes the same thing today.
UPMC has been steadily adding market share in Allegheny county and nearby counties. They are in direct competition with Highmark and have a vast network of providers. Despite ongoing disputes and litigation with Highmark, UPMC offers very competitive rates, and often features the lowest-cost options.
The cheapest offered policy is the Advantage Bronze $6,950/$35. Although the deductible is high, the pcp office visit copay is only $35 and the generic drug copay is $30 and not subject to an additional deductible or coinsurance. The Partner, Select, and Premium networks are available. The UPMC Advantage Silver $3500/$25 plan is also available in three network tiers. The deductible is only $3,500 and copays are included for both pcp office visits ($25) and specialist office visits ($75).Generic, preferred brand, and non-preferred brand drugs receive copays.
Perhaps the best "bargain" policy is the Advantage Gold $800/$20 EPO plan. The low $800 deductible is very attractive along with the $20 copay on pcp and specialist office visits. Households with incomes between the Federal Poverty Line (FPL) and 250% of the FPL are eligible for "cost-sharing," and may wish to consider the Advantage Silver $3,500/$25 plan. This feature can potentially save thousands of dollars in out-of-pocket expenses by reducing the deductible and copays.
NOTE: Highmark customers can utilize specialty UPMC hospitals as an "in-network" provider. 10 other hospitals can also be utilized until 2019. They include: Most UPMC hospitals in Allegheny County, Horizon in Greenville, Hamot in Erie, and Hillman Cancer Center. In 2021, the following cancer treatment systems will no longer be in-netwok: St. Clair Hospital, Washington Hospital, Heritage Valley Health System, Excela Health, and Butler Health System. UPMC Children's Hospital can be used until 2022.
Aetna And UnitedHealthOne
Two of the nation’s largest insurers, Aetna and UnitedHealthcare, also offer extremely competitive Group and Senior rates in the state. Both carriers have nationwide networks and most physicians and hospitals in the area accept coverage. Older "grandfathered" plans are still in-force for many individuals and families. Marketplace (Exchange) plans are not offered (under age-65 applicants), although selected policy options may retrurn in 2019 or 2020.
Aetna also offers policies through Coventry, a company they previously purchased. Medicare Advantage prescription drug plans are Advantra Choice (HMO), Advantra Silver (HMO), AdvantraOne (PPO), Advantra Silver (PPO), Aetna Medicare Silver (HMO), Advantra Gold (HMO), Advantra Gold (PPO), and Aetna Medicare Gold (PPO). The only Advantage option without RX coverage is the Advanta Basic Medical plan. Three available prescription drug plans (Part D) are Aetna Medicare Rx Select, Aetna Medicare Rx Saver, and First Health Part D Value Plus.UnitedHealthcare Options
UnitedHealthcare, the nation's largest health insurance company, offers private, Group, and Senior medical plans. Their single and family products are designed for applicants that have missed the Open Enrollment deadline, or prefer a low-cost alternative to conventional coverage. The three available Medicare Advantage plans are AARP Medicare Complete Plans 1, 2, and 3. Four available Special Needs plans (SNP) are Dual Complete, Dual Complete ONE, Assisted Living Plan, and Nursing Home Plan 2. Four available Part D prescription drug plans are AARP MedicareRx Walgreens, Symphonix Value Rx, AARP MedicareRx Preferred, and AARP MedicareRx Saver Plus. Supplement plans offered include A, B, C, F, G, K, L, and N.
Coverage For Seniors In Allegheny County And Western Pa
Medigap and Medicare Advantage options are also available throughout the Pittsburgh area. Whether it is AARP, Humana or other smaller carriers, there are many choices that will budget-friendly. An Open Enrollment is available yearly for persons with serious medical issues. Additionally, for children under age 19 in low-income households, CHIP is a very popular plan to utilize.
Medicare Supplement plans pay some (or most) of the out-of-pocket expenses not covered when you submit a claim. Several of the most affordable Allegheny County options are listed below. However, it is important to properly compare, review, and understand all available plans to ensure you are choosing the most appropriate coverage. Prices and plan selection will be different in Washington, Beaver, Butler, Westmoreland, and other surrounding Counties.
Plan A - AARP-UnitedHealthcare, Transamerica, and Western Catholic Union
Plan B - Transamerica, Shenandoah Life, and Continental Life
Plan C - Western Catholic Union, Shenandoah Life, and AARP-UnitedHealthcare
Plan D - Shenandoah Life, Western Catholic Union, and New Era Life
Plan F - Continental Life, Cigna, and Guarantee Trust Life
Plan F (High DEductible) - United American, New Era Life, and Cigna
Plan G - Transamerica, Shenandoah Life, and Liberty Bankers Life
Plan K - AARP-UnitedHealthcare and Humana
Plan L - AARP-UnitedHealthcare and Humana
Plan N - Continental Life, Equitable National Life, and Shenandoah Life
Medicare Advantage Plans (Part C) provide Parts A and B through a private insurer instead of the Federal Government. Premiums are typically lower than standard Supplement contracts, and also may offer additional benefits. Often, drug coverage (Part D) is included. Illustrated below are several Advantage contracts offered to Allegheny County residents:
Advantra Basic Medical - $0 monthly premium with maximum out-of-pocket expenses of $6,700. Monthly office visit copays are $0 and $35. The ER and Urgent Care copays are $80 and $50. The outpatient hospital copay is $300 per visit, and the inpatient hospital copay is $150 for the first five days. Rehab therapy services have a $35 copay. No drug benefits are included.
Advantra Choice Plan - $0 monthly premium with maximum out-of-pocket expenses of $6,700. Monthly office visit copays are $10 and $40. The ER and Urgent Care copays are $80 and $50. The outpatient hospital copay is $225 per visit, and the inpatient hospital copay is $550 per stay. Rehab therapy services have a $35 copay. The prescription drug 30-day copays for Tiers 1-5 are $0, $5, $42, $200, and 33%.
Advantra Silver - $0 monthly premium with maximum out-of-pocket expenses of $6,700. Monthly office visit copays are $5 and $40. The ER and Urgent Care copays are $80 and $50. The outpatient hospital copay is $300 per visit, and the inpatient hospital copay is $195 for the first 7 days. Rehab therapy services have a $35 copay. The prescription drug 30-day copays for Tiers 1-5 are $0, $5, $42, $100, and 35%.
Allwell Medicare - $0 monthly premium with maximum out-of-pocket expenses of $6,700. Monthly office visit copays are $0 and $40. The ER and Urgent Care copays are $80 and $40. The outpatient hospital copay is $250 per visit, and the inpatient hospital copay is $295 for the first 6 days. Rehab therapy services have a $40 copay. The prescription drug 30-day copays for Tiers 1-5 are $0, $10, $47, $100, and 33%.
Community Blue HMO Signature - $0 monthly premium with maximum out-of-pocket expenses of $6,700. Monthly office visit copays are $0 and $40. The ER and Urgent Care copays are $80 and $50. The outpatient hospital copay is $350 per visit, and the inpatient hospital copay is $275 for the first 5 days. Rehab therapy services have a $40 copay. The prescription drug 30-day copays for Tiers 1-5 are $0, $15, $42, $90, and 33%.
HumanaChoice H5216-116 - $0 monthly premium with maximum out-of-pocket expenses of $4,500. Monthly office visit copays are $10 and $35. The ER and Urgent Care copays are $80 and $10-$35. The outpatient hospital copay is $295 per visit, and the inpatient hospital copay is $295 for the first 6 days. Rehab therapy services have a $10-$40 copay. Prescription drug benefits are not included.
HumanaChoice R0923-001 - $0 monthly premium with maximum out-of-pocket expenses of $4,500. Monthly office visit copays are $10 and $35. The ER and Urgent Care copays are $80 and $10-$35. The outpatient hospital copay is $350 per visit, and the inpatient hospital copay is $350 for the first 6 days. Rehab therapy services have a $10-$40 copay. Prescription drug benefits are not included.
Final Note: We have listed below the major hospitals in the Pittsburgh area. Please contact us to determine if your policy includes these facilities in their provider network.
Allegheny Cancer Center
HealthSouth Harmarville Rehab
Jefferson Regional Medical Center
Ohio Valley Hospital
Saint Clair Memorial
West Penn Allegheny Health System
To compare Pittsburgh health insurance quotes, please provide your zip code at the top of the page, or you can get an "instant quote." You can also call us and we'll be happy to review your options. The enrollment process typically takes less than 15 minutes. Once your policy is approved, our award-winning customer service will still be available.
About 400,000 Pa residents (many reside in the Pittsburgh area) will not lose federal subsidies. The US Supreme Court ruling in King Vs. Burwell (6-3) allows states that use the Federal Exchange to continue to offer subsidized coverage.With 2016 Open Enrollment beginning in four months, once again, many low-cost policies will be available.
Hiighmark's BlueCard policyholders may have been affected by a security breach at Excellus BlueCross BlueShield which serves Rocherster (New York) and the surrounding area. Names, social security numbers, dates of birth, and financial information may have been compromised. The online attack happened in early August and may have impacted more than 10 million persons.
This security incident is not the first for Highmark, who in recent years has been attacked. As a result, free identity-theft and credit-monitoring services have been provided to help protection against future problems.