Western Pennsylvania health insurance rates are very affordable compared to other parts of the state. Catastrophic, copay, short-term and HSA plans are provided from most of the major health insurance companies (Highmark BCBS and UPMC are two of the biggest) in the Pittsburgh area either on or off the Exchange. Regardless what type of policy you need to purchase, there are many low cost options to consider. Applying and enrolling for 2017 is now easier and quicker than ever.
Finding The Best Pa Health Marketplace Rates
We research and find the most affordable Western Pa plans and make it easy for you to compare and apply for top-notch coverage at rates that are guaranteed to be the lowest offered by all of the medical providers. We compare all carriers so you can find a Marketplace policy (or policy without a federal subsidy) that meets your budget needs and gives you quality benefits. We only investigate top-ranked companies and never use any type of “discounted-benefit” plan.
Typically, prices in this part of the state are often lower than most other sections, especially the Philadelphia and surrounding area. Some of the cities (other than Pittsburgh) that feature very attractive rates include New Castle, McKeesport, Washington, Monroeville, Bethel Park, Mt. Lebanon, Plum, and Penn Hills.In addition to Allegheny County, other nearby counties with affordable private options include Beaver, Washington, Lawrence, Mercer, Westmoreland, Armstrong, Clarion, Vernango, Crawford, and Erie.
Streamlined 2017 Enrollment Link
NOTE: The streamlined method of enrolling for 2017 typically takes about 10-15 minutes. This is a major improvement from previous years, when glitches and delays often caused loss of information. You can use our direct enrollment link here and easily review the best plans in your area and get covered. And no medical questions will be asked!
The price you pay and the benefits you receive for your medical benefits are one of our priorities. There are hundreds of different policies that are offered, and we are dedicated to researching each and every one. Sometimes, Exchange plans create a challenge for consumers to understand, and we are always available for guidance.
The most popular health insurers for the Pittsburgh area are Aetna, UnitedHealthCare, UPMC, Highmark Blue Cross Blue Shield, Coventry, and Assurant. Other companies such as Celtic also are licensed in Pennsylvania but do not offer on-Marketplace options. Humana, one of the nation’s largest companies, does not offer individual insurance in the state.
Cigna, another big insurer, also does not offer private coverage in the state. Additional Pa regional carriers such as Geisinger, are available in other areas. UPMC began writing new individual business a few years ago and they have many attractive high-deductible plans. Also, Aetna purchased HealthAmerica's block of business, and the two entities share Aetna's provider network.
Highmark Blue Cross Blue Shield is one of the largest health insurance companies and serves the 29 counties of Western Pennsylvania. In this area, they have more than 5,000 employees, making them one of major financial influences in the industry. The recent creation of the Allegheny Health Network will give customers more choices in how they are treated and will also increase wellness opportunities.
The least expensive plan offered by Highmark BCBS is the Main Events Blue PPO 6350, which is designated as a "Community Blue" contract. Since it is offered in the "catastrophic" tier, only applicants younger than age 30 can apply. However, several financial hardship exceptions are available for persons that do not meet the age guideline.
This policy is structured in a very simple way. The deductible is $6,350. Once your medical expenses exceed that amount, all covered claims are covered at 100%. Of course, mandated preventive costs are always paid by Highmark and by utilizing their large provider network, your out-of-pocket expenses will dramatically reduce.
A popular, yet still affordable option, is the Shared Cost Blue PPO 2650, which is a Community Blue contract. Copays are $40 and $60 for primary care/specialist physician office visits. The major medical deductible is a manageable $2,650 and all prescriptions (including non-preferred and specialty drugs) are not subject to a deductible.
Since this option is in the Silver tier, special "cost-sharing" features apply. For example, if a family of four persons (ages 45, 45, 12 and 10) had household income of approximately $46,000, the deductible would reduce to only $500 and physician copays would reduce to $10 and $40. Outpatient lab fees, X-rays and diagnostic imaging would continue to be covered with a copay only.
UPMC is the other dominant carrier in the area. Their "friendly" rivalry with Highmark is covered well by the local media, but most importantly to consumers, UPMC offers a wide range of private plans for individuals and small businesses. With the top-ranked hospital in the state (University of Pittsburgh Medical Center), along with more than 20 additional participating hospitals and 3,000 doctors, plus other related medical personnel, their healthcare plans should always be considered.
A popular low-cost plan is the Advantage Silver $1,750/$30 plan that uses the Partner Network. Since it is a Silver-tier policy, it is eligible for "cost-sharing" deductible reductions. The deductible is only $1,750 and a $30 copay is available on pcp office visits. The specialist visit copay is $80. The generic RX copay is only $8 and of course, all preventive expenses are covered at 100%. The Advantage $6,000/$25 is one of the cheapest UPMC Pa Marketplace plans offered and still features a $25 copay ob pcp visits.
Other affordable single or family plans include the Advantage Bronze $5,500/$40, Advantage Silver HSA $2,000/20% (HSA-eligible), Advantage Silver $0/$50 (no deductible), and Advantage Gold $5,000/$15 that offers copays on physician visits and most prescriptions.
UnitedHealthcare is one of the biggest insurers in the country and also one of the Keystone state's biggest writers of policies. They did not participate in the Marketplace in 2014, but entered the Marketplace in 2015 with some very competitively-priced options. Their network-provider list extends across the US, which makes it very attractive to consumers that want the flexibility of being covered if they travel.
Some of the popular and most affordable plans are listed below:
Bronze Compass HSA 4900 - $4,900 deductible plan that is HSA-eligible. Maximum out-of-pocket expense is $6,450.
Bronze Compass 5500 - $5,500 deductible although copays ($35 and $75) for pcp and specialist visits are included.
Silver Compass HSA 1600 - Low $1,600 deductible and HSA-eligible. Since it is a Silver-tier plan, it is eligible for cost-sharing.
Gold Compass 500 - Low $500 deductible with $20 and $40 copays on office visits. $5 copay on generic drugs and$40 copay on brand drugs.
We have listed below several single and family examples with different household incomes in Allegheny County. The amount of subsidy, of course, is directly related to household earnings and the Federal Poverty Level guidelines. Rates illustrated are monthly and include federal subsidy. Five popular options are shown for each scenario.
Single 27 year-old with $21,000 income
$80 - UPMC Advantage Bronze
$86 - Highmark Shared Cost PPO Blue
$93 - UnitedHealthcare Bronze Compass HSA 4900
$126 - Coventry Bronze $20 Copay HMO
$141 - Highmark Shared Cost Blue PPO 1200
Single 43 year-old with $50,000 income
$161 - UPMC Advantage Bronze $6,000/$25
$170 - Highmark Shared Cost Blue PPO 5500
$178 - UnitedHealthcare Bronze Compass HSA 4900
$191 - Highmark Health Savings Blue PPO 2750
$233 UnitedHealthcare Gold Compass 500-HMO
Married 57 year-olds with $35,000 income
$132 - UPMC Advantage Bronze $6,000/$25
$166 - Highmark Shared Cost Blue PPO 5500
$261 - UnitedHealthcare Bronze Compass 5500-HMO
$304 - Coventry Bronze Deductible Only HSA
$399 - Highmark Health Savings Blue PPO 3400
Here you can learn about HSAs which have been increasing in popularity since they were established in 2004. Because of their cost-saving features, they should always be considered for individuals or families that do not often use their coverage. Highmark and Coventry offer very attractive rates in most of Western Pennsylvania. UnitedHealthcare was one of the first companies to offer a “single family deductible.” This concept allows every person's expenses in the household to count towards the only required deductible.
The Highmark plan, as mentioned, is extremely popular, especially if your personal physician is in their Network. We will be happy to review your options and help determine if this type of policy is the right fit for your needs. They are a great choice for your personal medical coverage but not appropriate if you are willing to pay a higher price for the right to office visit and prescription copays. As your circumstances change each year, of course, you can change policies and carriers.
UnitedHealthcare offers one of the least expensive HSA plans in Pennsylvania for 2015. The Bronze Compass HSA 4900 (HMO) has a $4,900 deductible with no coinsurance. The maximum out-of-pocket expense is $6,450. It is an ideal policy to consider if you have no existing medical conditions and wish to minimize your cost. If you qualify for a large subsidy, a Silver plan may be a better option. Their rates in the Pittsburgh area have vastly improved since Exchanges were created.
Get Rates Now
The free quote section at the top of the page will allow you to easily compare Western Pennsylvania health insurance plans. If you would like to speak to a live person, please call us at (888) 513 6446. You can apply direct or with the help of a broker. There is no cost for either method. Both "on" and "off" Marketplace plans are offered. To qualify and receive government subsidies, an "on" policy must be selected.
2-2014: Highmark's Community Blue option, a Pa Exchange policy, is one of the nation's (not just Pennsylvania!) most affordable plans, according to Kaiser research. Without tax subsidies, premiums are often less than $200 per month. With subsidies, the premiums can drop to $0-$150 per month.
The Silver PPO 2700 was used when comparing to other policies offered through various State Marketplaces. Increased competition with UPMC and Aetna have driven down prices. Also, by reducing the available network of providers, many more affordable choices are now offered.
11-2014: Highmark is able to exclude specific hospitals and doctors in the UPMC Network, a court ruled. The ruling, although challenged by the current administration, will apply to Community Blue Medicare Advantage plans, that feature a very low premium. However, other Highmark plans are offered that do include the UPMC network. The ruling is not expected to be appealed since Open Enrollment ends in about a month.
11-2014: Mobile Health Clinics have grown in popularity in the area. UPMC operates the Ronald McDonald Care Mobile unit, which services about 2,000 children each year. Pittsburgh Mercy Health System also operates a similar vehicle that cost more than $300,000. About 700 patients are expected to be helped each month. Mercy has been utilizing mobile clinics for more than 20 years.
2-2017: The Trump Administration will be replacing Obamacare (Affordable Care Act), although the final product is unknown. We anticipate an enhancement of HSA options, and a possible return of state high-risk pools. Pre-existing conditions will continue to be covered.