Compare the lowest allowable rates for your Pennsylvania health insurance plan coverage (Under age 65) and enroll in 20 minutes. 2023 Pa policies are available through the State Exchange (Pennie) with pre-existing conditions covered. You will not be denied for medical reasons, and an instant government tax credit may help you pay for the policy. Plans are also offered that do not receive a federal subsidy. Easy enrollment, free expert advice, and catastrophic, short-term, and comprehensive options are offered, along with Medicare plan options for qualified applicants that have reached age 65.
Prices are about 2% (average) lower than previous year’s rates. UPMC, Highmark, Geisinger, Independence Blue Cross, Capital Blue Cross, Ambetter, Cigna, and Oscar offer private single and family plans. Silver-Tier plans feature cost-savings options that can substantially reduce the deductible, copays, and maximum out-of-pocket expenses. Often, a Silver-tier plan will feature lower out-of-pocket expenses than a Gold-tier plan. Deductibles range from a maximum high of $9,100 to $0.
Senior Pa Medigap plans can also be easily reviewed. Medicare Supplement and Advantage contracts may be able to reduce your copays, deductibles, coinsurance, and specific out-of-pocket expenses not covered by original Medicare. Part D prescription drug coverage is also offered. Plans A-N are standardized, and also include a high-deductible (G-HD) option. Plan F (HD) is offered to persons that have been previously covered under the policy.
A comparison chart is provided to help understand differences in all plans, including out-of-pocket expenses and benefits. Supplement contracts pay many of the expenses not paid by Parts A and B, including copays and deductibles. Coverage can also include nursing facility care, foreign travel emergency benefits, blood transfusions, preventative benefits, and excess charges from insurers. Both Seniors and applicants under age 65 can qualify for guaranteed coverage.
Non-Obamacare options are also available. You can review alternative medical plans that offer lower rates without maternity and other previously-required benefits. If your employer does not provide benefits, or you are self-employed, many options are offered, including temporary and catastrophic non-ACA contracts. Several carriers reduced their rates and offer new plans. Commercial, Group, Medicaid, CHIP, and other products are also offered. Family PPO, EPO, and HMO contracts can be purchased along with indemnity plans. Many affordable options have become available for self-employed persons and small business owners.
Pa Pennie Exchange
Last year, Pennsylvania transitioned to a state-based Exchange (SBEP). Thus, the Open Enrollment period has expanded, and rates are slightly lower for many plans. The shopping experience is more user-friendly, and as your broker, we provide full plan comparison, enrollment, and policy servicing assistance at no charge. Middle-class individuals and families that don’t have access to group healthcare benefits are some of the main benefactors of the new Exchange, and healthcare.gov is no longer needed to enroll. Most carriers also offer dental benefits, and vision plans are also available.
Pennie allows Pa to retain more control over enrollment, plan design, pricing, and affordability. The length of the Open Enrollment has also been expanded by 30 days compared to the Federal Marketplace. Tax credits continue to reduce premiums for qualified applicants, and medical underwriting has been eliminated. January 1 and February effective dates are available, and advanced premium tax credits are offered to all qualified applicants. Special pandemic extended open enrollment periods can be added when needed (COVID).
Regardless if an applicant resides in Pittsburgh, Altoona, Harrisburg, Scranton, Reading, Lancaster, Allentown, Altoona, Philadelphia, or any other city, several policy options are always available. Small business, large group, self-funded, POS, and HSA plans provide additional policy options. Applicants that are between jobs or preparing for retirement can view several cost-savings options. Children may be eligible for CHIP, and wellness benefits are typically covered at 100%. Pediatric dental and vision benefits can be utilized on qualified Exchange (Pennie) plans.
Proposed 2023 Individual Plan (Under 65) Proposed Rate Changes:
Ambetter (Pennsylvania Health And Wellness) – 3.74% Decrease
Capital Blue Cross (Capital Advantage Assurance Company) – 12.07% Increase
Cigna – 6.00% Increase
Geisinger – 26.26% Increase
Geisinger Quality Options – 27.48% Increase
Highmark – 10.27% Increase
Highmark Benefits Group – 14.42% Increase
Highmark Advantage – 5.71% Increase
Independence Blue Cross – 2.07% Increase
Keystone Health Plan East – 2.42% Increase
Keystone Health Plan Central – 7.62% Decrease
Oscar – 10.40% Increase
UPMC – 5.5% Increase
UPMC Options – 5.20% Increase
Proposed 2023 Small Group Plan (Under 65) Proposed Rate Changes:
Aetna – 32.19% decrease
Aetna Life – 12.25% decrease
Capital Advantage Assurance Company – 9.01% increase
First Priority Life – .50% increase
Geisinger Health Plan – 7.58% decrease
Geisinger Quality Options – 5.51% decrease
Highmark Benefits Group – 3.80% increase
Highmark – 1.20% increase
Independece Blue Cross – .34% increase
Keystone Health Plan Central – 8.44% increase
All Pa Residents Eligible
Whether you are working for yourself, working for an employer, uninsured, self-employed, a single person, or a family, our website allows you to research, compare and apply for quality individual health care coverage in Pennsylvania, both on and off the Marketplace. Legislation often changes, and you can always view the most recent policy details and rates here. As current Administrations complete the partial change and updating of Obamacare and the Affordable Care Act, your options will be updated. The 10 required “essential health benefits” continue to be covered.
A new catastrophic option with lower premiums may become available in 2024. Designed to offer major medical and preventative benefits, premiums would be substantially less than Exchange plans. 12-month plans can now be purchased, creating flexible low-cost options. Typically, $2 million of coverage is the maximum offered, although benefits are limited in some areas. In-hospital and accidental expense riders can be added to reduce large out-of-pocket expenses. Hospital indemnity contracts are also available from several carriers.
Seniors can quickly view Medicare plans online. Several carriers that offer Medigap coverage include AARP-UnitedHealthcare, Aetna, Cigna, Humana, Keystone, Geisinger, UPMC, Capital Blue Cross, WellCare, Mutual Of Omaha, and Allwell. During Open Enrollment periods, the process is especially quick. Many additional plans are offered to small and large employers that provide their employees with medical benefits. CHIP and Medicaid coverage may be available through the Department of Human Services, depending on the household income.
Our free online tools and advice allow you to view options for all family members, including dependents and children. Ancillary products (dental, vision, life, disability, and long term care) are also available. You can also compare benefits, prices, service areas, network provider lists, and prescription drug formularies. Young adults can find many low-cost options by utilizing catastrophic and Bronze-tier plans. Pediatric dental benefits are included on all qualified plans. Private dental and vision plans can also be purchased.
Group plans through small and large employers provide flexible options, including high-deductible HSAs, and comprehensive contracts with lower copays and out-of-pocket expenses. Employees may also choose Marketplace plans for their coverage, although typically, a federal subsidy will not be available if a Group plan is offered. Total household income is considered when the instant tax credit is calculated. Also, Group plan Open Enrollment periods may differ from private plan OE periods.
Online Quotes And Rates Are Available 24/7
Your online Pa health insurance quotes are provided by an Agency/broker with more than 40 years of experience. In less than three minutes, you can view the most popular healthcare plans. Your service is provided by a live person, and not an automated website. Inexpensive Keystone State plans are available 24/7 on our website. If you qualify for a “Special Enrollment Period” exception, you can obtain subsidized or traditional coverage at any time throughout the year. It is possible that some family members may be eligible for Medicare, Medicaid, or CHIP. Group employer-provided benefits may also be available.
PPOs, HMOs, EPOs, HSAs, and all comprehensive and catastrophic plans are presented in an easy-to-understand format. If you are a small business owner or your employer does not offer health insurance, we help you purchase the policy that stays within your price range. A special business SHOP Exchange is available at any time and is not subject to Open Enrollment periods. Both comprehensive and high-deductible options are offered. Larger corporations can secure Group discounts for their employees, with multiple choices, including HSAs.
Catastrophic high-deductible plans are available for persons under age 30, and Seniors can choose a Plan F (existing plan) or Plan G (HD) Supplement option with a $2,490 deductible. These types of plans feature lower pricing, although higher out-of-pocket expenses are required before the deductible is met. During Open Enrollment, the plans can be changed. Maximum allowable deductibles generally change each year. Plan F is the most comprehensive plan, and covers both Medicare deductibles, and all coinsurance and copays. Prescription drug coverage is not included with Supplement plans, so a separate Part D plan will need to be purchased.
Medical coverage is much less costly than most other states. Currently, our own state has the 10th lowest rates in the US, according to an Administration study that was recently released. One of the primary reasons (as previously stated) is the availability of instant tax credits that immediately lower policy premiums. You may also qualify for Medicaid if your annual income (single person) is below $18,075. The limit for a family of two is $24,353, a family of three is $30,630, a family of four is $36,908, a family of five is $43,186, and a family of six is $49,463. Marketplace plans are offered to applicants that qualify for Medicaid and CHIP, although a federal subsidy is not available.
You can also apply for Marketplace plans at these income levels, but no federal subsidy will be offered. CHIP benefits may be offered to dependents in the household. Senior products are offered by more carriers than Under-65 products, and a Marketplace subsidy does not apply. For example, Cigna, and Aetna offer Medicare plans, but not private individual medical coverage for applicants that have not reached age 65. AARP partners with UnitedHealthcare to offer Supplement and Advantage plans. The network offers nationwide coverage.
Affordable Healthcare Plans Are Available In All Parts Of Pennsylvania
There are many policies that will fit in your budget, and we provide all of the free research and comparisons. These plans will be available when you need them, and contain the benefits that you are most likely to utilize. National healthcare reform in the last six years has changed many benefits, and we review how they affect you, and what coverage you now will receive. HMO, PPO, and EPO plans provide consumers with multiple network choices regarding their physicians and medical facilities. Typically, emergency (life-threatening) treatment is covered as an in-network claim.
For example, 10 “essential” benefits are included on all non-short-term policies. Maternity, ER, office visits, prescriptions, and pediatric dental are the most common required benefits on qualified plans. However, it is possible that several of these benefits will no longer be required in future years, providing more low-cost customized plans. Individual states may also be provided more funding and decision-making, which may create more local customized plan options.
Each year, new plans become available that often feature very attractive prices. You can keep an existing plan, or choose to enroll in a new policy. Marketplace policies that are offered to under-65 individuals and families are listed below:
UPMC Advantage Catastrophic $9,100/$0
UPMC Advantage Bronze $6,700/$0
UPMC VirtualCare Silver $4,400/$40
UPMC Advantage $3,900/$50 Silver
UPMC Advantage Silver $1,900/$80
UPMC Advantage Silver $6,800/$25
UPMC Advantage Gold $1,000/$10
UPMC Advantage Gold HSA $3,000/$0
Highmark Together Blue Major Events EPO Catastrophic 9100 – 3 Free PCP Visits
Highmark my Direct Blue Major Events EPO Catastrophic 9100 – 3 Free PCP Visits
Highmark my Blue Access Major Events PPO Catastrophic 9100 – 3 Free PCP Visits
Highmark Together Blue EPO Bronze 8900
Highmark my Direct Blue EPO Bronze 8900
Highmark Together Blue EPO Bronze 3800
Highmark my Direct Blue EPO Bronze 3800
Highmark Together Blue EPO Bronze 6900 HSA
Highmark my Direct Blue EPO Bronze 6900 HSA
Highmark Together Blue EPO Silver 5900
Highmark my Direct Blue EPO Silver 5900
Highmark my Blue Access PPO Silver 5900
Highmark Together Blue EPO Premier Silver 2900
Highmark my Direct Blue EPO Premier Silver 2900
Highmark my Blue Access PPO Premier Silver 2900
Highmark Together Blue EPO Gold 0
Highmark my Direct Blue EPO Gold 0
Highmark my Blue Access PPO Gold 0
Highmark Together Blue EPO Gold 1700 HSA
Highmark my Direct Blue EPO Gold 1700 HSA
Highmark my Blue Access PPO Gold 1700 HSA
Highmark Together Blue Diabetes EPO Gold 0
Highmark Together Blue EPO Premier Gold 0
Highmark my Direct Blue EPO Premier Gold 0
Highmark my Blue Access EPO Premier Gold 0
Capital Blue Cross
Catastrophic PPO 9100/0/0
Bronze Capital Advantage EPO 7450/0/50
Bronze PPO 7450/0/50
Bronze QHDHP PPO 6300/0/50 HSA
Silver PPO 6000/20/30
Silver Capital Advantage EPO 6000/20/30
Gold Capital Advantage EPO 2650/10/20
Gold Capital Advantage EPO 1800/10/20
Gold PPO 2650/10/20
Gold PPO 1800/10/20
Gold Simple PPO 0/0/25
Geisinger Marketplace All-Access Value
Geisinger Marketplace All-Access HMO Pharmacy First 8500
Geisinger Marketplace All-Access PPO 40/80/8400
Geisinger Marketplace All-Access HMO 40/80/8400
Geisinger Marketplace All-Access QHDHP PPO 6850 – HSA Eligible
Geisinger Marketplace All-Access HMO 25/50/4000
Geisinger Marketplace All-Access HMO 25/50/2500
Geisinger Marketplace All-Access HMO 25/50/3250
Geisinger Marketplace All-Access PPO 25/50/3250
Geisinger Marketplace Extra HMO 10/50/500
Geisinger Marketplace All-Access HMO 30/60/7000
Geisinger Marketplace All-Access PPO 30/60/7000
Geisinger Marketplace All-Access HMO 25/40/0
Independence Blue Cross
Independence Blue Cross Personal Choice EPO Catastrophic
Independence Blue Cross Personal Choice EPO Bronze Basic
Independence Blue Cross Personal Choice EPO Bronze Reserve
Independence Blue Cross Personal Choice PPO Bronze
Independence Blue Cross Personal Choice PPO Silver
Independence Blue Cross Personal Choice PPO Gold
Independence Blue Cross Personal Choice PPO Gold Classic
Keystone HMO Bronze
Keystone HMO Silver Basic
Keystone HMO Silver Classic
Keystone HMO Silver Proactive
Keystone HMO Silver Proactive Essential
Keystone HMO Silver Proactive Lite
Keystone HMO Silver Proactive Basic
Keystone HMO Gold Proactive
Keystone HMO Gold
Keystone HMO Gold Classic
Cigna Bronze 9100
Cigna Bronze 7800
Cigna Bronze 6800 Enhanced Diabetes Care
Cigna Bronze 7600 Enhanced Asthma COPD Care
Cigna Connect Bronze 6500
Cigna Connect Bronze HSA 6100
Cigna Connect Bronze 0
Cigna Connect Silver 5550
Cigna Connect Silver 3800 Enhanced Diabetes Care
Cigna Connect Silver 4200 Enhanced Asthma COPD Care
Cigna Connect Silver 3600
Cigna Connect Silver 3000
Cigna Connect Silver 6000
Cigna Connect Gold 750
Cigna Connect Gold 2500
Cigna Connect Gold 2100 Enhanced Asthma COPD Care
Cigna Connect Gold 1000
Cigna Connect Gold 1900 Enhanced Diabetes Care
Oscar Bronze Simple
Oscar Bronze Classic
Oscar Bronze Classic PCP Saver
Oscar Bronze Simple HSA
Oscar Bronze Classic Standard
Oscar Bronze Simple HSA
Oscar Bronze Classic $0 PCP
Oscar Bronze Classic $4700 Ded
Oscar Bronze Classic $3000 Ded
Oscar Bronze Elite – Specialist Saver
Oscar Gold Classic
Oscar Bronze Elite PCP Saver
Oscar Gold Elite
Oscar Silver Classic
Oscar Silver Simple – PCP Saver
Oscar Silver Classic Standard
Oscar Silver Simple – HSA
Oscar Silver Simple – Specialist Saver
Oscar Silver Simple – For Diabetes
Oscar Silver Elite – $0 Ded
Oscar Silver Elite – Specialist Saver
Oscar Silver Elite – $0 PCP
Oscar Silver Elite – $0 Ded
Oscar Gold Elite
Ambetter (Pennsylvania Health And Wellness Inc.)
Ambetter Clear Bronze
Ambetter Choice Bronze HSA
Ambetter Everyday Bronze
Ambetter Elite Bronze
Ambetter Clear Gold
Ambetter Everyday Gold
Ambetter Complete Gold
Ambetter Clear Saver
Ambetter Focused Silver
Ambetter Complete Silver
Ambetter Elite Gold
Ambetter Secure Care 5
Companies Must Be Licensed, Registered And Approved
Any Agency or individual that offers Pennsylvania plans must be licensed by the Department Of Insurance. Carriers that do business in the Keystone State must register and maintain a license. Any changes in premiums must be approved by the DOI and no broker or agency can offer you a “special price.” You will always be quoted the lowest possible rate on this website. There are never any costs or fees for utilizing our resources and we maintain very tight security. Rates are continuously updated and consumers can view proposed premium changes through a direct link to the Department of Insurance.
Financial information is never requested. The DOI also provides comparison tools and many consumer services. Policy, law, and regulation information is available upon request. Complaint ratios and rate filings can also be provided along with local office information. Star ratings and drug formulary lists can help compare Medicare products for Seniors. Consumers can also view the number of members (statewide and national) that are enrolled in the plan, along with a formulary drug list. The Pennie Exchange provides Marketplace options for applicants under age 65.
If you meet specific income requirements, up to 100% of your premium can be paid by the government. If you are uninsurable, you will not be denied benefits. When you apply for a policy, the only medical-related question required is whether you are a smoker or non-smoker. Your zip code and/or county of residence will impact the cost of coverage. And of course, your age and type of plan applied for, will also affect the rate. Senior plans are generally not medically-underwritten, although your age, sex, smoking status, and county of residence can impact the cost. Medicare Advantage (MA) and Medigap Supplement plans have distinct differences, so it is important to properly compare benefits.
Moving to a different service area will typically allow you to change plans outside of the Open Enrollment period. A “qualifying life event” (QLE) provides an SEP exception. A 60-day period is provided that allows you to shop, compare, and enroll in a plan offered in your service area. You may also choose a non-ACA plan. If your household does not qualify for a subsidy or Medicaid, these plans will likely offer a lower rate, although benefits will not be identical to a qualified plan. Preventative benefits may be provided, although 100% coverage is not likely. Limitations on non-Exchange plans may impact therapy, non-generic prescriptions, and out-of-network treatment.
Pa Senior Medigap Coverage – Compare Options On Our Website
If you have reached age 65, you are probably Medicare-eligible. Although original Medicare provides comprehensive benefits and covers most expenses, gaps still require you to pay many out-of-pocket medical costs. A Medigap plan (Supplement or Advantage) can help pay many of these expenses, which include deductibles, coinsurance, foreign travel, blood, skilled nursing care facility copays, and prescriptions. Many ancillary benefits, fitness center memberships, and incentives may also be included. Deductibles and out-of-pocket expenses will widely vary, depending upon the plan.
To qualify for a plan, you must be enrolled in both Parts A and B. You also can not have both an Advantage and Supplement plan in-force at the same time. Part D prescription drug coverage can be purchased separately, although sometimes it is included in Advantage contracts. Also, your Part B premium is paid directly to Medicare. Unlike under-65 policies, each individual applies separately for their own plan. Supplement plans allow you to use any approved provider. If you are not receiving Social Security benefits, you may have to sign up for coverage instead of automatically becoming eligible.
Therefore, two different policies may be purchased from two separate carriers. For example, one spouse may enroll in Plan A, while the other spouse selects Plan F. During Open Enrollment, each spouse may continue with their existing plan, or select a different plan. It’s also possible that one spouse will own an Advantage contract and the other spouse is covered with a Supplement plan, which is standardized and identified by a specific letter. Plan A must be offered by all carriers that market their plans in Pennsylvania.
Pennsylvania Medicare Supplement Plan Carriers (2023)
American Benefit Life
Atlantic Coast Life
Capital Blue Cross
First Health Life And Health
Great Southern Life
Guarantee Trust Life
Independence Blue Cross
Mutual Of Omaha
New Era Life
PA MA Plans
Medicare Advantage (MA) plans are also available. Private carriers contract with Medicare to offer Parts A and B coverage. Prescription drug benefits are also offered with many policies. Shown below are several plan options that received the “Highest Overall Rating” designation from US News & World Report. It is important however, to consider and compare all available options before enrolling. Also, many plans are only offered in specific counties, and not all Advantage plans include prescription benefits.
Each company offering these types of plans have specific provider networks that must be used. Many ancillary benefits are often provided, including dental and vision. Copays and annual limits will vary and network providers must be utilized. Companies offering coverage include: Lasso Healthcare, AARP, AmeriHealth, BlueJourney, Aetna, Capital Blue Cross, Cigna, Clover Health, Community Blue, Erickson, Freedom Blue, Gateway Health, Geisinger, Health Partners, Humana, Keystone, Lasso Healthcare, Personal Choice, Provider Partners, Security Blue, UnitedHealthcare, UPMC, Vibra Health Plan, and Wellcare.
Pa Part D prescription drug plans that are available, include AARP Medicare Rx Preferred, AARP MedicareRx Saver Plus, AARP MedicareRx Walgreens, Blue Rx PDP Complete, Blue Rx PDP Plus, Cigna Extra Rx, Cigna Saver Rx, Cigna Secure Rx, Clear Spring Health Premier Rx, Clear Spring Health Value Rx, Elixir Rx Plus, Elixir RxSecure, Humana Basic Rx Plan, Humana Premier Rx Plan, Humana Walmart Value Rx Plan, Mutual Of Omaha Rx, Mutual Of Omaha Rx Plus, Mutual Of Omaha Rx Premier, SecureRx – Option 1, SecureRx – Option 3, SilverScript Choice, SilverScript Plus, SilverScript SmartSaver, Wellcare Classic, Wellcare Medicare Rx Value Plus, and Wellcare Value Script.
Any broker or agent can show you a health insurance plan. But shopping and researching Pennsylvania is our specialty, and we make certain that you receive the highest quality coverage at the lowest available rates. No “discount” or “limited benefit” policies are ever be used, and we carefully review every page of each policy to make sure there are no “hidden” surprises. Although Senior Medicare Supplement plans have standard features, rates can widely vary. We make it easy to compare all available plans and customize options to match your medical and budget needs.
Please contact us any time for additional information regarding your personal, Marketplace, or Medigap coverage. We find the best plan for your specific situation and thoroughly explain all of your policy benefits. You can compare and review rates 24/7 on our website. If you have missed the Open Enrollment deadline, many options are available.