Pennsylvania Health Insurance

Medicare Open Enrollment begins on October 15th and continues through December 7th. Effective dates of new plans or changes to existing policies will be January 1st. Pa residents can apply for Part D prescription drug coverage, and also change from a Medicare Advantage contract to original Medicare benefits, or enroll in an Advantage plan, and terminate an existing Supplement contract. Of course, you can also leave all existing plans in place and make no changes. The single payer concept for Seniors pays about 80% or expenses, leaving the balance to be paid by the applicant. There are four portions to Medicare. Part A consists of hospitalization  and related expenses, including your room and surgery charges. Part B is standard medical insurance benefits. Part D is prescription drug benefits, and is provided in several ways. Part C is Medicare Advantage plan coverage, which replaces original Medicare benefits and can provide drug prescription benefits, depending on the contract. Cover Your Out-Of-Pocket Expenses Private insurers offer Medigap plans to help pay for may of the out-of-pocket expenses that may not be covered under original government-provided  coverage. Prescription drug benefits are provided separately (Part D), although many Advantage contracts include the coverage. NOTE: If your prescriptions changed during 2016 (or new ones were added), reviewing existing ...

The Pennsylvania Health Insurance Marketplace (Exchange) provides Pa residents the opportunity to purchase affordable high-quality medical plans. No medical questions. No hassle. No denials or cancellations. We know you have questions, so here are some of the answers: What Is The “Marketplace?” It’s actually just another name for the Pa Health Insurance Exchange. The two terms are interchangeable.  Typically, in a “marketplace,” you shop for the best deals from a variety of different companies. After learning and comparing, you have a much better understanding of the product choices. We help you find the most cost-efficient plans, and we also greatly simplify the enrollment process. Included in the operation are websites, online resources, and customer service call centers. More than 1 million residents in the state are without coverage, and we are here to help, by providing free comparisons, determining if your medical providers are “in-network,” and also calculating your federal subsidy. How Do I Find Available Plans? There are a few ways. Of course, going directly to the .gov website is one option, although delays and logjams have made the enrollment process almost impossible for thousands of visitors. Perhaps the easiest way to view policies is to utilize our free quote feature, and you can view and compare plans in your area. Remember that different parts of the state...

Affordable Pa Medicare Advantage plans for Seniors are available. We review and compare the highest-rated policies from all major companies. Part C benefits provided by private carriers in Pennsylvania, provide high-quality coverage at extremely low rates. Premiums are typically much less than standard Supplement options, and often out-of-pocket expenses are lower, with dental and vision benefits included. The online quotes you view are the lowest available rates from each carrier. As an alternative to traditional Medicare, plans cover preventive care, hospital and physician services, lab tests, x-rays, and conventional Medigap benefits. Part D prescription and drug coverage is also generally included. Top-rated companies offer policy options in Pittsburgh, Philadelphia, Harrisburg and all areas of the Keystone State. Applying and enrolling is quick and easy. And about half of all plans feature a $0 premium. You can’t get rates any lower! Many policy options offer prescription benefits. Referred to as Medicare Advantage Prescription Drug Plans (MAPDS), your healthcare and drug coverage are included in one contract. NOTE: We also reviewed Medigap plans in Pennsylvania. Since these contracts do not replace original benefits, premiums are typically higher than Advantage plan options. Different Types Of Available MA Plans PPO – The Preferred Provider Organization  concept is...

Medicare Supplement coverage in Pennsylvania is an affordable option to pay for healthcare expenses that are typically not covered by original Medicare. The Keystone State features many low-cost Senior plans that reduce your out-of-pocket costs and include guaranteed enrollment. The best Pa Medigap policies are also very easy to apply for. Maximum benefits or exclusions may apply to specific plans. Many attractive options are available to the elderly and disabled. Part D contracts cover drugs and prescriptions and can also be packaged with Advantage contracts. Separate coverage can also be purchased. If you are age 65 or older, our website allows you to easily view and compare all available plans at the lowest available rates. All quotes are free (see top of page) and are provided without any cost or obligation. Supplement policies are designed to pay your coinsurance, copayments, deductibles, and other expenses that are not typically paid for. Ten available plan options are offered, although prices and availability will vary, depending on your county of residence. Benefits are standardized, although pricing is different. Parts A (hospitalization)  and B (medical services) coverage are provided by the federal government. Part C is the privately-run Medicare Advantage plan options, which provide benefits for parts A and B, along with other coverage. Part D is your prescription...

Individual and small group health insurance rates in Pennsylvania typically increase each year. The amount of the increase is determined by how much the insurer is requesting, and the amount that is ultimately approved after careful review by the Department (DOI). Any rate change must be fair and appropriate for both the carrier and consumer. Increased market share while retaining profitability and affordability for the consumer is the ultimate goal. Prior to 2016, the general public could not view requests or findings unless the proposed increase was more than 10%. However, now you can view all results, regardless of the amount of change. And yes, sometimes, Pa health insurance prices reduce. Before a decision is made, several of the most important criteria include underwriting profits and losses, deducible and copay data, coverage changes, administrative fees, and historical and future predicted claim information. Companies can choose weather to offer Exchange policies in specific states. Many carriers, such as Aetna, Cigna, and UnitedHealthcare, often provide plans is specific states, but also choose to “sit out” may others. Senior coverage, such as Medicare Supplement and Advantage plans, are treated separately. We have listed below (courtesy of the DOI) the actual requested and approved changes submitted to the State Department of Insurance. These increases and decreases...

Although same-sex couples can now legally marry in all US states, here in Pennsylvania, gay and lesbian partners were already able to marry for the last year. But now, it is the “law of the land,” as the Supreme Court ruled 5-4 that 14 states will no longer be able to enforce their ban. It took about 20 years of litigation, but the fight appears to be over. In the majority opinion, Justice Anthony Kennedy proclaimed “no union is more profound than marriage. In forming a marital union, two people become greater than once they were.” The number of same-sex married couples (currently around 400,000) is expected to substantially increase. Self-insured and self-funded group health plans subject to ERISA requirements may now be forced to offer medical coverage to same-sex spouses. Although this segment of the legislation is a bit vague, employers may choose to avoid risky and expensive litigation and simply offer the benefits. Also, “domestic-partner” coverage may simply continue, since the cost and coverage would be identical. Discrimination Not Allowed Since the Keystone State allows these types of marriages already, an insurer can not discriminate against either partner when applying for a policy, or when a claim is paid. Premium tax-credits and potential out-of-pocket expenses must also be treated without discrimination. However, in order to take advantage of subsidies, the...

Platinum-tier Marketplace plans in Pa provide the best available medical coverage to individuals, families and small-business owners. The combination of low deductibles, copays and coinsurance, along with rich comprehensive benefits, makes these policies the “Cadillac” of Pennsylvania health insurance plans. Your maximum out-of-pocket expenses are low, and you won’t find a better policy anywhere. “No deductible” options are offered in some areas. What Is A Platinum Plan? When the “Patent, Protection And Affordable Care Act” (Obamacare) became law in 2010, (and upheld in a Supreme Cort ruling in 2012), a standardized method of comparing policies was enacted. “Metal” tiers were created, based on the actuarial value, or what percentage of your medical expenses were expected to be paid by the policy you were enrolling in. Of all of the Metal tiers, the Platinum options offer the most complete coverage to pay for your medical expenses. Gold, Silver, Bronze, and Catastrophic contracts are also offered. 90% of your anticipated healthcare expenses (actuarial value) are expected to be paid, which included copays, coinsurance and deductibles. Special “cost-sharing,” however, is only available to Silver-ter plans. This feature can greatly reduce the deductible and out-of-pocket expenses to moderate and lower-income households. Coinsurance And Deductibles Since it is the most expensive...

In Pennsylvania, infants, young adults, and teenagers can obtain affordable health insurance coverage from more than a dozen reputable companies. With help from recent changes in legislation and policy upgrades, these plans guarantee major medical benefits along with many other comprehensive features. Marketplace plans with federal subsidies or non-Obamacare options are available. We provide detailed information, reviews, and a simplified and easy enrollment process for all available Pa policies for young persons, along with expert and unbiased advice. Special policies are offered to students, single parents, and anyone that is no longer eligible to keep their existing plan. In certain circumstances, you can also remain on your parent’s plan if you are married (see below). Coverage Under Parent’s Plan If your parent’s private healthcare policy is active, federal law stipulates that you can  remain covered or enroll on that policy until you reach age 26. This could apply even if you are living at a different residence, married, or still have eligibility to enroll in your employer’s plan. Of course, at any time you can apply for your own individual policy. Although remaining on the policy is an option to consider, in many situations when a federal subsidy is available, enrolling for an individual plan may be a better choice. If the policy is a qualified group plan through their...