Pennsylvania Health Insurance

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Pennsylvania health care changes are happening all of the time! It’s now official that starting in 2014, it is required by law that you must purchase medical insurance. Exchanges will be created and set up so consumers can easily purchase policies. Of course, we know that it is likely they will initially be clunky and hard to navigate, so our website will continue to help you through the buying process. As a “Marketplace,” you will have the opportunity to buy benefits without answering medical questions.

We will help you compare the options that you have and easily apply for benefits and receive the appropriate federal tax credit that you deserve. There will be four main  “tier” categories (Bronze, Silver, Gold and Platinum) with many additional choices. We will also detail each choice as we get closer to 2014. It is possible that you will have to pick out new coverage, regardless if you have an existing private or group policy.

How To See Rates And Apply For A Policy

The first step, of course, is to view prices from the available carriers. The box at the top of the page allows you to enter your zip code and request a free quote. Don’t worry, there’s no cost or obligation.

Next, it’s important to determine how much of a federal subsidy you are going to receive. Although we can calculate it for you, if you want a quick estimate, this tool from Kaiser will help. For example,  if your household income (husband and wife) is $50,000, you would receive a subsidy of $1,286 to help pay premiums. Your maximum premium would be 9.5% of your income if are non-smokers. NOTE: This tool is updated by Kaiser each year.

It’s also important to understand that not all companies will offer policies. In past years, you could easily choose among large carriers such as Aetna, Highmark, Keystone and UnitedHealthcare, along with smaller regional companies such as Geisinger. But now, each insurer will decide  whether or not they wish to participate in Exchanges from one year to the next. Also, several insurers do not offer coverage in all counties.

Reform History

The process of reform gained momentum a few years ago as Governor Ed Rendell took action on four health care reforms in the state. Three of the four bills were part of his “Prescription For Pennsylvania” series of reforms. They were designed to lower the cost of medical coverage for Pa residents.

Highlights of some of the changes include expanding Cobra  benefits to small Pa  businesses and allowing uninsured single adult children (up to age 30) to be covered by their parents’ plan. And these are  changes that will help consumers, both young and old.

Some of the more recent differences that everyone notices is the preventive treatment that you no longer have to pay for. And, the waiting period is gone along with the $100 copays or $1,000 deductibles to meet. If you have children, you certainly noticed that most of the scheduled office visits now cost very little or nothing and immunizations are usually free.

Please use our Quote section at the top of the page. And you also can view additional Exchange information and updates here. Keep in mind that this is an ever-changing process that continues to evolve.


Reform is still moving  forward. However, we may see a Supreme Court ruling next year. We’ll keep you posted.

 Yes…that ruling is coming within the next 3-5 months. It should be a close decision. You’ll be hearing a lot about it starting in March when arguments are heard from both sides.

As mentioned above, in 2014, you are required to buy medical coverage.

The election results are in and we are waiting for 2014 when some of the biggest changes take place including higher rates and possible tax credits.

Open Enrollment is set to begin in October. The new law requiring the purchase of medical coverage is effective the first day of 2014. However, because of procedural delays, enforcement of this mandate along with income verification (for subsidies) won’t be fully implemented until 2015.

Obamacare enters its second year (2016), and although rates continue to increase, federal subsidies help provide very affordable options for many consumers here in the Keystone State. Highmark is significantly increasing prices, while a few other companies are expecting more moderate increases.