Pennsylvania Health Insurance

Affordable Pennsylvania Health Insurance Quotes

(888) 513-6446
Get Free Quotes
Compare
& Save

Pa catastrophic (high deductible) health insurance plans are an affordable low-cost option to reduce rates, and still maintain major medical benefits. We specialize in helping Pa residents find the least expensive catastrophic coverage with top-ranked companies, that cover emergencies, and offer 100% preventative benefits. The combination of higher deductible plans and supplemental coverage is often a popular cost-saving option. After Open Enrollment ends, you can continue to buy qualified plans with an approved exception. Seniors can consider a Plan F (HD) or Plan G (HD) Medicare Supplement plan option that features a $2,340 deductible.

Open Enrollment (Under Age 65)

During Open Enrollment, “Catastrophic-tier”  plans are often the cheapest policies offered to Pa residents. To be able to purchase these types of plans, you must be under age 30, or qualify for “economic hardship.” If the cost of coverage is more than 8% of the household income, the “economic hardship” rule will apply. This will allow you to save money by selecting a cheap plan, and utilize negotiated network discounts offered by each carrier. However, in many situations, selecting a Bronze-tier plan will be more cost-effective, since a federal subsidy may apply.

Expanded benefits may also be offered, including copays for an unlimited number of pcp (primary care physician) visits. Often, the least-expensive plans limit the number of primary-care physician (pcp) visits that are subject to only a copay. ER and Urgent Care visits also have deductibles to meet on most Bronze-tier plans. Non-generic prescription drugs are covered, although a deductible may have to be met. All Exchange plans offer unlimited coverage without annual limits or waiting periods.

If you forgot to sign up during the OE period, you can apply for several economical options that concentrate on paying larger claims, instead of routine office visits and medications. Since these policies are not designated for long-term use, it’s best to utilize them only until the next Open Enrollment, which typically occurs in November (October for Seniors). However, in the future, eligibility dates may change if future legislation creates more low-cost options. By 2022, several newer plans may be offered, that eliminate many benefits that most consumers do not utilize.

Many Companies Offer Plans

Individual and family plans are offered through large insurers such as Highmark Blue Cross Blue Shield, Capital Blue Cross, UPMC, Keystone, Independence Blue Cross, and Geisinger. The rates you view on this website are always the lowest issued by the carriers, and the exact rate that you would pay by going directly to the carrier. Therefore, by utilizing our 40 years of experience, you are always viewing the lowest offered premium. Note: HealthAmerica was purchased by Coventry, which was subsequently bought by Aetna. Northeastern Blue Cross also merged with Highmark.

Also, NE Blue Cross previously merged with Highmark, and Aetna, UnitedHealthcare, and other newer carriers may return to the under age-65 market in 2021 (private individual coverage). Additional carriers, such as Cigna and Humana, offer Senior products, but not private (non-Group) plans to persons under age 65. Ambetter specializes in Medicare products and offers affordable private plans in three Philadelphia-area counties. Oscar also recently began offering coverage in that area.

Pa Seniors covered by Medicare can also select an inexpensive option for Medigap benefits. After reaching $6,350 (out-of-pocket threshold or TrOOP) in out-of-pocket prescription drug expenses, a catastrophic benefit begins, and generally only a small copay or coinsurance applies. Plan F is the most comprehensive Medigap option, but high-deductible Plans (HD) F and G are offered that feature the same standard benefits, although a $2,300 deductible must be met. Despite the high deductible, foreign travel and emergency care, hospice care, and a skilled nursing facility copay are included. Plan G (HD) is offered to new applicants.

Catastrophic health insurance policies for persons under age 65, will insure major claims, such as hospital expenses (including semi-private room charges, surgery and fees charged by doctors, surgeons and nurses), outpatient surgery, and emergency room and facility charges. Also referred to as “high deductible” plans, this type of coverage typically has a high deductible (up to $8,550 for individuals and $17,100 for a family) that must be met before most non-preventative benefits are paid.

Out-of-pocket expenses will depend on which deductible is selected, along with the coinsurance option that you choose. Since these types of options are the cheapest health insurance plans in Pennsylvania, they are extremely popular with healthier applicants or persons with a limited budget. Bronze-tier plans are eligible for financial subsidies, and can often be purchased for less than $100 per month. Bronze-tier contracts are the most popular individual plan issued.

Whether you are one person, a family, uninsured, self employed or on Cobra, this type of plan is always worth considering. The concept is simple: In the event of an emergency, protect yourself against unexpected illness, disease or an accident. Supplemental options are available for persons that already have existing benefits, but simply want to cover some of the “gaps” in their policy. A Medigap plan works the same way. Medicare covers most expenses and a secondary policy fills in the “gaps.” Plans are designed to help Seniors, while special supplemental options can help persons under age 65 cover many out-of-pocket expenses.

During Open Enrollment (Under Age 65), if you are in reasonably good health (or if you have chronic conditions), you can apply and get approved for a policy with more coverage, such as office visits and lower out-of-pocket charges. You should, however, consider what effect that will have on your current and future situation. Having office visit copay benefits is always a great feature. But it’s important to determine if you are paying thousands of dollars per year for a coverage that only provides a few hundred dollars of coverage in return.

The Best Catastrophic Health Insurance Plans In Pennsylvania (Marketplace)

UPMC Catastrophic $8,550/$0 – Available in Partner, Select, and Premium Networks. $8,550 deductible with 0% coinsurance. Deductible must be met before non-preventative expenses are covered. Available in Western Pa, and other counties.

Highmark my Direct Blue Major Events EPO 8550  –  One of the least expensive plans available, it features a $8,550 deductible with no coinsurance. First three pcp office visits are covered at 100%.

Geisinger Marketplace All-Acess Value POS – $8,550 deductible with 0% coinsurance. Only available in Central Pennsylvania and various surrounding counties.  First three pcp office visits are covered at 100%. Other pcp office visits subject to $75 copay.

Capital Blue Cross Catastrophic PPO 8550/0/75 – $8,550 deductible with 0% coinsurance. Only available in Central Pennsylvania and various surrounding counties. This is a POS (Point Of Service) plan. First three pcp office visits are covered at 100%.

Oscar Secure – $8,550 deductible with 0% coinsurance.  First three pcp office visits are covered at 100%.

Independence Blue Cross Personal Choice EPO Catastrophic – $8,550 deductible with 0% coinsurance. Similar to other plans although first three pcp office visits are subject to $50 copay. Available in the Philadelphia area (Montgomery, Philadelphia, Chester, Delaware, and Bucks Counties). Telemedicine visits are provided with no charge.

Not Recommended are low-priced “limited benefit” medical plans. Generally, a large non-refundable enrollment fee ($75-$200) is required, benefits are vague, out-of-pocket expenses are high, and the provider network is significantly smaller than most major carriers. Often, policies are quickly canceled, and obtaining alternative coverage may be difficult if the Open Enrollment period has ended.

Specific coverage is capped, with large benefit gaps if a chronic condition or major medical condition occurs. Non-generic medications are generally not fully-covered, and ongoing therapy or chronic conditions are not fully covered. Instead of maximum out-of-pocket expenses capped at $5,000 or $8,000, a significant health condition could result in hundreds of thousands of dollars in expenses.

Medicare Supplement Plan F (High Deductible) For Seniors

A common option for Seniors is choosing the Medigap Plan F (HD) plan. Covered benefits include Part A coinsurance and hospital expenses, Part B coinsurance and copays, the first three pints of blood, Part A Hospice Care coinsurance and copay, skilled nursing facility coinsurance, Part A and Part B deductibles, Part B excess charges, and foreign travel emergency expenses. However, unlike standard Plan F, you must meet an annual $2,300 deductible before expenses begin to be covered. Once the deductible has been met, the benefits of the high-deductible Plan F is the same as the standard Plan F.

Plans F and G can be sold with the high-deductible option. Previously, Plan J could be used as a high deductible. Plan G became available in 2020 to newly-eligible Medicare applicants. Plan F is no longer available to new beneficiaries, although the plan will remain active if already purchased. The only major difference in coverage is that Plan B will not cover the Part B deductible ($198).

Premiums, however, are much lower with the “HD” option. Thus, if you rarely have covered medical expenses to submit, it may be a very cost-effective option to consider. Benefits are standardized, so comparison of premiums is fairly simple. You are generally not permitted to enroll in a Supplement and an Advantage plan. Although prices for the HD coverage are less than most other options (A, B, C, D, F, etc…), often the rates on an Advantage plan are less expensive than the high-deductible option. Advantage contracts also may include prescription drug benefits, along with dental, vision, and hearing coverage.

Plan F (HD) Monthly Rates From Selected Carriers (Male Age 65)

Pittsburgh Area

$42 – New Era Life

$47 – Great Southern Life

$47 – Cigna

$52 – Medico

$54 – Mutual Of Omaha

$92 – Highmark

 

Harrisburg, Williamsport, Chambersburg, and York Areas

$36 – New Era Life

$41 – Great Southern Life

$43 – Cigna

$47 – Mutual Of Omaha

$48 – Medico

$77 – Highmark

 

Philadelphia Area

$51 – Great Southern Life

$52 – New Era Life

$53 – Cigna

$57 – Medico

$62 – Mutual Of Omaha

$75 – Independence BC

 

 

Allentown, State College, Hazleton, and Scranton Areas

$32 – United American

$38 – New Era Life

$43 – Cigna

$45 – Medico

$51 – Mutual Of Omaha

$58 –  Continental Life

$62 – Humana

$67- Aetna

 

Erie and Johnstown Areas

$37 – United American

$38 – New Era Life

$42 – Medico

$43 – Cigna

$51 – Mutual Of Omaha

$58 – Continental Life

$62 -Humana

$66 – Aetna

 

Reading, Wilkes-Barre, Easton, and Bethlehem Areas

$32 – United American

$38 – New Era Life

$43 – Cigna

$47 – Medico

$51 – Mutual Of Omaha

$58 – Continental Life

$62 -Humana

$66 – Aetna

 

Lancaster, Lebanon, and State College Area

$32 – United American

$38 – New Era Life

$42 – Medico

$43 – Cigna

$51 – Mutual Of Omaha

$58 –  Continental Life

$62 – Humana

$67- Aetna

 

Altoona Area

$37 – United American

$38 – New Era Life

$43 – Cigna

$44 – Medico

$51 – Mutual Of Omaha

$58 – Continental Life

$62 -Humana

$66 – Aetna

 

Pottstown Area

$37 – United American

$45 – New Era Life

$54 – Cigna

$54 – Medico

$62 – Humana

$68 – Mutual Of Omaha

$73 –  Continental Life

$80 – Aetna

 

Plan G (HD) Monthly Rates From Selected Carriers (Male Age 65)

Pittsburgh Area

$42 – New Era Life

$48 – Mutual Of Omaha

$50 – Aetna

$52 – Humana

 

Harrisburg Area

$36 – New Era Life

$42 – Mutual Of Omaha

$44 – Aetna

$45 – Humana

 

Philadelphia Area

$52 – New Era Life

$54 – Aetna

$55 – United States Fire

$56 – Mutual Of Omaha

$58 – Humana

$68 – Independence BC

 

Allentown Area

$36 – New Era Life

$42 – Mutual Of Omaha

$44 – United States Fire

$44 – Aetna

$45 – Humana

Summary

We’re committed to finding the plan that best matches your specific budget and needs. You can apply online for coverage or we can assist you. Please feel free to email or call us at (888) 513 6446. The top section of the website is where your free online quote is provided.

Updates From The Past:

Catastrophic coverage is available as Exchange plans. To qualify to purchase this type of policy, you must be under age 30 or have special “hardship” exemptions. Typically, major medical expenses are covered, and a deductible applies to most non-preventive expenses. Most deductibles are high.

Some of the most popular catastrophic options for the Pa Exchange (you can get free quotes at the top of the page) include Highmark Major Events Blue, HealthAmerica HMO, UPMC Advantage Secure Select, Keystone Healthy Benefits Value HMO, Geisinger Marketplace Value, Aetna Basic, Independence Personal Choice and Blue Cross of NE Pa MyBlue.

The government is now allowing policyholders that have had their plan cancelled due to the implementation of Obamacare, to purchase catastrophic plans on the Exchange. Prior to this announcement (see above), only applicants under age 30 could qualify. A copy of the cancellation letter will be required by most companies to obtain this special low-cost policy.

If you qualify for an exception, you can still buy a plan that receives subsidies. There are about 10 situations that allow you to qualify for financial help after Open Enrollment has ended. Otherwise, there are additional low-cost options that we can discuss with you. Simply contact us with your information.