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Pennsylvania Health Insurance

In Pennsylvania, health insurance is a big decision, as it is throughout America. Since a serious illness or accident could drain your financial resources, it is only common sense to protect yourself with PA health insurance. Once you have evaluated your medical needs and budget, you will be ready to select from the variety of options available for health insurance in Pennsylvania.

Pennsylvania Health Insurance Plans

There are a variety of PA health plans on the market today, each with its own advantages and disadvantages. By understanding them you will be better able to select which one meets your needs. 

HMO (Health Maintenance Organization): An HMO is a managed care type of plan that requires you to select a Primary Care Provider (PCP) from the network in order to oversee your healthcare. You are only covered for healthcare within the network. It is the most affordable type of plan, but also the most restrictive.

PPO (Preferred Provider Organization): A PPO is also managed care but you have the option of self-directing your own care. You may choose to use healthcare providers who are within the network or outside of it. Your coinsurance rate will change, however depending on if the provider belongs to the network or not.

POS (Point of Service): A POS plan is a combination of the PPO and the HMO. You have more choice in your healthcare than with an HMO. You can see out-of-network providers with coverage if your primary physician refers them.


Fee-for-Service: This is the traditional indemnity plan. You pay premiums, pay for healthcare out of pocket and submit receipts for reimbursement. You are reimbursed minus deductible and any coinsurance applicable, up to a maximum per year. It is the most expensive plan, requires the most work on your part but allows the most choice.

Pennsylvania Health Insurance: Group Or Individual

You can find Pennsylvania health insurance through group plans or individual ones. It is important to know the differences and why you might want to choose one over the other.

Pennsylvania group health insurance coverage is usually offered through employers, but you may also be able to find it through other groups you belong to like professional associations and business groups. It is convenient and easy because all the choices have been made.

There is no underwriting requirement for group health insurance therefore it is great for people with pre-existing conditions or overall poor health. Pennsylvania does not offer a high-risk insurance pool to those who are deemed high-risk; therefore group insurance may be their only option.

If you work for a company with 20 or more employees and you leave the company then you are also entitled to a group continuation plan called a Pennsylvania COBRA health insurance plan.

Pennsylvania individual health insurance can be tailored to your exact needs and budget. You get only what you need and expect to use. Underwriting is required for individual health insurance so that the company can analyze the risk you present.

For anyone in good health, individual health insurance is less expensive than group policies because you are not paying an additional amount to help subsidize those less-than-healthy individuals in a group plan. Plus, you have more control over the type of plan you are getting.

Pennsylvania Health Insurance: State Programs

The state of Pennsylvania has a program in place to ensure that all children have access to health insurance regardless of their family income. The plan is called the PA Children’s Health Insurance Program or CHIP. Depending on family incomes the program may be free, low cost or full premium.

AdultBasic is another plan administered by the state but for adults. It offers basic healthcare through 4 insurance companies for a low monthly premium and low co-payments. It ensures accessible coverage to all adults who are eligible, meaning their income is too high for Medicaid, but does not exceed the limit for the family size, set by the program.

If you have major pre-existing health conditions and are having trouble finding a health insurance company that will accept you onto their plan then be sure and ask your PA health insurance agent or the Pennsylvania Department of Insurance if you qualify for a Pennsylvania HIPAA health insurance plan.

Pennsylvania Health Insurance Companies

Selecting an insurance company to trust your healthcare coverage to is a difficult choice. You want to feel comfortable in the balance of coverage you receive in exchange for price you pay. You also want to know that you won’t have to worry in case of catastrophic illness. That is why shopping around carefully, comparing coverage, reading the fine print and researching the company you choose are vitally important.

Companies offering health insurance in Pennsylvania include:

  1. HealthAssurance Pennsylvania

  2. Aetna

  3. CIGNA

  4. Americhoice of Pennsylvania

  5. Coventry

  6. Keystone

  7. Gateway

  8. Blue Cross Blue Shield

  9. Vista

  10. Avalon

  11. United Healthcare

Pennsylvania Health Insurance Quotes

You can get a variety of Pennsylvania health insurance quotes to compare and contrast, easily and quickly using our free online quote tool at the top of this page.

You just need to click on the box, enter your zip code and answer a few questions. In no time you will get quotes from top insurers serving your area of Pennsylvania.

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