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Pennsylvania Health Insurance

Looking for a Pennsylvania health insurance plan? Discover affordable options from top insurers in the federal marketplace. Get expert guidance to find the right coverage that fits your needs and budget.


Pennsylvania Health Insurance CrosswalkChoosing the Right Pennsylvania Health Insurance Plan

Picking the right metal-tier plan for your Pennsylvania health insurance is crucial. It’s all about matching what you expect to need for healthcare with what you can afford. Always keep in mind your health and what you can budget to find the plan that’s just right.

  • Bronze Tier: The Bronze tier plans typically have the lowest monthly premiums but higher out-of-pocket costs when you receive medical services. These plans generally cover around 60% of your healthcare expenses, while you would be responsible for the remaining 40%. Bronze plans are a good choice for individuals who want to keep their monthly premium costs low and are relatively healthy with minimal medical needs.
  • Silver Tier: Silver-tier plans strike a balance between premiums and out-of-pocket costs. They cover approximately 70% of your medical expenses, leaving you responsible for the remaining 30%. Silver plans also offer cost-sharing reductions (CSR) for eligible individuals, which further lower out-of-pocket expenses for those with lower incomes. These plans are suitable for individuals who need more coverage than what a Bronze plan offers but want to avoid higher premiums of Gold or Platinum plans.
  • Gold Tier: Gold tier plans have higher monthly premiums compared to Bronze and Silver plans but provide more extensive coverage. They typically cover about 80% of your medical costs, leaving you with 20% to pay out of pocket. Gold plans are a good fit for individuals who expect to have higher medical expenses and want more predictable and comprehensive coverage.
  • Platinum Tier: Platinum tier plans have the highest monthly premiums but the most comprehensive coverage. They cover around 90% of your healthcare expenses, and you are responsible for the remaining 10%. Platinum plans are ideal for individuals who frequently use medical services and want the most extensive coverage with minimal out-of-pocket expenses.




Lowest-Costing PA Health Insurance Plans by County

Pennsylvania offers many affordable health insurance plans for residents, ensuring essential coverage without breaking the bank. Below, you’ll find the cheapest plans listed by county.


CountyCostInsurance company & Plan NameMetal Level
Adams$343.43Highmark BCBS my Direct Blue EPO Bronze 8900Bronze
Allegheny$215.88Highmark BCBS Together Blue EPO Bronze 8900Bronze
Armstrong$276.34Highmark BCBS my Direct Blue EPO Bronze 8900Bronze
Beaver$241.53UPMC Advantage Bronze $6,700/$0 - Select NetworkBronze
Bedford$228.49UPMC Advantage Bronze $6,700/$0 - Partner NetworkBronze
Berks$325.79Ambetter Clear BronzeBronze
Blair$228.49UPMC Advantage Bronze $6,700/$0 - Partner NetworkBronze
Bradford$293.54Ambetter Clear BronzeBronze
Bucks$276.99Independence BC Keystone HMO BronzeBronze
Butler$215.88Highmark BCBS Together Blue EPO Bronze 8900Bronze
Cambria$276.34Highmark BCBS my Direct Blue EPO Bronze 8900Bronze
Cameron$336.78Highmark BCBS my Blue Access PPO Bronze 8900Bronze
Carbon$277.59Oscar Bronze Simple- StandardBronze
Centre$354.75Geisinger Marketplace All-Access HMO Pharmacy First 8500Bronze
Chester$276.99Independence BC Keystone HMO Bronze
Clarion$276.34Highmark BCBS my Direct Blue EPO Bronze 8900Bronze
Clearfield$326.47UPMC Advantage Bronze $6,700/$0 - Standard NetworkBronze
Clinton$302.75UPMC Advantage Bronze $6,700/$0 - Partner NetworkBronze
Columbia$354.75Geisinger Marketplace All-Access HMO Pharmacy First 8500Bronze
Crawford$276.34Highmark BCBS my Direct Blue EPO Bronze 8900Bronze
Cumberland$338.84Bronze Capital Advantage EPO 7450/0/50Bronze
Dauphin$338.84Bronze Capital Advantage EPO 7450/0/50Bronze
Delaware$276.99Indipendence BC Keystone HMO BronzeBronze
Elk$336.78Highmark BCBS my Blue Access PPO Bronze 8900Bronze
Erie$215.88Highmark BCBS Together Blue EPO Bronze 8900Bronze
Fayette$241.53UPMC Advantage Bronze $6,700/$0 - Select NetworkBronze
Forest$276.34Highmark BCBS my Direct Blue EPO Bronze 8900Bronze
Franklin$343.43Highmark BCBS my Direct Blue EPO Bronze 8900Bronze
Fulton$372.79Capital BC Bronze PPO 7450/0/50Bronze
Greene$276.34Highmark BCBS my Direct Blue EPO Bronze 8900Bronze
Huntingdon$302.01UPMC Advantage Bronze $6,700/$0 - Premium NetworkBronze
Indiana$302.01UPMC Advantage Bronze $6,700/$0 - Premium NetworkBronze
Jefferson$302.01UPMC Advantage Bronze $6,700/$0 - Premium NetworkBronze
Juniata$372.79Capital BC Bronze PPO 7450/0/50Bronze
Lackawanna$277.59Oscar Bronze Simple- StandardBronze
Lancaster$302.93Oscar Bronze Simple- StandardBronze
Lawrence$228.49UPMC Advantage Bronze $6,700/$0 - Partner NetworkBronze
Lebanon$343.43Highmark BCBS my Direct Blue EPO Bronze 8900Bronze
Lehigh$294.27Oscar Bronze Simple- StandardBronze
Luzerne$277.59Oscar Bronze Simple- StandardBronze
Lycoming$302.75UPMC Advantage Bronze $6,700/$0 - Partner NetworkBronze
Mckean$302.01UPMC Advantage Bronze $6,700/$0 - Premium NetworkBronze
Mercer$228.49UPMC Advantage Bronze $6,700/$0 - Partner NetworkBronze
Geisinger Marketplace All-Access HMO Pharmacy First 8500Bronze
Monroe$277.59Oscar Bronze Simple- StandardBronze
Montgomery$276.99Independence BC Keystone HMO BronzeBronze
Montour$354.75Geisinger Marketplace All-Access HMO Pharmacy First 8500Bronze
Northampton$294.27Ambetter Clear BronzeBronze
Northumberland$354.75Geisinger Marketplace All-Access HMO Pharmacy First 8500Bronze
Perry$338.84Capital BC Bronze Capital Advantage EPO 7450/0/50Bronze
Philadelphia$276.99Independence BC Keystone HMO BronzeBronze
Pike$312.03Highmark BCBS my Priority Blue Flex PPO Bronze 8900Bronze
Potter$336.78Highmark BCBS my Blue Access PPO Bronze 8900Bronze
Schuylkill$294.27Ambetter Clear BronzeBronze
Snyder$354.75Geisinger Marketplace All-Access HMO Pharmacy First 8500Bronze
Somerset$228.49UPMC Advantage Bronze $6,700/$0 - Partner NetworkBronze
Sullivan$293.54Ambetter Clear BronzeBronze
Susquehanna$293.54Ambetter Clear BronzeBronze
Tioga$302.75UPMC Advantage Bronze $6,700/$0 - Partner NetworkBronze
Union$354.75Geisinger Marketplace All-Access HMO Pharmacy First 8500Bronze
Venango$228.49UPMC Advantage Bronze $6,700/$0 - Partner NetworkBronze
Warren$276.34Highmark BCBS my Direct Blue EPO Bronze 8900Bronze
Washington$215.88Highmark BCBS Together Blue EPO Bronze 8900Bronze
Wayne$293.54Ambetter Clear BronzeBronze
Westmoreland$215.88Highmark BCBS Together Blue EPO Bronze 8900Bronze
Wyoming$277.59Oscar Bronze Simple- StandardBronze
York$343.43Highmark BCBS my Direct Blue EPO Bronze 8900Bronze


Lowest-Costing Pennsylvania Health Insurance Plans by Metal Level

Choose a health plan by evaluating your healthcare needs, finances, and risk tolerance. Plans are grouped by metal tiers, representing coverage and costs. The table below shows the cheapest plan by metal level.


Metal LevelCostPlan Name
Bronze$338.84Capital BC Bronze Capital Advantage EPO
Silver$520.72Capital BC Silver Capital Advantage EPO
Gold$457.77Capital BC Gold Capital Advantage EPO 2650/10/20
*based on a healthy 35-year-old individual in Harrisburg, Pennsylvania.



Lowest-Costing Pennsylvania Health Insurance Plans by Insurance Company 

Picking the right health insurance plan matters. If you want the cheapest option from your preferred insurer, this list can assist you.


Insurance companyCostPlan NameDescription
Capital Blue Cross$338.84Bronze Capital Advantage EPO 7450/0/50Deductible: $7,450
Specialist: $85
Geisinger Health Plan$425.70Marketplace All-Access HMO Pharmacy First 8500Deductible:$8,500
PCP:$0 after deductible
Specialist: $0 after deductible
Geisinger Quality Options, Inc.$488.14Marketplace All-Access PPO 40/80/8400Deductible:$8,400
Specialist: $80
Highmark BCBS$343.43my Direct Blue EPO Bronze 8900Deductible:$8,900
PCP:$0 after deductible
Specialist: $0 after deductible
UPMC Health Plan$398.23Advantage Bronze $6,700/$0 - Premium NetworkDeductible:$6,700
PCP:$0 after deductible
Specialist: 40% after deductible
*based on a healthy 35-year-old individual in Harrisburg, Pennsylvania.

Pennsylvania Provider LogoHealth Insurance Carriers

Pennsylvania’s health insurance marketplace operates through, serving as a gateway for individuals and families to explore a range of vital coverage options. Among the insurance companies participating in this marketplace are:



Capital Blue Cross


Geisinger Health Plan

Geisinger Quality Options, Inc.

Highmark Blue Cross Blue Shield

Independence Blue cross

Oscar Health

UPMC Health Plan


These reputable carriers offer a variety of health insurance plans to Pennsylvanians, tailored to their specific needs and preferences.


Pennsylvania Health Insurance HeartPennsylvania Health Insurance Statistics and Figures

In 2021, a total of 11,883,000 individuals were insured, while 681,000 remained uninsured, and as of 2023, the average cost of health insurance is $433, representing a 5.6% rise compared to the average premium in the previous year.


Insured (2021)11,883,000
Uninsured (2021)681,000
Ave. cost of Health Insurance (2023)$433
Change from Prev. Year's Ave. Premium (2022-2023)5.6%

*based on dataset


Pennsylvania Health Insurance BookHealth Insurance Terms to Learn When Getting a Plan

Understanding the most basic health insurance terms is vital to making informed decisions about your coverage, comparing different plans, and effectively managing your healthcare expenses.

Premium: The premium is the amount you pay to the health insurance company regularly, usually on a monthly basis, to maintain your coverage. It is a fixed cost, regardless of whether you use healthcare services or not.

Deductible: The deductible is the amount you must pay out of pocket for covered medical services before your insurance starts to pay. For example, if you have a $1,000 deductible, you are responsible for paying the first $1,000 of covered medical expenses before your insurance coverage kicks in.

Co-payment (Co-pay): A co-payment is a fixed amount you pay for certain medical services, such as doctor visits or prescription drugs, at the time of service. Co-payments are typically a specific dollar amount (e.g., $20 per doctor visit) and can vary depending on the service.

Coinsurance: Coinsurance is the percentage of the cost of a covered healthcare service that you are responsible for paying after you’ve met your deductible. For instance, if your insurance plan has a 20% coinsurance for hospitalization, you would pay 20% of the covered costs, and the insurance company would cover the remaining 80%.

Out-of-Pocket Maximum (OOP Max): The out-of-pocket maximum is the highest amount you have to pay for covered medical services in a given year. Once you reach this limit, your insurance company covers 100% of the remaining covered medical expenses for the rest of the year.

Network: A network refers to a group of doctors, hospitals, and other healthcare providers that have contracted with a specific insurance company to provide services at discounted rates. Staying in-network usually results in lower out-of-pocket costs for the insured individual.

Out-of-Network: Out-of-network providers are healthcare professionals or facilities that do not have agreements with your insurance company. If you use an out-of-network provider, you may have higher costs, and some services may not be covered.

Enrollment Periods: For plans offered through the Health Insurance Marketplace, 

Open Enrollment Period (OEP) occurs once a year, typically from November 1 to December 15, allowing individuals to enroll in or change health insurance plans for the upcoming coverage year through the Health Insurance Marketplace or their employer. Special Enrollment Period (SEP) Allows individuals to enroll in or change health insurance plans outside of the regular Open Enrollment period due to qualifying life events such as marriage, birth of a child, losing other health coverage, moving, or changes in household income. Medicare Initial Enrollment Period (IEP) is available for those eligible for Medicare, lasting seven months, beginning three months before the 65th birthday and ending three months after, allowing enrollment in Medicare Part A, Part B, Part D, and Medicare Advantage plans.



Pennsylvania Health Insurance ShieldFree Health Insurance Options in Pennsylvania

In Pennsylvania, there are several free or low-cost health insurance options available to eligible individuals and families who meet specific criteria. These programs aim to provide essential healthcare services and coverage to those with limited financial resources. Here are some of the main options:

Medicaid: Medicaid is a state and federally-funded program that offers free or low-cost health coverage to low-income individuals and families, including pregnant women, children, parents, and adults with disabilities. Eligibility is based on income and other factors.

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