Compare Affordable Pennsylvania Health Insurance Quotes
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.
Choosing 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.
| County | Cost | Insurance company & Plan Name | Metal Level |
|---|---|---|---|
| Adams | $343.43 | Highmark BCBS my Direct Blue EPO Bronze 8900 | Bronze |
| Allegheny | $215.88 | Highmark BCBS Together Blue EPO Bronze 8900 | Bronze |
| Armstrong | $276.34 | Highmark BCBS my Direct Blue EPO Bronze 8900 | Bronze |
| Beaver | $241.53 | UPMC Advantage Bronze $6,700/$0 - Select Network | Bronze |
| Bedford | $228.49 | UPMC Advantage Bronze $6,700/$0 - Partner Network | Bronze |
| Berks | $325.79 | Ambetter Clear Bronze | Bronze |
| Blair | $228.49 | UPMC Advantage Bronze $6,700/$0 - Partner Network | Bronze |
| Bradford | $293.54 | Ambetter Clear Bronze | Bronze |
| Bucks | $276.99 | Independence BC Keystone HMO Bronze | Bronze |
| Butler | $215.88 | Highmark BCBS Together Blue EPO Bronze 8900 | Bronze |
| Cambria | $276.34 | Highmark BCBS my Direct Blue EPO Bronze 8900 | Bronze |
| Cameron | $336.78 | Highmark BCBS my Blue Access PPO Bronze 8900 | Bronze |
| Carbon | $277.59 | Oscar Bronze Simple- Standard | Bronze |
| Centre | $354.75 | Geisinger Marketplace All-Access HMO Pharmacy First 8500 | Bronze |
| Chester | $276.99 | Independence BC Keystone HMO Bronze | Bronze |
| Clarion | $276.34 | Highmark BCBS my Direct Blue EPO Bronze 8900 | Bronze |
| Clearfield | $326.47 | UPMC Advantage Bronze $6,700/$0 - Standard Network | Bronze |
| Clinton | $302.75 | UPMC Advantage Bronze $6,700/$0 - Partner Network | Bronze |
| Columbia | $354.75 | Geisinger Marketplace All-Access HMO Pharmacy First 8500 | Bronze |
| Crawford | $276.34 | Highmark BCBS my Direct Blue EPO Bronze 8900 | Bronze |
| Cumberland | $338.84 | Bronze Capital Advantage EPO 7450/0/50 | Bronze |
| Dauphin | $338.84 | Bronze Capital Advantage EPO 7450/0/50 | Bronze |
| Delaware | $276.99 | Indipendence BC Keystone HMO Bronze | Bronze |
| Elk | $336.78 | Highmark BCBS my Blue Access PPO Bronze 8900 | Bronze |
| Erie | $215.88 | Highmark BCBS Together Blue EPO Bronze 8900 | Bronze |
| Fayette | $241.53 | UPMC Advantage Bronze $6,700/$0 - Select Network | Bronze |
| Forest | $276.34 | Highmark BCBS my Direct Blue EPO Bronze 8900 | Bronze |
| Franklin | $343.43 | Highmark BCBS my Direct Blue EPO Bronze 8900 | Bronze |
| Fulton | $372.79 | Capital BC Bronze PPO 7450/0/50 | Bronze |
| Greene | $276.34 | Highmark BCBS my Direct Blue EPO Bronze 8900 | Bronze |
| Huntingdon | $302.01 | UPMC Advantage Bronze $6,700/$0 - Premium Network | Bronze |
| Indiana | $302.01 | UPMC Advantage Bronze $6,700/$0 - Premium Network | Bronze |
| Jefferson | $302.01 | UPMC Advantage Bronze $6,700/$0 - Premium Network | Bronze |
| Juniata | $372.79 | Capital BC Bronze PPO 7450/0/50 | Bronze |
| Lackawanna | $277.59 | Oscar Bronze Simple- Standard | Bronze |
| Lancaster | $302.93 | Oscar Bronze Simple- Standard | Bronze |
| Lawrence | $228.49 | UPMC Advantage Bronze $6,700/$0 - Partner Network | Bronze |
| Lebanon | $343.43 | Highmark BCBS my Direct Blue EPO Bronze 8900 | Bronze |
| Lehigh | $294.27 | Oscar Bronze Simple- Standard | Bronze |
| Luzerne | $277.59 | Oscar Bronze Simple- Standard | Bronze |
| Lycoming | $302.75 | UPMC Advantage Bronze $6,700/$0 - Partner Network | Bronze |
| Mckean | $302.01 | UPMC Advantage Bronze $6,700/$0 - Premium Network | Bronze |
| Mercer | $228.49 | UPMC Advantage Bronze $6,700/$0 - Partner Network | Bronze |
| Mifflin | $354.75 | Geisinger Marketplace All-Access HMO Pharmacy First 8500 | Bronze |
| Monroe | $277.59 | Oscar Bronze Simple- Standard | Bronze |
| Montgomery | $276.99 | Independence BC Keystone HMO Bronze | Bronze |
| Montour | $354.75 | Geisinger Marketplace All-Access HMO Pharmacy First 8500 | Bronze |
| Northampton | $294.27 | Ambetter Clear Bronze | Bronze |
| Northumberland | $354.75 | Geisinger Marketplace All-Access HMO Pharmacy First 8500 | Bronze |
| Perry | $338.84 | Capital BC Bronze Capital Advantage EPO 7450/0/50 | Bronze |
| Philadelphia | $276.99 | Independence BC Keystone HMO Bronze | Bronze |
| Pike | $312.03 | Highmark BCBS my Priority Blue Flex PPO Bronze 8900 | Bronze |
| Potter | $336.78 | Highmark BCBS my Blue Access PPO Bronze 8900 | Bronze |
| Schuylkill | $294.27 | Ambetter Clear Bronze | Bronze |
| Snyder | $354.75 | Geisinger Marketplace All-Access HMO Pharmacy First 8500 | Bronze |
| Somerset | $228.49 | UPMC Advantage Bronze $6,700/$0 - Partner Network | Bronze |
| Sullivan | $293.54 | Ambetter Clear Bronze | Bronze |
| Susquehanna | $293.54 | Ambetter Clear Bronze | Bronze |
| Tioga | $302.75 | UPMC Advantage Bronze $6,700/$0 - Partner Network | Bronze |
| Union | $354.75 | Geisinger Marketplace All-Access HMO Pharmacy First 8500 | Bronze |
| Venango | $228.49 | UPMC Advantage Bronze $6,700/$0 - Partner Network | Bronze |
| Warren | $276.34 | Highmark BCBS my Direct Blue EPO Bronze 8900 | Bronze |
| Washington | $215.88 | Highmark BCBS Together Blue EPO Bronze 8900 | Bronze |
| Wayne | $293.54 | Ambetter Clear Bronze | Bronze |
| Westmoreland | $215.88 | Highmark BCBS Together Blue EPO Bronze 8900 | Bronze |
| Wyoming | $277.59 | Oscar Bronze Simple- Standard | Bronze |
| York | $343.43 | Highmark BCBS my Direct Blue EPO Bronze 8900 | Bronze |
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 Level | Cost | Plan Name |
|---|---|---|
| Bronze | $338.84 | Capital BC Bronze Capital Advantage EPO |
| Silver | $520.72 | Capital BC Silver Capital Advantage EPO |
| Gold | $457.77 | Capital 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 company | Cost | Plan Name | Description |
|---|---|---|---|
| Capital Blue Cross | $338.84 | Bronze Capital Advantage EPO 7450/0/50 | Deductible: $7,450 PCP:$50 Specialist: $85 |
| Geisinger Health Plan | $425.70 | Marketplace All-Access HMO Pharmacy First 8500 | Deductible:$8,500 PCP:$0 after deductible Specialist: $0 after deductible |
| Geisinger Quality Options, Inc. | $488.14 | Marketplace All-Access PPO 40/80/8400 | Deductible:$8,400 PCP:$40 Specialist: $80 |
| Highmark BCBS | $343.43 | my Direct Blue EPO Bronze 8900 | Deductible:$8,900 PCP:$0 after deductible Specialist: $0 after deductible |
| UPMC Health Plan | $398.23 | Advantage Bronze $6,700/$0 - Premium Network | Deductible:$6,700 PCP:$0 after deductible Specialist: 40% after deductible |
*based on a healthy 35-year-old individual in Harrisburg, Pennsylvania.
Health Insurance Carriers
Pennsylvania’s health insurance marketplace operates through Pennie.com, 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:
Geisinger Health Plan
Geisinger Quality Options, Inc.
Highmark Blue Cross Blue Shield
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 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 kff.org dataset
Health 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.
Free 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.