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Pennsylvania Health Insurance

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Pennsylvania Health Insurance (PA)

Choose from the list below to learn more about specific health insurance providers in Pennsylvania. Read on to learn about health insurance regulations in your state. Or enter your zip code in the box above to request a health insurance quote.

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Health Insurance Providers in Pennsylvania (PA)

Aetna
American Medical Security
Assurant Health (formerly Fortis)
Celtic
Fairmont Specialty Group
Golden Rule
Guardian
Security Life

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Individual Health Insurance in Pennsylvania (PA)

Individual health insurance has different regulations than group health. Also, there are different rules for Blue Cross Blue Shield of Pennsylvania than for other private insurers.

For Blue Cross Blue Shield, if you apply for individual coverage, the company is required to issue a policy to you. If you are HIPAA eligible, they must offer you two policies that are state approved and the company is the only option for individual guaranteed issue insurance in the State. If you are given a policy, the company may require a waiting period of no more than 30 days for non-accident claims and six months for certain other elective claims. If you have a pre-existing condition, they can impose an exclusion period of three years, unless you are HIPAA eligible. In a non-guaranteed policy, however, the company can attach an elimination rider to the policy. Both pregnancy and genetic information can be considered pre-existing conditions in Pennsylvania. Community rating will help set the cost of a guaranteed issue policy. However, non-guaranteed policies have no limitations on costs. Your Blue Cross Blue Shield insurance cannot be cancelled due to your illness.

Other private insurers of individual health policies are allowed to reject your application for insurance due to a health problem. If you have a pre-existing condition, the private insurer can attach an elimination rider to the policy or it can impose an exclusion period of no more than three years. There are no creditable coverages in any individual health policies. There are no limits on the cost of the premium for individual insurance, but the policy cannot be cancelled due to your illness. The Pennsylvania Insurance Department has an extensive list of information that should be covered before acquiring a new health insurance policy.

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Group Health Insurance in Pennsylvania (PA)

Pennsylvania regulations for group health insurance dictate that qualified persons cannot be turned down for group coverage, nor can they be charged more because of a health problem. A new employer may require a waiting period before offering group insurance. Life changes relating to family, children, marriage, or job loss can entitle you to special opportunities for group coverage. Newborns and disabled children have special considerations in Pennsylvania, provided there are dependent coverages in the policies. If you have a pre-existing condition, group insurance companies can review your medical records for the six months prior to coverage. They can require an exclusion period of no more than 12 months for the condition. If you have had no break in your coverage of over 63 days, you are allowed to get credit toward the exclusion period.

Small Business Health Insurance in Pennsylvania (PA)

Small employers of two to 50 employees cannot be turned down for small group health insurance and their policies cannot be cancelled due to health problems within the employee groups. Premiums may have higher costs due to health problems in the group however. Blue Cross Blue Shield premiums are based on modified community rating.

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Self-Employed Health Insurance in Pennsylvania (PA)

The self-employed are not allowed to purchase group health insurance. Because the self-employed and small businesses join associations that are trade or business related and that offer group health coverages, it is recommended you contact the Pennsylvania Department of Insurance for regulations.

Pennsylvania Department of Insurance
1326 Strawberry Square
Harrisburg, PA 17120
(717) 787-2317
www.ins.state.pa.us/ins/site/default.asp


Pennsylvania Programs (PA)

Financial assistance in Pennsylvania is provided through several programs, such as Medicaid, Healthy Women Project, and Pennsylvania’s Children Health Insurance Program.


Health Insurance in Pennsylvania Cities (PA)

Learn more about health insurance (including medical facility details) in Altoona, Erie, Harrisburg, Philadelphia, Pittsburgh, Reading, Scranton, and Williamsport.

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