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Pennsylvania Health Insurance

pennsylvania health insurance types

The Affordable Care Act gives many Pennsylvania residents new health insurance options in 2014. According to a Kaiser Family Foundation (KFF) profile of Pennsylvania, in 2012 Gov. Tom Corbett announced the state would not create its own health insurance marketplace. Pennsylvania is one of five states still openly debating Medicaid expansion.

Pennsylvanians must visit the federal marketplace at during open enrollment to apply for private marketplace insurance plans and find out if they qualify for tax credits to offset their premiums. is also the gateway to apply for Medicaid or the Children’s Health Insurance Program (CHIP).

Do you qualify for a subsidy to help pay for health insurance in Pennsylvania? 

A January 2014 KFF report on the ACA’s effect in Pennsylvania says about half of the state’s uninsured non-elderly population might qualify for financial assistance. Assistance comes from Medicaid, CHIP or tax credits to help pay for plans purchased on the marketplace. People who already have a way to access qualified, affordable insurance generally aren’t eligible for assistance. 

Tax subsidies:The ACA offers federal income tax credits to people who earn between 100 and 400 percent of the federal poverty level. This works out to an income between $23,550 and $94,200 for a four-person family and between $11,490 and $45,960 for an individual. Generally, subsidies will be based on 2013 poverty level limits, and Medicare and CHIP qualification will be based on 2014 limits.

Medicaid:Nondisabled Pennsylvania parents who earn less than 38 percent of the federal poverty level may qualify for Medicaid, which is about $9,065 a year for a family of four in 2014.

CHIP: Pennsylvania children from families with income less than 319 percent of the poverty level, or about $76,080 for a family of four in 2014, might qualify for CHIP.

Some Pennsylvanians earn too much to qualify for any public assistance, but they might choose to purchase private marketplace insurance anyway. Qualified marketplace plans must provide certain minimum benefits, and insurers cannot discriminate against applicants with pre-existing medical conditions.

Pennsylvania health insurance companies

These insurers offer health insurance for Pennsylvania residents on the marketplace:

  • Aetna
  • Blue Cross of Northeastern Pennsylvania
  • Capital BlueCross
  • Geisinger Health Plans
  • HealthAmericaOne
  • Highmark Health Insurance Company
  • Highmark Health Services
  • Independence Blue Cross
  • Keystone Health Plan Central
  • UPMC Health Plan

Pennsylvania health and coverage statistics

Pennsylvania population (2013): 12,773,801

Population 65 and older (2012): 16 percent
Life expectancy (2010): 78.5 years
Number of Medicaid beneficiaries (2012): 1,926,800
Number of Medicare beneficiaries (2012): 1,896,800
Estimated number of uninsured residents (2012): 1,447,600

Overall state health ranking: 29

Sources: Kaiser Family Foundation, U.S. Census Bureau, America’s Health Rankings 2014 report.

Pennsylvania health insurance resources

Federal marketplace:

Pennsylvania Health Department:

Pennsylvania Insurance Department:

Pennsylvania Department of Aging:

Kaiser Family Foundation:

Health Insurance by State

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