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Health Insurance in Pennsylvania

A Pennsylvania health insurance plan helps cover your medical costs for emergencies and routine doctor visits. Not only does health insurance help you financially, but it is also a requirement if you wish to avoid fees and other penalties. Comparing health insurance quotes is an important aspect of finding a plan that works for your needs. The federal health insurance marketplace contains numerous options for you to choose from when selecting a new plan. Many affordable health insurance options are available for you to compare in the marketplace. However, if you need help paying for medical insurance plans for yourself or your family, then the state of Pennsylvania also offers several forms of financial assistance. Continue reading to find out what you need to start the health insurance enrollment process, compare health insurance quotes in Pennsylvania and get help paying for insurance.

Why You Must Have Health Insurance in Pennsylvania

Medical insurance is a requirement in Pennsylvania and the rest of the U.S. due to the Affordable Care Act. If you are able to afford health insurance, then you are required to purchase a plan and stay enrolled in a plan at all times. Failing to enroll in a medical insurance plan when you are financially able to do so will result in being charged a fine from the IRS on your annual taxes. Typically, the fine is assessed for each month that you went uninsured in the past year. Oftentimes, fines for failing to have health coverage end up costing the same amount that you would have paid for an insurance plan in the first place. As an additional consequence, you will be forced to cover any hospital bills you may receive in the event of a medical emergency if you do not have insurance.

These health insurance penalties do not apply in Pennsylvania if you meet certain requirements. You may be exempt from the PA medical insurance mandate and any fees for not having insurance if any of the following apply:

  • You were uninsured for less than three consecutive months.
  • You did not meet income requirements for insurance.
  • You could not find an affordable insurance plan.
  • You endured a hardship that affected your ability to maintain your insurance coverage.
  • You were a U.S. citizen living abroad.

Note: You are only exempt from the health coverage mandate in Pennsylvania if you submit a form to the IRS stating why you did not have insurance.

Government Assistance for Pennsylvania Health Insurance Applicants

If you are unable to locate an affordable health insurance plan, then you may be eligible for assistance from the Pennsylvania government. Two main forms of health insurance assistance are offered by the Pennsylvania Department of Human Services (DHS): Medical Assistance, otherwise known as Medicaid, and the Children’s Health Insurance Program, known commonly as CHIP. To get health insurance help through Medicaid or CHIP, you must meet income requirements and other eligibility criteria. To see whether you are eligible for Medicaid, use the national COMPASS system or contact your local PA county office that handles medical assistance claims. If you do not meet the requirements for Medicaid, then you may still be eligible for CHIP.

If you are not eligible for a reduced health insurance rate using Pennsylvania’s Medicaid or CHIP programs, then you may be required to enroll in a health care insurance plan in the traditional way.

How to Fill Out a Pennsylvania Health Insurance Application

When you need to sign up for PA health insurance, you may use the national health care marketplace to find a plan. The health insurance marketplace can be accessed at any time for informational purposes and to find quotes for health insurance before you buy a plan. You can only apply for health insurance during times known as open enrollment periods. However, you may fill out a medical insurance application at other times of the year when you have a qualifying life event. Life events that change your health insurance needs include having a baby, getting married, losing your current insurance plan or other similar situations. If you do not wish to use the health insurance marketplace, then you may sign up for health care in Pennsylvania using a private insurance company.

Completing an application for health insurance will require you to provide similar information regardless of whether you use a private insurance company in Pennsylvania or use the national marketplace. In general, the health insurance enrollment process will require you to provide information, such as your name, Social Security Number, household size and household income.

How to Get an Affordable Pennsylvania Health Insurance Rate

PA health insurance can be expensive, but there are numerous reasons that medical insurance is worthwhile. You may be able to find a more affordable health insurance plan by trying the following:

  • Shop for a new health insurance plan during the next open enrollment period.
  • See if you are eligible for CHIP or Medicaid in Pennsylvania.
  • Consider a plan with a higher deductible, which will have lower monthly payments.