Pennsylvania residents have several health insurance options. With five regional Blue Cross and Blue Shield plans, many private insurers and government-sponsored health plans, most Pennsylvania residents should be able to find coverage. The Pennsylvania Insurance Department can help consumers navigate through the maze of health insurance information and even help apply and explain options to residents.
Individual Health Insurance
Many employers offer group health insurance to their employees but if you are self-employed, unemployed or your employer does not offer coverage; you can purchase individual health insurance. Individual health insurance is available from each of the five regional Blue Cross and Blue Shield plans in Pennsylvania, even if you have a pre-existing condition, per Pennsylvania law should you meet certain criteria. Other private health insurers can choose whether to cover you. Insurers who may be available in parts of Pennsylvania include Geisinger, Aetna, Health America and United HealthCare.
Medicaid and CHIP
Medicaid is a health insurance program available to qualified individuals based on financial need. The Pennsylvania Department of Public Welfare can provide information on applying, eligibility and benefit information. Contact Pennsylvania DPW at 1-800-692-7462 or visit its website at dpw.state.pa.us/ for more information about Medicaid. Children in Pennsylvania may qualify for the Children's Health Insurance Plan, a program offering health insurance to uninsured children under age 19. Children may be eligible for CHIP despite their parent's financial status. The Pennsylvania CHIP hotline for more information is 800-986-KIDS and its website is chipcoverspakids.com.
Pennsylvania Fair Care
When a Pennsylvania resident cannot obtain private health insurance due to a pre-existing medical condition, they may qualify for the Pennsylvania Fair Care program. Pennsylvania Fair Care offers comprehensive health insurance to Pennsylvania residents uninsured for at least six months prior to applying for Pennsylvania Fair Care coverage. Individuals enrolled in Medicare or Medicaid is not eligible for this program. This federally funded program establishes a waiting list when funds run out and re-evaluates funding every six months. More information about Pennsylvania Fair Care is available by calling 888-767-7015.
Resources
The Pennsylvania Insurance Department provides many resources to help Pennsylvania residents navigate through health insurance information. Residents can call the Pennsylvania DOI at 877-881-6388 or email them at ra-in-consumer@state.pa.us with questions. Additionally, the website offers many printable consumer brochures and fact sheets on health insurance topics such as adult children insurance, CHIP, COBRA, discount health plans, Medicare and other types of insurance. Other website features include information on choose an insurance company, find a licensed agent and file a complaint.
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