Pennsylvanians can choose insurance coverage from private individual or group plans, or from government programs.
As elsewhere, health insurance in Pennsylvania is regulated at the state level. There are three basic types of health coverage to choose from: individual plans, group plans, or government-subsidized programs. Monitor this situation closely to see if the new national insurance health plan, now taking effect, will change this situation.
Individual Health Insurance
Individual health insurance provides coverage for you and your family members. With one exception, this type of insurance is not guaranteed to every applicant; eligibility is determined by your health status. Blue Cross insurance in Pennsylvania does, however, offer at least one policy to any resident of the state on a guaranteed-issue basis. This means that, regardless of your health status, you will qualify for this coverage, but must pay the premiums.
Group Health Insurance
Group health insurance is generally offered through employers or affinity groups. In the case of the former, you must meet certain eligibility guidelines, such as employment status (number of hours worked for the employer) and a waiting period. Both of these are determined by the employer. A group plan consists of you and other members. All of the premiums will be equal for all members in the plan based on the tier they are in. For example, all individuals electing an individual coverage plan will be charged the same premium, while all members with family plans will be charged a different premium. Some employers offer full coverage as part of their benefits packages; in other cases, employees must pay part or all of the premium.
Government Programs
Among the government insurance programs available to Pennsylvania residents are Medicaid; Pennsylvania's Children Health Insurance Program; Pennsylvania AdultBasic: Health Insurance for the Uninsured; and The Healthy Woman Project. All are public health insurance plans that involve state or federal subsidies. These plans offer specialized care for specific groups of people. For example, the Healthy Women's Project will provide free breast-exam screenings, while Medicaid is designed for low-income families and individuals. You must meet income and age qualifications for each program. Also, depending on the plan, you may need to pay a small premium based on your income level and assets.
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