How To Find the Best Health Insurance in Pennsylvania

Shopping around and comparing prices from multiple health insurance companies will enable you to find a health plan in Pennsylvania at the lowest price possible. Fortunately for Pennsylvanians, the state boasts fairly low average health insurance rates and a well-rated health care system.

Read on for more information about Pennsylvania health insurance such as when you can sign up for coverage and how much premiums may vary by city.

On This Page

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  Is Health Insurance Required in Pennsylvania?

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  Pennsylvania Health Insurance Rankings

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  How Much Does Health Insurance Cost in Pennsylvania?

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  What Is the Average Cost of Health Insurance in Pennsylvania by City?

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  Which Health Insurance Companies Are the Most Affordable in Pennsylvania?

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  When Is Open Enrollment for Health Insurance in Pennsylvania?

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  What Types of Health Insurance Are Available in Pennsylvania?

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  How To Get Health Insurance in Pennsylvania

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  FAQs

Is Health Insurance Required in Pennsylvania?

Under the Affordable Care Act (ACA), Americans in every state are required to maintain ACA-compliant health insurance.^[1] That said, penalties for going without coverage are only applied at the state or district level and the Pennsylvania government does not fine residents who don’t have health insurance.

Pennsylvania Health Insurance Rankings

According to the Commonwealth Fund, Pennsylvania is tied with New York for the No. 9 spot on a ranking of the health care systems in each state in the country plus the District of Columbia. Highlights of Pennsylvania’s health system include first-place finishes regarding the treatment of ambulatory care-sensitive conditions in adults under the age of 65 who could otherwise experience needless hospitalizations and the extent to which income is a factor impacting whether adults go without usual care.^[2]

You can check out the table below to see where Pennsylvania ranked on each of the major dimensions the Commonwealth Fund measured.^[2]

How Much Does Health Insurance Cost in Pennsylvania?

The average cost of a Marketplace benchmark plan is $445 per month in Pennsylvania. This means Pennsylvania is generally a cheap state for health insurance compared to the nation as a whole, where a benchmark health plan costs $477 per month on average. Additionally, Pennsylvanians pay an average of $302 per month for the lowest-cost bronze plan in the state, $434 per month for the lowest-cost silver plan and $391 per month for the lowest-cost gold plan.^[3]

Cheapest Health Insurance Options in Pennsylvania

If you want the lowest monthly premiums possible, then you should opt for a plan in the bronze health insurance tier. However, these plans also come with the highest out-of-pocket costs whenever you access health care, which means you may be better off purchasing a higher-tiered gold or platinum plan if you expect to need regular medical treatments.^[4]

Alternatively, you could save money on both premiums and out-of-pocket costs like deductibles, copays and coinsurance by enrolling in a health maintenance organization (HMO). Keep in mind that HMO plans don’t cover some of the services covered by preferred provider organization (PPO) plans such as specialist visits without a referral from your primary care physician (PCP) and routine care from out-of-network providers.^[5]

What Is the Average Cost of Health Insurance in Pennsylvania by City?

In the table below, you’ll find median health insurance rates across all metal levels for people living in five large cities in Pennsylvania. These monthly rates have been collected from Pennsylvania’s state-run marketplace website, Pennie, and are based on a sample population consisting of 30-year-olds with a yearly income of $40,000 looking for individual coverage.^[6]

Which Health Insurance Companies Are the Most Affordable in Pennsylvania?

Highmark offers the cheapest health plan overall in Pennsylvania, with a starting rate of $244 per month for one of its bronze health plans. Meanwhile, the lowest average premium across all silver plans comes from Jefferson Health Plans. Below is a table listing insurers with average monthly silver plan rates below $700 per month for 40-year-olds in Pennsylvania.^[7]

When Is Open Enrollment for Health Insurance in Pennsylvania?

Health insurance open enrollment through Pennie begins on November 1 and continues until January 15. If you enroll by December 15, your health coverage will take effect on January 1.^[8] In the event that you fail to sign up during open enrollment, you may still be able to join a plan if you are eligible for a special enrollment period due to a qualifying life event like your marriage or the birth of your child.^[9]

What Types of Health Insurance Are Available in Pennsylvania?

If you live in Pennsylvania, you should have access to several types of health insurance including these: 

• Marketplace health insurance
• Private coverage purchased directly from an insurance company such as short-term health insurance
• Employer-sponsored group health insurance
• Consolidated Omnibus Budget Reconciliation Act (COBRA) continuation coverage
• Medicare
• Medicaid (also known as Medical Assistance in Pennsylvania)
• Children’s Health Insurance Program (CHIP)
• Department of Veterans Affairs (VA) health benefits
• Student health plans

How To Get Health Insurance in Pennsylvania

Collecting quotes from around three to five different health insurance companies is the best way to figure out whether you are getting a good deal on your health plan. To get a quote, you’ll need to provide information like your age, ZIP code, household income and more. This can make for an excruciating process if you try contacting insurance carriers one at a time.

Thankfully, SmartFinancial makes comparison shopping for affordable health insurance much easier. Simply answer a few questions and then let us do the legwork of finding policies that match your coverage needs and budget. Speak to an insurance agent today about your health insurance needs.