How to Get Health Insurance
There are various types of health insurance and different markets. Pennsylvania's health insurance market can be broken down into commercial fully insured/self-insured, Medicaid and Medicare and CHIP. There are different ways to obtain coverage depending on the market and the type of insurance that's best for you.
Pennie.com
Pennie is Pennsylvanian's insurance marketplace and provides individuals and families with the ability to shop for high-quality health care plans and easily apply for financial assistance.
All PA residents who are citizens, U.S. nationals, or have a qualified immigration status can apply and enroll in health coverage through Pennie.
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Open Enrollment Period - Open enrollment for individual health coverage runs from November 1 through January 15.
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Special Enrollment Periods - If you experience certain changes in your life's circumstances, you can sign up at any time during what are called Special Enrollment Periods. These changes include losing health care insurance through your employer, a change in marital status, or if you have moved to a different area. Visit
Pennie's Qualifying Life Event (QLE) page for more information on what qualifies as a life event.
Visit Pennie.com to get started.
Medicare
Medicare is federal health insurance for people 65 or older and is administered by the federal Department of Health and Human Services and provides coverage either directly or through private health insurance companies, at four different levels:
- Medicare Part A (Hospital coverage)
- Medicare Part B (Medical coverage)
- Medicare Part C, or Medicare Advantage (Parts A and B together)
- Medicare Part D (Prescription Drug coverage)
If enrolling in Medicare is the best choice for you, it's important to know the right time to enroll. It may be better to enroll when you first become eligible (this is your Medicare Initial Enrollment Period) since electing to enroll in Medicare after your initial eligibility may result in a higher premium for late enrollment. The Medicare Initial Enrollment Period begins three months before a person turns 65 and ends three months after. The General Enrollment Period for Medicare allows you to sign up if you didn't sign up during your initial enrollment period and takes place from January 1-March 31 each year though you may be subject to penalties. There are also select situations that may qualify for a Special Enrollment Period. Medicare open enrollment, allows current Medicare enrollees to make changes to their plan and takes place October 15-December 7 each year.
For more information on Medicare enrollment and eligibility, visit www.medicare.gov.
Medicare Supplement Insurance (Medigap)
Medicare Supplement Insurance is private insurance that fills in the gaps left by Medicare. For instance, when you have a hospital or doctor bill, Medicare pays its approved amount first, then the supplemental insurance pays other costs, such as deductibles and copays.
For more information visit our Medicare Supplement Insurance page.
Medical Assistance/CHIP
Depending on your income, you and your family may qualify for free or low-cost health insurance through the Children's Health Insurance Program (CHIP)or Medicaid.
Enrollment in these programs is open year-round. Medical Assistance provides comprehensive coverage and is there for people who fall on hard times and need help.
The best way to apply for Medical Assistance is the Commonwealth's COMPASS tool.
COBRA/Mini-COBRA Continuation Coverage
If you've been laid off COBRA allows you to continue the coverage provided by your former employer. If you are entitled to elect COBRA coverage, you must be given an election period at any time for up to 60 days.
If you choose to continue your COBRA health insurance plan at your own expense, you will also pay the portion of the premium your former employer paid on your behalf. Please note, just because you may be entitled to elect COBRA coverage, does not mean you must elect it. It is recommended that you explore your coverage options before deciding, as sometimes
marketplace coverage through Pennie.com may be the more affordable option.
Learn more by visiting our COBRA & Mini-COBRA page to learn more.