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Pennsylvania Health Insurance Plans

Pennsylvania health insurance plans can often be quite confusing to try and understand – especially if one has been used to having their employer or one of their family members always take care of the details. However, PA health insurance plans really shouldn’t be that difficult. The biggest hindrance to figuring out all of the details often is the method of obtaining the PA health plan information.

The first thing to do in order to best understand all of the different Pennsylvania health insurance plan options is to get organized. Take advantage of the convenience and efficiency of the Internet to view and compare competing PA insurance company’s plans side by side online. You can save yourself quite a bit of time (and a headache) by just relaxing in your home or office and viewing different health plan options in nice “apples to apples” layout on your computer screen.

Go ahead and get some concrete numbers on PA health insurance plan premiums in your area. Take a few seconds and compare top insurance company’s plans by viewing free Pennsylvania health insurance quotes now!

How To Find The Best Pennsylvania Health Insurance Plan

While many people have the advantage of obtaining insurance through their employer, many individuals are tasked with finding Pennsylvania health insurance plans on their own.

Unfortunately, Pennsylvania is no exception when it comes to a complex health insurance system.  This article will explain the differences between group and individual insurance, as well as different types of plans that are available.

Further, the search tools available on this page will assist you in finding the right and most affordable health insurance plans in Pennsylvania. 

Pennsylvania Health Insurance Plan Types

The best place to start is by defining the difference between an individual plan, which is a plan purchased directly from the insurance company, and a group plan, which is purchased through an association or an employer.  From there, the plans break down into four groups:

  1. Individual insurance:  This again is a plan purchased directly though the insurance companies.  Anthem BC/BS offers a guaranteed policy in PA, but your options may be limited and waiting periods may apply.  Other insurance companies do not have to offer a policy depending on your health conditions.


  1. Group insurance through an employer:  This coverage is gained and paid through your employer, although the insurance plan is through a specific private insurance company.


  1. Association:  This is insurance offered through organizations or associations that can often times cut down on the insurance premium.


  1. Government:  This is health insurance to disabled or senior citizens such as Medicare or Medicaid.  This is also available to certain conditions related to Military service or economically disadvantaged.

Pennsylvania Health Insurance Plan Definitions

There are two basic differences in plans: one type is referred to as a fee-for service plan, and the other is referred to as a managed care plan.  A fee-for-service plan is also referred to as a traditional insurance plan and includes the following characteristics:

  • A deductible may be paid up front before medical care is received.
  • There are no restrictions on doctors/hospitals used for medical care.
  • Co-payments are usually a required payment at each service.

The next type of plan is called a managed care plan, which is the most commonly known insurance plan.  This refers to HMO’s, PPO’s, and POS’s.

  • Health Maintenance Organization (HMO):  In this type of provider, you are assigned a primary care physician that you must get referrals from whenever you want to see another doctor.  However the benefit is that there is a set amount for a premium each month.


  • Preferred Provider Organization (PPO):  This type of coverage has a set of “in-network” providers that you are able to see for lower deductibles or co-pays.


  • Point of Service (POS):  This final type of managed care combines the best of both of these plans.  It allows you to pay a set amount each month and assigns a primary care physician, but if you want to go see someone out of your assigned physicians, you may decide at POS to see a different doctor for a co-payment or higher deductible.

After you have reviewed which type of plan applies to you (or is best for you), take a look at the two different health insurance policies that are available.

1.  Basic Medical – This is sometimes referred to as “what if” insurance and only covers hospital and surgery to a certain dollar and day amount.  This is a minimum type policy, so make sure to compare with other policies to ensure this is the right one for you.


2.  Major Medical – This typically not only provides broader and longer time period of coverage for hospital visits or surgeries than basic, but it provides broader insurance to allow for doctors visits and preventative care.

There are also supplemental insurance that can be purchased to enhance your comprehensive policy.  These include the following:

  • Disability insurance
  • Maternity insurance
  • Accident insurance
  • Dental insurance
  • Prescription benefit coverage

The most important step in finding affordable and comprehensive insurance in PA is to do your research and compare multiple policies before choosing a plan.  

Compare Pennsylvania Health Insurance Plans Now!

Now that you have the tools and know what to look for, start comparing Pennsylvania health insurance plans today!

Use our free tools at the top of the page to start your search comparing plans from top PA health insurance carriers.

Get started finding Pennsylvania health insurance today!

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