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Health Insurance Pennsylvania

Last modified: Sep 29, 2022

Do you want to purchase the best health insurance in PA? If you are searching for health insurance, you should check out the health insurance marketplace in  PA by visiting Pennie.com. At the State Marketplace, you will discover several different types of PA health insurance plans

Which health insurance provider should you choose? We have compared the different health insurance providers in PA by comparing their plans, prices, and customer reviews. You can use our detailed Pennsylvania health insurance guide to assist you in your decision. You can also check out our list of top health insurance providers in the US to help you explore your options even further.

Health Insurance Companies in PA

Below is a list of health insurance providers in PA and the plans they offer.

UPMC Health Plan


Geisinger Health Plans


Capital Blue Cross










Cheapest Health Insurance Plan by Cities in PA

If you are trying to find cheap health insurance in PA, the three insurance providers offering the cheapest health insurance in PA areUMPC Health Plan, Highmark, and Geisinger. If you live in Pennsylvania, you can expect to pay $9,258 on health care expenses each year.

You can select from three common PA health insurance plans. You can choose a bronze, silver, or gold health insurance plan. You will pay a higher premium each month if you opt for a higher coverage level.

As you can see, the most affordable health insurance in PA is the Bronze plan, with the Gold plan being the most expensive, which means you’ll find yourself paying a higher premium each year for health insurance. 

Gold health insurance plans cost almost 38% more than Bronze ones. Gold health insurance covers about 80% of the medical expenses, whereas Bronze plans cover about 60% of the medical expenses. 

If you want the lowest level of health insurance coverage, you should choose Catastrophic plans where the premiums are low, but the deductible is high ($8,150).

Cheap Health Insurance in PA by Cities 

The estimated insurance premiums are for a single adult, aged 40.

Average Cost of Health Insurance in PA 

What is the average cost of health insurance in Pennsylvania?

The average health insurance rates in PA for individual health insurance plans are $459 each month and $5,500 each year. The health insurance quotes in PA depend on several factors, including the city you reside in. You will have to compare the various rates from health insurance companies to obtain low-cost health insurance in PA.

The average cost of health insurance by family size in Pennsylvania?

The size of your family can increase your monthly premium in the state. You also need to look at your coinsurance and copays when purchasing individual and family health insurance. 

Coinsurance refers to the percentage of expenses a person pays after they have met their deductibles, while copays refer to a fixed amount covering the medical services a person pays to the doctor before they receive a medical service.

You can choose a plan by factoring in the level of medical care you need. For instance, if you need more health coverage, opt for Gold and Platinum health coverage plans to get low deductibles, coinsurance, and copayment but higher premiums.

Size of Family Average Cost of Health Plan Per Month
Individual and child $746
Couple aged 40 $933
An adult couple and one child $1,213
Adult couple and two children $1,492
Adult couple with three children $1,771

Pennsylvania Health Insurance Guide 

Types of Health Insurance

You and your family can obtain Pennsylvania health insurance coverage from your employer, or you and your kids can obtain health insurance coverage through your partner’s employer. 

You can obtain individual health insurance in  PA or family health insurance from the PA health insurance exchange. The state provides private health insurance in PA through its federally operated health insurance exchange. 

You can apply for health insurance PA through the State Exchange or insurance companies that operate privately. Most private health insurance companies in PA offer the Affordable Care Act (ACA) or Obamacare


Medicare provides affordable health insurance coverage in PA to people aged 65 years and older. You can choose from different health coverage options. This includes Part A, B, C, and D. You can qualify for the Medicare Savings Program if you meet these requirements: 

Medicare Coverage

How Many Are Enrolled Under Medicare in Pennsylvania?

Medicare enrollment in the state covers around 2.8 people living in the state. 45% of the state’s beneficiaries have health coverage under the Medicare Advantage coverage plan instead of the Original Medicare coverage plan. 


Medicaid is health insurance coverage for children and low-income families. It allows them to get low-cost or free health insurance in PA. The state has established Medicaid financial requirements for people wanting to obtain affordable primary care. For a household with:

Coverage for Children

The Children’s Health Insurance Program (CHIP) and Medicaid are two options for children to receive health coverage. Through both types of health insurance, children will be eligible to go for regular visits to physicians, receive dental care, and get immunizations. Apart from children, families, and seniors, people with disabilities can also look into this option.

Tips to Save on Health Insurance in PA

Do you want to save money on individual health insurance in PA? If you are considering buying health insurance from a Pennsylvania health insurance provider, these tips will help you reduce your premium.

You can increase your deductible to reduce your monthly premiums. The downside to doing that is that you won’t receive comprehensive health coverage.

You need to consider many health insurance companies in PA  before you select one. You can compare the various quotes. If you increase your deductible and change your copays and coinsurance, it will affect the cost of your health insurance coverage plan, so factor both of them too when deciding on the insurance provider to go with.

You can turn to over-the-counter medicines and home remedies for alleviating normal illnesses such as sore throat, allergies, and coughs. If the symptoms persist, you need to visit a healthcare professional. 

Bad habits can increase your premium. If you smoke, for instance, you need to quit.  If you can’t quit smoking, work out daily, eat healthy food, and take vitamins.

Branded and generic prescriptions differ in price but not in their benefits. You can tell your doctor to prescribe you the generic version of the brand name prescription medication. 

You need to review your health insurance coverage plan before visiting a healthcare professional for treatment. In doing so, you will know what your health insurance plan provides coverage for and what it doesn’t. Once you know, convey it to your doctor, as there might be a way to reduce your medical expenses.

Factors that Contribute to Your Premium Costs

If you have a high Body Mass Index (BMI), you will be at higher risk of developing a medical condition. Therefore, health insurance providers in PA may charge you a higher monthly premium.   

Smoking can increase your risk of developing a health condition and cause your premium to increase.

Most health insurance providers charge a higher premium to older people than they do to younger people. 

Cost-sharing reductions can reduce your out-of-the-pocket costs. People earning an income under 200% of the poverty level will benefit the most.

The current law states that health insurance providers in PA can’t refuse to provide health insurance to a person with a pre-existing condition. Once you have health insurance, they will have to pay for medical treatment for your pre-existing condition. 

Factors that don’t affect premiums

Under the ACA, health insurance companies in the state can’t charge a different price for the same health insurance coverage plan for men and women. They also can’t charge you more if you have a pre-existing medical condition and cover the costs of it from the first day your health coverage starts.

Should You apply as a family or individually?

Individual health insurance in PA may cost you less, as health insurance companies are likely to charge more for covering an entire family.


When is PA open enrollment for 2021 health insurance coverage?

The 2021 open enrollment period starts on November 1, 2020, and ends on January 15, 2021.

Did Pennsylvania expand Medicaid?

Yes, the state expanded Medicaid on January 1, 2015.

What is the income limit for Medicaid in Pennsylvania?

The maximum income limit for Medicaid in the state for one person is $16,971 each year, whereas the maximum income limit for Medicaid for four people is $34,846 each year.

Why is healthcare so expensive in Pennsylvania?

Healthcare insurance coverage in the state is expensive because it has a higher elderly and disabled population than the national average.

What does short-term health insurance cover?

Short-term health insurance in PA provides preventive care, urgent care, doctor visits, and emergency care.

What is the uninsured population rate in PA?

In the state, 7.6% of men and 5.7% of women in 2017 lacked health insurance. Families choosing health insurance can apply for CHIP health insurance PA if they are younger than 19 and uninsured.

Is health insurance mandatory in Pennsylvania?

Yes, today the state requires every resident to have health insurance that complies with the Affordable Care Act. This is why it is important to purchase the best health insurance in PA to provide you with coverage and benefits.

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