Home » Pennsylvania Market Overview

Pennsylvania Market Overview


The Private Pennsylvania Health Insurance Market

In Pennsylvania, Blue Cross Blue Shield sells individual health insurance plans to everyone regardless of medical history.  Highmark Blue Cross Blue Shield administers the western Pennsylvania health insurance market, Blue Cross of Northeastern Pennsylvania obviously covers the northeast, and central Pennsylvania is covered by Capital Blue Cross.  The entire Philadelphia market is offered by Independence BCBS. Additionally, Blue Cross Blue Shield offers two plans to the HIPAA population.

Every other Pennsylvania health insurance company were allowed to decline individuals for health insurance until health reform took effect, and all Pennsylvania companies can extend a 30-day probationary period to verify claims for non-accident.  Additionally, the PA health insurance companies were allowed to mandate a 12-month preexisting condition limitation, and go back five years during the medical underwriting process, which is no longer permitted by the Affordable Care Act.


Public Health Plans in Pennsylvania

The state of Pennsylvania offers several health plans for low-income and uninsured residents in need of coverage. Government health plans in Pennsylvania include Medical Assistance, CHIP, and the temporary federal risk pool, PA Fair Care, for individuals who have health conditions. Many Pennsylvanians who cannot obtain coverage on the private market either because of the high cost or being high risk may qualify for coverage through one of these programs.

Other benefit programs are available as well to those in need. Find out what assistance you may be able to receive through the COMPASS website, and apply for benefits such as Medical Assistance.