Pennsylvania Health Insurance

The Private Pennsylvania Health Insurance Market Health Plan

In Pennsylvania Blue Cross Blue Shield sells individual health insurance plans to everyone regardless of medical history.  Highmark Blue Cross Blue Shield adminsters the Western Pennsylvania health insurance market, BCBS of Northeastern Pennsylvania obviously covers the Northeast, and Central Pennsylvania is covered by Capital Blue Cross Blue Shield.  The entire Philadelphia market is offered by Independence BCBS.  Additionally Blue Cross Blue Shield offers 2 plans to the HIPAA population.

Every other Pennsylvania health insurance company is allowed to decline individuals for health insurance, and all Pennsylvania companies can extend a 30 day probationary period to verify claims for non accident.  Additionally the PA health insurance companies are allowed to mandate a 12 month pre existing limitation, and go back five years during the medical underwriting process.

The Pennsylvania Public Health Plans

Compass is the Pennsylvania government health program that operates many of the states public health plan options.   If you want to find out if you qualify for Pennsylvania health and human services, apply for new benefits, finish your application or check your status, you’re in the right place.

By using COMPASS you can apply at any time during the day or night from home, a library or any location with Internet access.

COMPASS is an online application for Pennsylvanians to apply for many health and human service programs.

About COMPASS
COMPASS is a Web site that allows individuals and community based organizations access to screen for, apply for, and renew a broad range of social programs.
COMPASS serves as a single access point for application and renewal of:
Health Care Coverage Medical Assistance Medical Assistance for Worker’s with Disabilities Medical Savings Program for Payment of Medical Assistance Premiums Children’s Health Insurance Program adultBasic Food Stamp Benefits Cash Assistance Long Term Care Home and Community Based Services for individuals with mental retardation Consolidated Waiver for Individuals with Mental Retardation Person/Family-Directed Support Waiver for Individuals with Mental Retardation Mental Retardation Services (non-MA) Low-Income Home Energy Assistance Program (Seasonal availability) Free or Reduced Price School Meals SelectPlan for Women (Family Planning Services) Child Care Works
COMPASS also provides screening for the programs mentioned above, all home and community-based services, and the school lunch and breakfast program. Screening allows a user to provide basic information to determine if they are potentially eligible for a health and human service.
COMPASS allows current recipients of Department of Public Welfare benefits to create secure, personal accounts through a process called “My COMPASS Account.” My COMPASS Account provides recipients with information about their:
Health Care Benefit Package Food Stamp Benefit Cash Assistance Benefit SelectPlan for Women Benefit
COMPASS “Community Partner View” offers registered COMPASS Community Partners access to enhanced tools such as: the Power User application Streamlines the application process Decreases application processing time Provides e-Signature functionality Application Management Allows Users to initiate and track applications Portfolio of submitted and suspended applications Quick Reports Printable Forms
What are the benefits of COMPASS?
Individuals/families who can’t get to the office during normal business hours can apply for or renew benefits online. By using COMPASS, consumers and the professionals who help them, can apply or renew at any time of the day or night from a home, library, health care clinic, community center or any location with Internet access. Users have up to 30 days to complete the e-Form (application and renewal) process, and can log in and out of the system as they please. Although face-to-face interviews are still required for some programs, application or renewal processing begins the moment the e-Form is submitted electronically. When a person hits the “Submit” button, the system seamlessly sends it to the appropriate state agency. COMPASS uses the latest technology to make the program easier for people with disabilities to use, reducing any barriers for those with visual, hearing, physical or cognitive disabilities. The e-Form(applications and renewal) process is compliant with the American with Disabilities Act. Both English and Spanish versions are available, and ten other languages are used to indicate to non-English speaking individuals that it is an application or renewal process for important benefits, and where to find assistance to help complete the process.
Who is eligible to apply?
Anyone with Internet access can use COMPASS, whether they are applying for or renewing benefits for their own family or helping someone else. There are eligibility requirements for specific benefits.
Who is eligible to use COMPASS Community Partner View?
Registered COMPASS Community Partners have access to the Community Partner View features. Click on the Sign up to be a Community Partner link displayed at the bottom of the “Welcome to COMPASS” screen to learn more about becoming a COMPASS Community Partner.
How can the user check the status of an e-Form application?
COMPASS allows users to check the status of an application by entering the e-Form number and their password. The status check lists each individual, benefits for which they applied and whether the application is approved, denied, in process, or not available.
Will COMPASS tell me if I am eligible for benefits?
No, COMPASS does not determine eligibility. Caseworkers for the Department of Public Welfare (DPW) determine eligibility for DPW benefits such as Medical Assistance-related health care, food stamps, cash assistance, long term care, home and community based waivers, the Low-Income Home Energy Assistance, and Child Care Works Program. Workers for the Insurance Department determine eligibility for CHIP and adultBasic health care benefits. School employees determine eligibility for the Free or Reduced Price School Meals Program.
What does “Renewal” mean?
A renewal is a review of all eligibility factors that are subject to change to determine if a recipient remains eligible for benefits.
Renewals are also known as reapplications, recertification, and re-determinations.
Who is eligible to renew on COMPASS?
Anyone who receives a “Renewal Notice” can use COMPASS to renew eligibility for the benefits they currently receive.
The Renewal Notice will be mailed to current recipient of benefits. The notice will contain information about the COMPASS Renewal process and will provide the information required to logon to the COMPASS e-Form Renewal.
When submitting a renewal electronically, users must remember to send or fax the signature page and any necessary verification to the address provided on the screen.
Face-to-face interviews are required for some programs, but not for most health care renewals.
Can the user check the status of a renewal?
At this time, the status of a renewal cannot be checked on COMPASS.
Secure, Private and Confidential
An encryption process protects information during electronic transmission on COMPASS. A user identification/password ensures confidentiality once the application or renewal is received. Individuals can use their unique user identification/password to check on the status of their application after it is submitted or to suspend the application or renewal for up to 30 days in order to gather additional information.
What health and human service programs can be accessed through COMPASS?
COMPASS first offering in October 2001 was the joint application for Medical Assistance and the Children’s Health Insurance Program (CHIP). Since that time COMPASS has expanded to include a variety of health and human service programs.
COMPASS provides access to:
Medical Assistance (including Medical Assistance to Worker’s with Disabilities and the Medical Savings Program for payment of Medicare premium) identifies eligible individuals/families and helps them overcome the barriers to getting enrolled in free, comprehensive health care coverage. Medical Assistance provides payment for health care benefits on behalf of eligible low-income individuals and individuals with limited income and high medical expenses. Payments are made directly to the health care providers. In some cases, individuals may qualify for payment of medical services that were received up to three months before the month in which a Medical Assistance application was completed.
Children’s Health Insurance Program (CHIP) is Pennsylvania’s program to provide quality health insurance for children of working families who otherwise could not afford it.
adultBasic promotes access to quality care by providing basic health insurance to Pennsylvanians age 19 through 64 who need it but cannot afford it. Benefits offered through the program include preventive care; physician services; diagnosis and treatment of illness or injury; inpatient hospitalization or outpatient services; and emergency accident and medical care.
Cash Assistance is available to low-income people/families based on rules and standards established by the state Department of Public Welfare.
Food Stamp Benefits are available to those who have sufficient income to meet most of their basic living costs but need help to supplement their food expenses.
Long Term Care offers a wide range of assistance, services or devices provided over an extended period of time and designed to meet medical, personal and social needs in a variety of settings or locations to enable a person to live as independently as possible.
Home and Community-Based Programs provide eligible people with physical, mental or other disabilities support to live independently in their homes and communities based on income and resources, need for care and availability of services.
Low-Income Home Energy Assistance Program (LIHEAP), is a Federally-funded, state-administered program that helps low-income households meet their home heating needs via energy-assistance grants. Through LIHEAP, qualifying households may receive cash benefits to assist with heating bills, crisis benefits to resolve heating emergencies, and Weatherization/energy conservation assistance to provide long range solutions to the heating problems of low-income households. Only the Cash benefits component of the LIHEAP program may be applied for on COMPASS.
School meals programs provide nutritious meals at free or reduced price to students from households that meet income guidelines.
SelectPlan for Women, is a Federally-funded, state-administered program that helps provide family planning services for Pennsylvanian women between age 18 through 44.
Child Care Works Program helps eligible families of low-income, including families that are receiving Temporary Assistance for Needy Families (TANF), general assistance or food stamp benefits, pay their child care fees. This program is managed by the Child Care Information Services (CCIS) agency located in your county or geographic area. The CCIS agencies also offer all parents, regardless of income, a resource and referral service in all communities across Pennsylvania. Resource and Referral services provide you and your family with information on quality child care and personalized child care referrals to child care providers, based on your specific needs or preferences.
COMPASS – An Award-winning Web site
The COMPASS Web site earned First Place in the category of State General Government in the Center for Digital Government’s 2003 Best of Web competition. The Commonwealth of Pennsylvania has been recognized in numerous other publications and awards for its outstanding commitment to serving citizens by web-enabling government programs through COMPASS.

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