Selecting Health Coverage
Everyone needs health insurance. Even though you do not plan on getting sick or hurt, chances are that you will need medical care at some point. There are many benefits of having health insurance, including access to routine medical care, access to emergency care, and preventive care and screenings.
Key Benefits of Health Insurance
- Immediate, “everyday” care—such as primary care, children’s health and dental care, specialty care, mental health care, and prescriptions
- Emergency, inpatient, and follow-up care—such as when you receive emergency medical care, are admitted to the hospital, and after you leave the hospital
- Preventive care and chronic care management—such as vaccinations, health screenings, and care to manage conditions like diabetes and asthma
Health insurance is available to everyone, regardless of medical condition, sex, or age.
Whether you need health insurance for the first time, or already have health insurance and are comparing your options, it is very important to get covered—and stay covered.
How Can I Get Health Coverage?
There are many plans available to meet your needs and budget, and financial assistance may be available that help to lower your monthly premiums or out-of-pocket costs.
You may buy insurance during the “open enrollment period” which typically begins during November unless you qualify for a “special enrollment period” due to a life event like losing coverage, getting married, or having a baby.
Pennsylvania’s State-based Insurance Exchange: Pennie™
If you buy insurance for you or your family and live in Pennsylvania, Pennie™ is the state's health insurance exchange. The Pennie™ website is easy to use and includes Pennie101 to help you become familiar with the process. Helpful links:
Pennie™ also provides information about state and federal assistance and other programs that provide various types of support for Pennsylvania families that qualify. Visit the site to learn more and find out if you qualify for free or low-cost health insurance coverage through Medicaid or the Children’s Health Insurance Program (CHIP).
If You Don’t Live in Pennsylvania
HealthCare.gov provides a list of states that have their own state-based exchanges and provides additional information and links to those websites. If you live in a state with its own health insurance exchange, you will buy your health insurance coverage through your state.
For many Americans who live in states that do not have a state-based exchange, the HealthCare.gov website provides an easy way to see available insurance plans, and determine whether you qualify for financial help.
You also can buy health insurance through a licensed insurance agent.
Through Your Employer
If your employer offers health insurance, you may choose to purchase insurance for you or your family from your employer. If your employer does not offer coverage or you decide to not purchase coverage from your employer, you may be able to buy insurance through Pennie™, HealthCare.gov, or from a licensed insurance agent.
For Older Pennsylvanians
If you are age 65 or older and qualify, you may be eligible for Medicare. There are several choices, including traditional Medicare Part A and Part B plans, Medicare Advantage plans, prescription drug coverage, and Medicare Supplement Insurance (Medigap). There are specific times when you can sign up for these plans or make changes to the coverage you already have.
For those who qualify, coverage may be available through Pennsylvania’s Medical Assistance program (Medicaid) or Pennsylvania’s CHIP. A comprehensive list of assistance programs available to Pennsylvanians is available at the Pennsylvania Department of Health’s Assistance web page.