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Pennsylvania Health Insurance

Health insurance is available in two broad categories at present: individual and group. Those who decide to buy individual insurance are usually self-employed, or are employed by a company that does not offer a health plan, or they have a family who want individual insurance for their family members. When one buys an individual plan, he/she is required to pay an annual premium as well as a deductible for each insured dependent, up to a base amount. Or if one buys a group policy, he/she needs to pay an annual premium, co-payments payable at each medical service, and a deductible payable before the insurer begins paying for his/her stipulated medical bills.

In Pennsylvania, rules for Blue Cross Blue Shield of Pennsylvania are different from those for other private insurers. For Blue Cross Blue Shield, the company must give you individual insurance if you seek one. If you are HIPAA eligible, they must offer you two policies that are state approved and the company is the only option for individual guaranteed issue insurance in the State. The insurer may need a waiting period of not more than 30 days for non-accident claims and six months for certain other elective claims. In case you have a pre-existing condition, the insurance companies can impose an exclusion period of three years. This does not apply for HIPAA eligible people. In a non-guaranteed policy, the insurer is free to attach an elimination rider to the policy. Both pregnancy and genetic information can be treated as pre-existing conditions in Pennsylvania. Your Blue Cross Blue Shield insurance cannot be cancelled because of your illness.

Other private insurers in Pennsylvania can reject your application due to a health problem. If you have a pre-existing condition, it can attach an elimination rider to the policy or it can impose an exclusion period of a maximum period of three years. There is no creditable coverage in any individual health policies.

In the case of group insurance in Pennsylvania, qualified persons can neither be denied nor charged extra for it because of a health problem. Your new employer may ask for a waiting period before providing coverage. There are some special, but conditional considerations for newborns and disabled children in the state. If you have a pre-existing condition, insurers can review your medical records for the last six months before coverage. They can also seek an exclusion period of no more than 12 months for the condition. If you have had no break in your coverage of over 63 days, you are entitled to creditable coverage.

Small employers with two to 50 employees cannot be refused small group health insurance or their policies cancelled due to health problems within the employee groups.
Self-employed people are not allowed to purchase group health insurance. For joining business associations, one can contact the Pennsylvania Department of Insurance for regulations.

Several programs, such as Medicaid, Healthy Women Project, and Pennsylvania’s Children Health Insurance Program offer financial help in Pennsylvania.

As choosing the right quotes are not easy, you should do some research before making a final decision. However, it is always better to appoint professional health insurance agents and brokers who can help you in this regard.

Some prominent health insurance providers in Pennsylvania are Aetna, American Medical Security, Assurant Health (formerly Fortis), Celtic, Fairmont Specialty Group,
Golden Rule, Guardian and Security Life.


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To find US News rankings of a Pennsylvania Health Insurance Plan, Click the logo:

An annual guide is provided by US News to what it considers the best health insurance plan(s) in each state. Click through the pages on a Pennsylvania health insurance plan or New Jersey medical insurance plan to view specific reports.


To know more about medically uninsurable, contact Pennsylvania Department of Insurance Consumer Services division at (717) 787-2317.

You can contact your New Jersey-elected officials about health care issues:

On national level

On state level


Health Insurance Information on Official State of New Jersey Sites

  • Pennsylvania Insurance Department – The State of Pennsylvania's department of insurance provides official information all types of insurance.
  • Consumers Guide to Health Insurance (PDF) – This guide answers some frequently asked questions about health insurance, explains some of the most common types of health insurance policies and offers tips to consider when purchasing health insurance coverage. Information also is provided about what to do and where to go if you have a question, problem or complaint with your health insurance coverage.
  • Health Insurance Tips for Pennsylvania Consumers – From the Pennsylvania Insurance Department.
  • Frequently-Asked-Questions about Health Insurance – From the Pennsylvania Insurance Department.
  • Childrens Health Insurance Program – CHIP is Pennsylvania's program intended to provide health insurance for children of working families who otherwise could not afford it.


Specific New Jersey Information on Federal Government sites


Health insurance can be purchased in these Pennsylvania Counties: Adams County, Allegheny County, Armstrong County, Beaver County, Bedford County, Berks County, Blair County, Bradford County, Bucks County, Butler County, Cambria County, Cameron County, Carbon County, Centre County, Chester County, Clarion County, Clearfield County, Clinton County, Columbia County, Crawford County, Cumberland County, Dauphin County, Delaware County, Elk County, Erie County, Fayette County, Forest County, Franklin County, Fulton County, Greene County, Huntingdon County, Indiana County, Jefferson County, Juniata County, Lackawanna County, Lancaster County, Lawrence County, Lebanon County, Lehigh County, Luzerne County, Lycoming County, McKean County, Mercer County, Mifflin County, Monroe County, Montgomery County, Montour County, Northampton County, Northumberland County, Perry County, Philadelphia County, Pike County, Potter County, Schuylkill County, Snyder County, Somerset County, Sullivan County, Susquehanna County, Tioga County, Union County, Venango County, Warren County, Washington County, Wayne County, Westmoreland County, Wyoming County and York County.

Health insurance can be purchased from various cities in Pennsylvania: Aliquippa, Allentown, Altoona, Arnold, Beaver Falls, Bethlehem, Bradford, Butler, Carbondale, Chester, Clairton, Coatesville, Connellsville, Corry, DuBois, Duquesne, Easton, Erie, Farrell, Franklin (Venango County), Greensburg, Harrisburg, Hazleton, Hermitage, Jeannette, Johnstown, , Hershey, Lancaster, Latrobe, Lebanon, Lock Haven, Lower Burrell, McKeesport, Meadville, Monessen, Monongahela, Nanticoke, New Castle, New Kensington, Oil City, Parker, Philadelphia, Pittsburgh, Pittston, Pottsville, Reading, St. Marys, Scranton, Shamokin, Sharon, Sunbury, Titusville, Uniontown, Warren, Washington, Wilkes-Barre, Williamsport and York.

Health insurance can be purchased from various towns and boroughs in Pennsylvania: Abbottstown, Adamsburg, Adamstown, Addison, Akron, Alba, Albion, Alburtis, Aldan, Alexandria, Allenport, Ambler, Ambridge, Apollo, Applewold, Archbald, Arendtsville, Armagh, Arona, Ashland, Ashley, Ashville, Aspinwall, Atglen, Athens, Atwood, Auburn, Austin, Avalon, Avis, Avoca, Avondale, Avonmore, Baden, Baldwin, Bally, Bangor, Barkeyville, Bath, Beallsville, Bear Creek Village, Bear Lake, Beaver, Beaver Meadows, Beavertown, Bechtelsville, Bedford, Beech Creek, Bell Acres, Bellefonte, Belle Vernon, Bellevue, Bellwood, Ben Avon, Ben Avon Heights, Bendersville, Benson, Bentleyville, Benton, Berlin, Bernville, Berrysburg, Berwick, Bessemer, Bethany, Bethel Park, Big Beaver, Biglerville, Big Run, Birdsboro, Birmingham, Blain, Blairsville, Blakely, Blawnox, Bloomfield, Blooming Valley, Blossburg, Bolivar, Bonneauville, Boswell, Bowmanstown, Boyertown, Brackenridge, Braddock, Braddock Hills, Bradfordwoods, Brentwood, Briar Creek, Bridgeport, Bridgeville, Bridgewater, Brisbin, Bristol, Broad Top City, Brockway, Brookhaven, Brookville, Brownstown, Brownsville, Bruin, Bryn Athyn, Burgettstown, Burlington, Burnham, Burnside, California, Callensburg, Callery, Callimont, Cambridge Springs, Camp Hill, Canonsburg, Canton, Carlisle, Carmichaels, Carnegie, Carrolltown, Carroll Valley, Cassandra, Casselman, Cassville, Castle Shannon, Catasauqua, Catawissa, Centerport, Centerville, Centerville, Central City, Centralia, Centre Hall, Chalfant, Chalfont, Chambersburg, Chapman, Charleroi, Cherry Tree, Cherry Valley, Chester Heights, Chester Hill, Chest Springs, Cheswick, Chicora, Christiana, Churchill, Clarendon, Clarion, Clark, Clarks Green, Clarks Summit, Clarksville, Claysville, Clearfield, Cleona, Clifton Heights, Clintonville, Clymer, Coal Center, Coaldale, Coaldale, Coalmont, Coalport, Cochranton, Cokeburg, Collegeville, Collingdale, Columbia, Colwyn, Confluence, Conneaut Lake, Conneautville, Connoquenessing, Conshohocken, Conway, Conyngham, Coopersburg, Cooperstown, Coplay, Coraopolis, Cornwall, Corsica, Coudersport, Courtdale, Crafton, Cranesville, Creekside, Cresson, Cressona, Cross Roads, Curwensville, Daisytown, Dale, Dallas, Dallastown, Dalton, Danville, Darby, Darlington, Dauphin, Dawson, Dayton, Deemston, Deer Lake, Delaware Water Gap, Delmont, Delta, Denver, Derry, Dickson City, Dillsburg, Donegal, Donora, Dormont, Dover, Downingtown, Doylestown, Dravosburg, Driftwood, Dublin, Duboistown, Dudley, Dunbar, Duncannon, Duncansville, Dunlevy, Dunmore, Dupont, Duryea, Dushore, Eagles Mere, East Bangor, East Berlin, East Brady, East Butler, East Conemaugh, East Greenville, East Lansdowne, East McKeesport, East Petersburg, East Pittsburgh, East Prospect, East Rochester, East Side, East Stroudsburg, Eastvale, East Vandergrift, East Washington, Eau Claire, Ebensburg, Economy, Eddystone, Edgewood, Edgeworth, Edinboro, Edwardsville, Ehrenfeld, Elco, Elderton, Eldred, Elgin, Elizabeth, Elizabethtown, Elizabethville, Elkland, Ellport, Ellsworth, Ellwood City, Elverson, Emlenton, Emmaus, Emporium, Emsworth, Enon Valley, Ephrata, Ernest, Etna, Evans City, Everett, Everson, Exeter, Export, Factoryville, Fairchance, Fairfield, Fairview, Falls Creek, Fallston, Fawn Grove, Fayette City, Felton, Ferndale, Finleyville, Fleetwood, Flemington, Folcroft, Ford City, Ford Cliff, Forest City, Forest Hills, Forksville, Forty Fort, Fountain Hill, Foxburg, Fox Chapel, Frackville, Frankfort Springs, Franklin, Franklin Park, Franklintown, Fredonia, Freeburg, Freedom, Freeland, Freemansburg, Freeport, Friendsville, Galeton, Gallitzin, Garrett, Geistown, Georgetown, Gettysburg, Gilberton, Girard, Girardville, Glasgow, Glassport, Glen Campbell, Glendon, Glenfield, Glen Hope, Glenolden, Glen Rock, Goldsboro, Gordon, Grampian, Gratz, Great Bend, Greencastle, Green Hills, Green Lane, Greensboro, Green Tree, Greenville, Grove City, Halifax, Hallam, Hallstead, Hamburg, Hanover, Harmony, Harrisville, Hartleton, Harveys Lake, Hastings, Hatboro, Hatfield, Hawley, Hawthorn, Haysville, Heidelberg, Hellertown, Herndon, Highspire, Hollidaysburg, Homer City, Homestead, Homewood, Honesdale, Honey Brook, Hookstown, Hooversville, Hop Bottom, Hopewell, Houston, Houtzdale, Howard, Hughestown, Hughesville, Hulmeville, Hummelstown, Hunker, Huntingdon, Hyde Park, Hydetown, Hyndman, Indiana, Indian Lake, Industry, Ingram, Irvona, Irwin, Ivyland, Jackson Center, Jacobus, Jamestown, Jeddo, Jefferson, Jefferson, Jefferson Hills, Jenkintown, Jennerstown, Jermyn, Jersey Shore, Jessup, Jim Thorpe, Johnsonburg, Jonestown, Juniata Terrace, Kane, Karns City, Kenhorst, Kennett Square, Kingston, Kistler, Kittanning, Knox, Knoxville, Koppel, Kulpmont, Kutztown, Laceyville, Laflin, Lake City, Landingville, Landisburg, Lanesboro, Langhorne, Langhorne Manor, Lansdale, Lansdowne, Lansford, Laporte, Larksville, Laureldale, Laurel Mountain, Laurel Run, Lawrenceville, Leechburg, Leesport, Leetsdale, Lehighton, Lemoyne, Lenhartsville, Le Raysville, Lewisberry, Lewisburg, Lewis Run, Lewistown, Liberty, Liberty, Ligonier, Lilly, Lincoln, Linesville, Lititz, Little Meadows, Littlestown, Liverpool, Loganton, Loganville, Long Branch, Lorain, Loretto, Lumber City, Luzerne, Lykens, Lyons, McAdoo, McClure, McConnellsburg, McDonald, McEwensville, McKean, McKees Rocks, McSherrystown, Macungie, McVeytown, Madison, Mahaffey, Mahanoy City, Malvern, Manchester, Manheim, Manns Choice, Manor, Manorville, Mansfield, Mapleton, Marcus Hook, Marianna, Marietta, Marion Center, Marion Heights, Marklesburg, Markleysburg, Mars, Martinsburg, Marysville, Masontown, Matamoras, Mayfield, Mechanicsburg, Mechanicsville, Media, Mercer, Mercersburg, Meshoppen, Meyersdale, Middleburg, Middleport, Middletown, Midland, Midway, Mifflin, Mifflinburg, Mifflintown, Milesburg, Milford, Millbourne, Mill Creek, Millersburg, Millerstown, Millersville, Mill Hall, Millheim, Millvale, Mill Village, Millville, Milton, Minersville, Modena, Mohnton, Monaca, Monroe, Mont Alto, Montgomery, Montoursville, Montrose, Moosic, Morrisville, Morton, Moscow, Mount Carbon, Mount Carmel, Mount Gretna, Mount Holly Springs, Mount Jewett, Mount Joy, Mount Oliver, Mount Penn, Mount Pleasant, Mount Pocono, Mount Union, Mountville, Mount Wolf, Muncy, Munhall, Municipality of Monroeville, Municipality of Murrysville, Myerstown, Nanty-Glo, Narberth, Nazareth, Nescopeck, Nesquehoning, New Albany, New Alexandria, New Baltimore, New Beaver, New Berlin, New Bethlehem, New Brighton, New Britain, New Buffalo, Newburg, Newburg, New Centerville, New Columbus, New Cumberland, New Eagle, Newell, New Florence, New Freedom, New Galilee, New Holland, New Hope, New Lebanon, New Milford, New Morgan, New Oxford, New Paris, New Philadelphia, Newport, New Ringgold, Newry, New Salem, New Stanton, Newton Hamilton, Newtown, Newville, New Washington, New Wilmington, Nicholson, Norristown, Northampton, North Apollo, North Belle Vernon, North Braddock, North Catasauqua, North Charleroi, North East, Northern Cambria, North Irwin, Northumberland, North Wales, North York, Norwood, Nuangola, Oakdale, Oakland, Oakmont, Ohiopyle, Ohioville, Oklahoma, Old Forge, Olyphant, Orangeville, Orbisonia, Orrstown, Orwigsburg, Osborne, Osceola Mills, Oswayo, Oxford, Paint, Palmerton, Palmyra, Palo Alto, Parkesburg, Parkside, Parryville, Patterson Heights, Patton, Paxtang, Pen Argyl, Penbrook, Penn, Penndel, Penn Lake Park, Pennsburg, Pennsbury Village, Perkasie, Perryopolis, Petersburg, Petrolia, Philipsburg, Phoenixville, Picture Rocks, Pillow, Pine Grove, Pitcairn, Platea, Pleasant Hills, Pleasantville, Pleasantville, Plum, Plumville, Plymouth, Point Marion, Polk, Portage, Port Allegany, Port Carbon, Port Clinton, Portersville, Portland, Port Matilda, Port Royal, Port Vue, Pottstown, Pringle, Prompton, Prospect, Prospect Park, Punxsutawney, Quakertown, Quarryville, Railroad, Rainsburg, Ramey, Rankin, Red Hill, Red Lion, Renovo, 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Smethport, Smicksburg, Smithfield, Smithton, Snow Shoe, S.N.P.J., Snydertown, Somerset, Souderton, South Bethlehem, South Coatesville, South Connellsville, South Fork, South Greensburg, South Heights, Southmont, South New Castle, South Philipsburg, South Renovo, South Waverly, Southwest Greensburg, South Williamsport, Spartansburg, Speers, Springboro, Spring City, Springdale, Spring Grove, Starrucca, State College, Steelton, Stewartstown, Stillwater, Stockdale, Stockertown, Stoneboro, Stoystown, Strasburg, Strattanville, Strausstown, Stroudsburg, Sugarcreek, Sugar Grove, Sugar Notch, Summerhill, Summerville, Summit Hill, Susquehanna Depot, Sutersville, Swarthmore, Swissvale, Swoyersville, Sykesville, Sylvania, Tamaqua, Tarentum, Tatamy, Taylor, Telford, Terre Hill, Thompson, Thompsontown, Thornburg, Three Springs, Throop, Tidioute, Timblin, Tioga, Tionesta, Topton, Towanda, Tower City, Townville, Trafford, Trainer, Trappe, Tremont, Troutville, Troy, Trumbauersville, Tullytown, 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