Blue Cross Blue Shield provides the cheapest HMO Bronze, Silver and Gold plans in Pennsylvania. However, the premiums, deductibles and maximum out-of-pocket expenses may differ based on the selected metal tier, age, income and coverage requirements.
If you are looking to balance monthly premiums with quality claims and coverage, MoneyGeek analyzed the best health insurance in Pennsylvania.
Most Affordable Health Insurance in Pennsylvania
Cheapest Health Insurance in Pennsylvania by Metal Tier
Blue Cross Blue Shield's Keystone HMO Silver Proactive Essential plan is the cheapest Silver health insurance plan in Pennsylvania, priced at $389 per month. Higher metal tiers typically correspond to more expensive plans but also provide broader coverage.
If you're searching for the cheapest health insurance plans, here is a list of the least expensive plans by metal tier offered in Pennsylvania:
- Catastrophic: Together Blue Major Events EPO Catastrophic 9100 - 3 Free PCP Visits ($151 for a 26-year-old)
- Bronze: Together Blue EPO Bronze 8900 ($226 per month)
- Gold: Together Blue EPO Gold 1700 HSA ($303 per month)
- Silver: Together Blue EPO Silver 5900 ($349 per month)
Choosing a higher health insurance metal tier can lessen the amount of out-of-pocket expenses for medical services. Although Gold and Platinum tiers usually have higher monthly premiums, they also have lower deductibles and maximum out-of-pocket costs.
The health insurance exchange categorizes plans into metal tiers, such as Bronze, Silver, Gold and Platinum, based on their coverage levels. Generally, higher metal tiers come with higher premiums but lower out-of-pocket costs. Young and healthy individuals may prefer lower metal tiers, while those expecting frequent medical services may choose higher ones. Silver plans strike a good balance between premium cost and coverage quality across all metal tiers. They offer greater flexibility in choosing health care providers. Buyers with lower incomes may be eligible for cost-sharing reductions, which can help lower deductibles associated with Silver plans.
Cheapest Silver Plans in Pennsylvania
Blue Cross Blue Shield's Keystone HMO Silver Proactive Essential plan is the cheapest Silver plan in Pennsylvania, with a monthly premium of $389. If you're seeking the most affordable health insurance in Pennsylvania, the following are the least expensive Silver plans available:
- Keystone HMO Silver Proactive Essential from Blue Cross Blue Shield: $389 per month
- Keystone HMO Silver Proactive Basic from Blue Cross Blue Shield: $407 per month
- Clear Silver from Ambetter: $420 per month
Silver plans are preferred because they effectively balance monthly premiums and coverage options. Eligible individuals may also qualify for cost-sharing reductions, which help reduce out-of-pocket expenses associated with these plans.
Although HMO plans are not necessarily the cheapest, they are the most accessible plan type in Pennsylvania. This is why MoneyGeek focuses its recommendations on them in this section.
Cheapest Gold Plans in Pennsylvania
Together Blue EPO Gold 1700 HSA plan from Blue Cross Blue Shield is the most affordable Gold plan available in Pennsylvania, priced at $303 per month. The most inexpensive Gold plans are:
- Together Blue EPO Gold 1700 HSA from Blue Cross Blue Shield: $303 per month
- UPMC Advantage Gold HSA $3,000/$0 - Partner Network from UnitedHealthcare: $309 per month
- Together Blue EPO Gold 0 from Blue Cross Blue Shield: $323 per month
Gold plans offer lower out-of-pocket costs and more comprehensive coverage than Silver or Bronze plans, but they generally have higher monthly premiums.
Cheapest Bronze Plans in Pennsylvania
The least expensive health insurance in Pennsylvania in the Bronze tier is Blue Cross Blue Shield's Together Blue EPO Bronze 8900 plan, costing an average of $226 per month. The following are the cheapest Bronze tier plans in the state:
- Together Blue EPO Bronze 8900 from Blue Cross Blue Shield: $226 per month
- UPMC Advantage Bronze $6,700/$0 - Partner Network from UnitedHealthcare: $239 per month
- Together Blue EPO Bronze 3800 from Blue Cross Blue Shield: $249 per month
Bronze plans have the most affordable monthly premiums among all metal tiers, but they offer limited coverage with higher out-of-pocket expenses. While Bronze plans may be suitable for healthy people who do not anticipate frequent medical expenses, they may not be the best alternative for those with chronic health conditions or who require regular medical care.
Cheapest Catastrophic Plans in Pennsylvania
Blue Cross Blue Shield’s Together Blue Major Events EPO Catastrophic 9100 - 3 Free PCP Visits is the cheapest Catastrophic plan, with an average monthly cost of $151 for 26-year-olds.
The three cheapest Catastrophic plans are:
- Together Blue Major Events EPO Catastrophic 9100 - 3 Free PCP Visits from Blue Cross Blue Shield ($151 per month)
- UPMC Advantage Catastrophic $9,100/$0 - Partner Network from UnitedHealthcare ($181 per month)
- UPMC Advantage Catastrophic $9,100/$0 - Select Network from UnitedHealthcare ($191 per month)
Catastrophic plans have low monthly premiums but have higher deductibles. They are only available to individuals under 30 years or with a hardship exemption.
Cost-sharing reductions (CSRs) are a type of financial assistance provided to eligible individuals who purchase health insurance through the Health Insurance Marketplace. These reductions help lower out-of-pocket expenses associated with a health insurance plan, including deductibles, copayments and co-insurance. The reduction amount is based on the individual's income level and chosen plan, and it is automatically applied to the cost-sharing obligations of the plan when covered medical services are received. To qualify for CSRs, individuals must meet the income eligibility criteria, and the reductions apply only to Silver tier plans.
Cheapest Health Insurance in Pennsylvania by Plan Type
Health Maintenance Organization (HMO) plans are Pennsylvania's most popular type of health insurance plan, providing an affordable option for accessing in-network health care. The state marketplace also offers other plan types, such as Exclusive Provider Organization (EPO) and Preferred Provider Organization (PPO). Here are the most affordable Silver plans in other plan types:
- EPO: Together Blue EPO Silver 5900 from Blue Cross Blue Shield ($349 per month)
- PPO: my Priority Blue Flex PPO Silver 5900 from Blue Cross Blue Shield ($510 per month)
Compared to HMO plans, EPO and PPO plans generally provide greater flexibility, including seeing a specialist without needing a referral. However, these plans also tend to have higher costs than HMOs, so it is important to consider whether the added flexibility is worth the extra costs.
The three types of health insurance plans offered in Pennsylvania are HMOs, EPOs and PPOs.
- Health Maintenance Organization (HMO) plans are usually the most cost-effective and the least versatile option. To access specialized care, you must obtain a referral and stay within a predetermined network of health care providers and facilities.
- Exclusive Provider Organization (EPO) plans, like HMOs, require you to stay within a network of providers, except in emergencies. However, EPO plans do not require a referral to see a specialist.
- Preferred Provider Organization (PPO) plans provide greater flexibility than other plan types since they offer a more extensive network of medical providers, and you can see a specialist without a referral. However, these plans are usually more costly.
Cheapest Health Insurance in Pennsylvania by County
Pennsylvania's health insurance plan availability and rates may vary by location and county. To find the most affordable health insurance in Pennsylvania, comparing the cost of different plans by county is essential. The table below can compare Silver plans' costs across counties and find the cheapest options.
Health Insurance Costs in Pennsylvania by Age and Metal Tier
The average cost of health insurance in Pennsylvania may vary depending on the metal tier you select. The following are the average monthly premiums for a 40-year-old in each metal tier:
- Catastrophic: $241 per month (for a 26-year-old)
- Bronze: $371 per month
- Silver: $516 per month
- Gold: $487 per month
Furthermore, health insurance premiums tend to rise with age, resulting in higher costs for seniors compared to teenagers. For example, an 18-year-old can expect to pay an average monthly premium of $407 for a Silver plan. In contrast, a 60-year-old typically pays an average monthly premium of $1,095 for the same plan.
What to Know About Pennsylvania Health Insurance
MoneyGeek analyzed data from several private health insurance plans to assist you in discovering the most affordable choices accessible throughout the open enrollment phase of the Pennsylvania Marketplace.
If your income is low, you may qualify for Medicaid. Additionally, if you are a senior citizen or have a disability, you may be eligible for Medicare. Depending on your income and circumstances, these programs may be a more cost-effective option and better suited for Pennsylvania residents who meet the eligibility requirements.
Private Health Insurance in the Pennsylvania Marketplace
In Pennsylvania, private health insurance plans can be bought during the open enrollment period, typically starting on November 1 and concluding on December 15 every year. Registering before December 15 guarantees that your coverage will begin on January 1 of the following year, providing you with uninterrupted health insurance coverage.
If you can't enroll during the open enrollment period, you might still be eligible to register for a marketplace plan through special enrollment. A special enrollment period may be an option if you experience a qualifying life event, such as losing your job, getting married, having a baby or relocating to a new area.
Medicaid in Pennsylvania
Pennsylvania residents with an income falling below 138% of the Federal Poverty Level can enroll in the Medicaid program.
Medicaid is a government program that offers eligible individuals low-cost or free health insurance. Those living in states with expanded Medicaid, like Pennsylvania, may qualify based on their income level. Medicaid is the most cost-effective alternative for individuals who meet the criteria for the program.
Medicare in Pennsylvania
Pennsylvania residents aged 65 or older are entitled to Medicare, a federal initiative that provides coverage for specific medical expenses. Medicare comprises three parts: Part A, Part B and Part D.
Hospital insurance, hospice care and care facilities fall under Part A coverage of Medicare, while Part B covers outpatient expenses such as medical supplies, preventive care and medical devices. Prescription drugs and doctor-recommended vaccines are covered under Part D of Medicare.
To aid seniors in navigating their health care options, MoneyGeek has recently revised its list of the Best Medicare Advantage Plans in Pennsylvania and the Best Medicare Supplement Plans in Pennsylvania.
Expert Advice on Cheapest Health Insurance in Pennsylvania
- How do I take advantage of cost-sharing reductions and tax credits for health insurance in Pennsylvania?
- Outside of plans on the health insurance exchange, where else can I get health insurance in Pennsylvania?
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Pennsylvania Health Insurance Frequently Asked Questions
Listed below are answers to inquiries about health insurance expenses and accessibility that people frequently ask when seeking coverage.
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