Mother with child talking with doctor

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:

  • 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?

HealthCare.gov is a federal insurance exchange and Americans living in states that do not have their own insurance marketplace can purchase insurance on the national HealthCare.gov site. Some states, like Pennsylvania, have state-based insurance exchanges and those state residents purchase health insurance through their state-based exchange.

Not sure if your state has its own health insurance exchange?

Healthcare.gov is a great place to start. Normally, you purchase health insurance during open enrollment periods (usually during the fall) or during a special enrollment period if you have life changes like losing health coverage, moving, or having a baby.

If you live in a state like Pennsylvania with its own state-based insurance exchange, HealthCare.gov will provide that information too.

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. 

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).

The next open enrollment period will be from November 1, 2021, to January 15, 2022. Visit the Pennie™ website for more details about obtaining health care coverage in Pennsylvania. Pennie also has a savings calculator to see if you qualify for lower health insurance costs.

If You Don’t Live in Pennsylvania

State-based Exchanges

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.

HealthCare.gov

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.

Insurance Agents

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.

Other Programs

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.

HAP News

September 09, 2021

How Health Equity Impacts Patient Care

During the first day of HAP’s virtual Patient Safety and Quality Symposium, health care leaders from Pennsylvania and across the nation discussed the ways COVID-19 has transformed care, health equity, and the latest state and federal regulatory updates.

August 09, 2021

Report: Hospital Recovery Uneven amid Spread of Delta Variant

Through June, the nation’s hospitals and health systems have seen mixed progress in their recovery from the pandemic, but the threat of the Delta variant looms during the second half of the year, according to the latest hospital national snapshot report from Kaufman Hall.

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