Pennsylvania Health Insurance

Knowing about any applicable laws and regulations that might affect your purchase can be a vital asset when you are shopping for health coverage.  Most of Pennsylvania’s health insurance regulations happen to be tilted slightly in favor of the consumer, which can be a great advantage in getting the best available as long as you know what you need to watch out for.  Therefore, we offer Pennsylvania residents the following listing of relevant regulatory guidelines currently in place.

• State law in Pennsylvania requires all health insurance sold here to include a guarantee of renewability.  So long as you’ve paid your premiums in full and on time, your insurer must honor your intent to renew your coverage as many times as you see fit.  Not only that, but your insurer is prohibited from cancelling your coverage without specific consent when you suffer illness or injury.
• Any newborn or newly-adopted child that joins a Pennsylvania family is automatically considered to be covered under a parent’s health insurance, provided that said insurance is applicable to dependents.  This automatic coverage lasts for 31 days, by which point the parent(s) will most likely have made other arrangements.
• Pre-existing conditions, defined as any health issue that has been treated or diagnosed within five years before the starting date of your policy, are one of the areas in which Pennsylvania residents need to be particularly cautious.  It is considered legally acceptable for health insurance providers to designate specific pre-existing conditions as excluded from coverage for up to twelve months after your policy takes effect.  Fortunately, any waiting period you’ve already had to endure under a previous policy will automatically be credited to any new health insurance you obtain, provided you maintain continuous coverage through this period.
• Private insurance companies are allowed to determine whether to accept any application for coverage based on considerations like the health, age, and family history of the applicant, but once you’ve purchased a policy your insurer cannot choose to later raise your premiums based solely on changes in your health status.  Factors like age and geographic location are still fair game, though.
• Pennsylvania requires Blue Cross Blue Shield to grant coverage to all residents who  apply, and its premiums may never be based on the health status of the applicant.
• Insurers in Pennsylvania may require a probationary period of up to 30 days before any policy they sell actually goes into effect.
• Small businesses in Pennsylvania are automatically eligible to purchase group health coverage comparable to what other companies of their size enjoy, provided that their enterprise employs between two and fifty people. 
• Group insurance policies granted to any small business can potentially be terminated if the company does not meet certain conditions.  These can include ensuring that at least a certain percentage of the employees participate in the company health plan, or a minimum per-employee contribution to the policy’s premiums.  Under no circumstances can coverage be cancelled on the grounds of health problems among the insured, however.
• The cost of coverage for small businesses is only lightly controlled by Pennsylvania state law, and can vary based on typical risk factors like age, health, and so on.
• Self-employed residents of Pennsylvania are not automatically considered eligible for group coverage unless they have at least one employee other than themselves.  On the bright side, those who purchase individual health insurance instead may be able to deduct a significant portion of their premiums from their taxes.

The ability of anyone to take advantage of the opportunities inherent to a competitive marketplace is dependent on how well-informed that person is.  Nowhere is this more true than in the health insurance market, and residents of Pennsylvania (or any state, for that matter) will find their bargaining position drastically improved if they make sure to learn as much as possible about what they are looking for before entering the market.  Once you do start shopping, you should be sure to compare prices between as many competing insurers as possible to ensure that you’re able to find the best deals available.

From Our Customers