Health Insurance Carriers in Pennsylvania (PA)
Pennsylvania’s insurance laws differ from
those of other states. For your convenience, we have provided
a list of links below so that you can explore your options. Below,
we’ve done the research on details of Pennsylvania insurance
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Health Insurance Providers in Pennsylvania
American Medical Security
Assurant Health (Formerly Fortis)
Fairmont Specialty Group /
Group Health Insurance in Pennsylvania
- Eligible applicants may not be denied group
coverage or be charged more due to health issues.
- Employer may impose a waiting period on new employees.
- Life changes relating to family or job loss may provide
special opportunities for coverage.
- Newborns and disabled children are guaranteed special
- In the case of a pre-existing condition, providers may
review medical records for the six months prior to coverage.
- An exclusion period of up to 12 months may apply to the
- If continuous coverage has been maintained for over 63
days, creditable coverage applies to any exclusion period.
Small Business Health Insurance in Pennsylvania
- Small businesses with fewer than 50 employees
may not be denied small group coverage or cancelled based on health
problems within the employee group.
- Premiums may be higher based on health problems within
- Blue Cross Blue Shield premiums are based on modified
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Self-Employed Health Insurance in Pennsylvania
- The self-employed may not buy group health
- Contact the Pennsylvania Department of Insurance for regulations
concerning associations that are trade or business related and
offer group health coverage.
Pennsylvania Department of Insurance
1326 Strawberry Square
Harrisburg, PA 17120
Individual Health Insurance in Pennsylvania
- There are different regulations for Blue
Cross Blue Shield of Pennsylvania than for other private providers.
- Blue Cross Blue Shield is required to issue a policy to
- The HIPAA eligible, must be offered two state approved
- Blue Cross Blue Shield may require a waiting period of
up to 30 days for non-accident claims and six months for other
- For pre-existing conditions, an exclusion period of three
years may apply unless the applicant is HIPAA eligible.
- In a non-guaranteed policy, the provider may attach an
elimination rider to the policy.
- Pregnancy and genetic information may be classified as
- Community rating set the cost of a guaranteed issue policy.
- Non-guaranteed policies have no limits on costs.
- Blue Cross Blue Shield policies may not be cancelled based
- Other private insurers may deny coverage due to a health
- In the case of a pre-existing condition, private providers
may attach an elimination rider to the policy or require an exclusion
period of up to three years.
- There is no creditable coverage for individual health
- There are no limits on premium costs.
- Coverage may not be cancelled due to illness.
- Contact the Pennsylvania Insurance Department for information
that should be considered before purchasing health insurance coverage.
Pennsylvania Health Care Programs
Medicaid, Healthy Women Project, and Pennsylvania’s
Children Health Insurance Program provide assistance to low income
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