Free and Low-Cost Health Insurance Options
for Pennsylvania Residents
It is no secret that health insurance premiums have gone through the roof or that the high cost of coverage has caused many individuals and families to go without insurance.
Living without health insurance can be risky, and medical bills are a leading cause of bankruptcy filings. Before you give up on coverage, you should check out the free and low-cost health insurance options the Commonwealth of Pennsylvania offers its residents. Here are some of the affordable options Pennsylvania residents can use to protect themselves and their loved ones.
Medicaid is the Federal health care program for the poor and disabled. Even though the program is Federal, each state is responsible for administering their own Medicaid program. In the state of Pennsylvania, individuals whose earnings fall below the Federal Poverty Level (FPL) may be eligible for Medicaid if they also meet certain asset limitations and eligibility requirements.
For 2015, individuals earning less than $11,770 may qualify for free health care coverage under the Pennsylvania Medicaid program. Low-income individuals earning more than $11,770 may be eligible for low-cost health insurance coverage under the expansion of Pennsylvania Medicaid, currently known as Healthy PA (see below).
Starting in 2015, Pennsylvania is expanding eligibility for its Medicaid program. That expanded Medicaid program is known as Healthy PA, and it is designed to cover healthy low-income adults who were previously ineligible for Medicaid coverage. The program is open to individuals whose incomes are too high for traditional Medicaid but too low to afford private coverage on their own.
For 2015, individuals earning up to 138% of the Federal Poverty Level (FPL), roughly $16,242 can apply for the Health PA program. Applicants for Healthy PA must also be legal residents of the Commonwealth of Pennsylvania and able to provide proof of their stated income.
Parents, whether they are eligible for low-cost health insurance through Medicaid or not, may be able to enroll their children in the Children's Health Insurance Program. This program is designed to cover eligible young people in the Commonwealth of Pennsylvania and help them get the healthcare benefits they need to get healthy and stay that way.
Like other programs designed for low-income Pennsylvanians, eligibility for CHIP is based on the Federal Poverty Limit guidelines. In order to qualify for CHIP, the child must be under 19 years of age, a U.S. citizen, U.S. National or Qualified Alien, a resident of Pennsylvania, uninsured and not eligible for Medical Assistance.
The income limits for CHIP are based on family size and total income. To qualify for free coverage under CHIP, the household income for a single child aged cannot exceed $24,482. For a family of four, the income limit for free CHIP coverage is $50,440.
Children who are ineligible for free coverage under CHIP may still qualify for low-cost health insurance under the program. For children age 0-1, the income limit for low-cost coverage is $36,958 for a single child and $69,840 for a family of four. Costs are applied on a sliding scale, with higher-income families paying more for covered services and low-income families paying less.
Children whose families earn too much for either free or low-cost health insurance through CHIP may still qualify for coverage at full price. There is no income limit for such coverage, although the out-of-pocket costs can be much higher.
Individuals who do not qualify for health insurance through Medicaid or Medicaid expansion may still be able to get coverage at an affordable price. The Affordable Care Act, also known as Obamacare, includes provisions for hefty tax subsidies designed to allow individuals to cope with the high cost of health insurance.
The income limits for these tax subsidies are much more generous than the ones for traditional Medicaid and the Healthy PA version of Medicaid expansion. While those programs top out at 138% of the Federal Poverty Guidelines, individuals earning up to 400% of the FPL may still qualify for subsidized health insurance coverage through the ACA.
For 2015, that means an individual earning up to $47,080 may qualify for an ACA subsidy. For a family of four, the income limit is $97,000. As with the cost-sharing provisions of CHIP, Affordable Care Act subsidies are applied on a sliding scale. The closer an individual or family is to the basic Federal Poverty Level, the more generous the subsidies. Individuals whose incomes fall closer to the 400% threshold may qualify for only a small subsidy, while an individual earning 200% of FPL would receive a much higher one.
While nothing has been able to stop the steady rise in health insurance premiums, these programs are designed to make coverage more affordable for single individuals, families and children. If you think you might be eligible for one of these free or low-cost Pennsylvania healthcare programs, just contact your health insurance broker or contact the plan directly.
Financial Help Is Available
The United States Government is committed to helping people aquire affordable health insurance.With the implementation of the Affordable Care Act (ACA) in 2014 many individuals and families throughout Pennsylvania are now qualifying for tax credits and subsidies. How much you pay for coverage depends on your age, location, household size and household income.
You Can't Be Denied Coverage
If you have a pre-existing condition dont worry because you can no longer be denied health insurance coverage. Also, you cannot be singled out for rate increases due to previous medical history.
Do I qualify for Lower Insurance Premiums or Cost Sharing Reduction (CSR)
Please look at the Federal Poverty Level (FPL) chart below to see if you qualify. Approximately 75% of Pa residents qualify for a subsidy.The health care law is most commonly known as the Affordable Care Act (ACA) or the Patient Protection and Affordable Care Act (PPACA) also referred to as Obamacare.
How may I obtain a Gov't Subsidy to lower my insurance premiums?
We can help you with the Government Subsidy/Tax Credit, Please call (888)620-8988 during normal business hours or click the free quote button below.