Pennsylvania had an uninsured rate of about 5.7% as of 2019, which is lower than the national average but still represents about 709,100 people without health insurance in the Keystone State. That’s according to a report by the Kaiser Family Foundation (KFF), a nonprofit that tracks healthcare data. KFF also looked at the uninsured rate again in 2021 and found that of the people without coverage, nearly 349,000 of them would qualify for marketplace health insurance.
Marketplace coverage is robust health insurance. It covers 10 essential health benefits, such as preventive care and hospitalization, as well as pre-existing conditions. These plans also include subsidies for people who qualify, and most people do.
Subsidies, officially known as advance premium tax credits, offer financial help to people with incomes of 100% to 400% of the federal poverty level.
According to KFF, approximately 28% of the people without health insurance in Pennsylvania who qualify for marketplace coverage could get a bronze plan for free thanks to these subsidies.
The nonprofit also analyzed premium data for Pennsylvania. They found that average lowest cost premiums among the different metal tiers were as follows: $306 a month for bronze plans, $439 a month for silver and $427 for gold. Note that the average lowest price for gold plans is slightly less than the average for silver.
These averages don’t take into account any subsidies. If you think you qualify for a tax credit, your best option would be to use the state’s official insurance marketplace at Pennie.com. That’s because Pennsylvania runs its own health insurance exchange (not every state does).
If you don’t qualify for subsidies, then you may want to shop around using a private marketplace, like ours. Using our own marketplace, we found that a 40-year-old living in Philadelphia who earns $37,000 a year could find a bronze plan for just over $280 a month. That does not include subsidies.
Cost and plan options vary based on where you live. In Pennsylvania, there are at least 7 insurers offering marketplace plans in 2021. They include Oscar, Highmark and Capital Blue Cross, among others.
Sources
Kaiser Family Foundation, “Health Insurance Coverage of the Total Population”
Kaiser Family Foundation, “Marketplace Eligibility Among the Uninsured: Implications for a Broadened Enrollment Period and ACA Outreach” (January 27, 2021)
Kaiser Family Foundation, “Average Marketplace Premiums by Metal Tier, 2018-2021”
Kaiser Family Foundation, “Insurer Participation on the ACA Marketplaces, 2014-2021” (November 23, 2020)