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Affordable Health Insurance in Pennsylvania: What Most People Don't Know
Five facts most Pennsylvanians learn the expensive way.
1. "Affordable" on the marketplace means subsidized
Pennie prices are designed to be offset by the premium tax credit. Without it, you're paying the full cost of a guaranteed-issue pool.
2. There's a second market
Private shared-network plans on Cigna, Aetna and PHCS PPO price on health instead of income. For healthy people above the subsidy line they're often half the price, with a PPO.
3. Your doctor probably takes the PPO, not the HMO
National PPO networks are what most employer plans use. Many doctors in Philadelphia and Pittsburgh are in the Cigna, Aetna and PHCS PPO network and not in the narrow marketplace HMOs.
4. You can enroll in a private plan any month
No waiting for November. Apply by the 20th, coverage on the 1st.
5. The deduction applies either way
Pennsylvania has a flat 3.07% state income tax and many municipalities add earned-income taxes, so the self-employed premium deduction helps at the federal level and the state tax is simple.
And one Pennsylvania-specific thing
Pennsylvania runs its own marketplace, Pennie, and hospital systems like UPMC and Jefferson are so central that many buyers choose a plan around their doctors — which is exactly what a PPO network question looks like.
Check your options to see what affordable actually looks like for your situation.