How health insurance works in Pennsylvania
Pennsylvanians buying their own coverage have two markets: Pennie (pennie.com), where plans from Highmark, Independence Blue Cross, UPMC Health Plan, Capital Blue Cross, and Geisinger are guaranteed-issue and priced on income, and the private shared-network market, where PPO plans on Cigna, Aetna and PHCS PPO are underwritten and priced on age and health.
Medicaid is expanded in Pennsylvania. Pennsylvania has no state individual mandate.
What it costs
Full-price marketplace plans for a 40-year-old in Philadelphia commonly run $550–$850 a month in 2026; with a subsidy, often under $300. Private PPOs for the same healthy person run roughly $320–$480. 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.
The Pennsylvania picture
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.