A Guide to Health Insurance in Pennsylvania (PA)

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The reality with shopping for Pennsylvania Health Insurance is that unfortunately it won’t be cheap, and it could cost you a lot, however the reality is that not having it could cost you an awful lot more.

Every year health insurance in Pennsylvania continues to increase in price, and statistics show that over the last ten years that average premiums have more than doubled.

However, the same is true of at source health costs. If you wander sick into a hospital and have to stay overnight without health insurance, then you can expect to a bill to your home of up to $10,000, depending on what you are treated for and the hospital you are staying in.

A quick look at up to date statistics of how much different types of surgery’s cost in the United States is quite shocking. 
Here are some estimated average 2011 billed charges for different types of transplant operation in the United States, courtesy of the United Network for Organ Sharing.

Intestine Transplant - $1,206,800
Heart and Lung Transplant - $1,148,400
Heart Transplant - $997,700
Double Lung Transplant - $797,300
Liver Transplant - $577,100
Single Lung Transplant - $561,200

So, whilst there is no getting away from the fact that likely premiums for Pennsylvania Health Insurance are going to be higher than you would like. It is still a good investment when you consider the “lottery win” type of amounts that you would otherwise have to pay out if you didn’t have any.

The bottom line is that if you have a major health incident and don’t have any health insurance in Pennsylvania then the most likely outcome is that you will end up having to declare bankruptcy.

When you shop around for health insurance you really need to ask yourself some key questions before you finally take the plunge.


Here is a selection of ten of the questions that you need to ask:


1/ How often do you see a Doctor?

2/ Do you ever have to see any specialists?

3/ How much can you realistically afford to spend every month?

4/ Do you mind if you have a Doctor appointed for you, or do you have a Doctor you already have a good relationship with that you would like to continue using?

5/ Do you understand exactly what is and is not covered in any potential policy?

6/ Does the Pennsylvania Health Insurance that you have picked include prescription drugs, or are there some exclusions?

7/ Do the insurance policies you are researching cover you for anything else such as psychiatric assessments, alternative therapies or vaccinations?

8/ Do you have any pre-existing medical conditions that may affect your ability to get a policy?

9/ Is the Pennsylvania Health Insurance company that you have chosen financially sound? (You can check this by checking the company either on the Pennsylvania Insurance Department website, doing a search for “credit ratings agency” and checking online that way, or else by visiting your local library and asking the Librarian to check for you).

10/ Which policy offers the best value for money?


In many ways there are a lot of subjective elements to choosing health insurance in Pennsylvania, but one objective measure is exactly what the terms and conditions of each policy that you look at are.

You will find considerable overlap between the policies, but if you read closely then you will find that there are areas of difference, and some of these can be significant.

It is a good idea to compare the premiums, the terms and conditions, and also how great the likely out of pocket expenses may be if you ever have to make a claim.

Some plans can have slightly lower monthly premiums, but often the out of pocket expenses such as deductibles, co-insurance and co-payments can be considerably higher.

If you can afford to pay a little more for your insurance then it is often a good idea to choose the policy that may have slightly higher monthly premiums, but with far fewer barriers to actually using the policy in the form of out of pocket expenses if you have to see a Doctor.

Ideally, you want to feel as though you can actually make a claim on the policy! And not be put off ever claiming by the thought of horrendously high deductibles.


At the end of the day you will have to exercise your own judgment when choosing between policies, and which Pennsylvania Health Insurance Plan you end up buying will be down to your discretion.

But do try to help yourself by taking the time to ask sensible questions of any plans that you are considering buying, as it can end up saving you considerable heartache and money if you choose the right Pennsylvania Health Insurance at the first time of asking!


 

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