Eligibility for Obamacare in Pennsylvania

Residents should find out what are the requirements to apply for the Affordable Care Act in Pennsylvania before starting the enrollment process. Learning how to qualify for ACA insurance plans will ensure that petitioners have the documents needed during the Obamacare application process to prove they are eligible for benefits and financial assistance. While almost any PA resident can sign up for insurance through the marketplace, knowing what are the Affordable Care Act income requirements and thresholds for tax subsidies can help petitioners select a plan they can afford. Continue reading the information below to find out more about who is eligible for Obamacare premium reduction and qualification requirements to consider.

What are the requirements to apply for the Affordable Care Act in Pennsylvania?

To meet Obamacare coverage eligibility requirements, Pennsylvania applicants must be a U.S. citizen, U.S. national, temporary or permanent lawful resident or an immigrant with a work or student visa. Residents must also apply for the Affordable Care Act insurance plans during open enrollment periods or by meeting the criteria for a special enrollment period. To qualify for ACA enrollment, PA petitioners must apply for Obamacare during the open enrollment periods, which usually start in November. In some cases, people can enroll in coverage even when the official enrollment period is closed. There are certain qualifying life events that supersede enrollment period restrictions, such as:

  • Losing existing health coverage.
  • Losing Medicaid, Medicare or CHIP eligibility.
  • Getting married or divorced.
  • Turning 26 years of age and losing coverage on a parental plan.
  • Having a baby or adopting a child.

To find out more about ACA enrollment requirements and periods, download our free and comprehensive health care guide.

What are the Affordable Care Act income requirements in Pennsylvania?

The Obamacare coverage eligibility requirements included new rules and regulations to several provisions of Medicaid, increased eligibility and made medical insurance available to low-income consumers in the medical marketplace. The Affordable Care Act income requirements are set higher than the previous Medicaid income requirements, making affordable care more accessible for more residents of Pennsylvania. The ACA expansion provided increased protections and benefits for residents. Pennsylvania is one of 33 states that participates in the Affordable Care Act expanded eligibility and benefits programs.

Under the Affordable Care Act income requirements, you may be eligible for subsidized health insurance coverage on the medical marketplace if your income is a certain percentage bracket of the federal poverty level. To qualify for ACA in 2018 and receive a cost-sharing reduction credit, your income cannot be higher than 400 percent above the federal poverty level. ACA eligibility requirements vary depending upon family size and household income, among other factors. The federal poverty level changes annually, so eligibility for ACA tax credits may change from year to year.

Download our in-depth health care guide for specific details about income thresholds for ACA tax subsidies.

Who is not eligible for Obamacare in Pennsylvania?

You will not qualify for ACA insurance plan enrollment if you or a family member has affordable coverage through an employer. You are also not eligible for an Obamacare insurance plan if you meet the qualifications for Medicaid, Medicare or another government insurance subsidy program. The Affordable Care Act requires that all residents have a health care insurance plan either through Medicaid if they meet income eligibility requirements, health insurance through their employers or the medical insurance marketplace for people whose employers do not provide insurance coverage.

You may not have to worry about Obamacare coverage eligibility requirements if you are a member of a federally recognized Native American tribe or receive Indian Health Services. Members of some religious groups with religious objections to health insurance may also qualify for ACA exemptions and do not need to enroll. Affordable Care Act health coverage is also not required for people serving time in jail or prison. Other exemptions include but are not limited to citizens living overseas and people in the U.S. illegally.

Who is eligible for Obamacare penalty waivers in Pennsylvania?

Obamacare coverage requires all U.S. residents must have health care insurance. If someone who is eligible for Obamacare or some other health care insurance plan does not obtain coverage, then he or she will be subject to a financial penalty. As mentioned earlier, certain people are eligible for ACA penalty waivers. In addition to members of Native American tribes and religious believers, penalty-fee waivers may apply to those in an income gap. For example, if your income is too high to qualify for government assistance coverage but too low to afford the lowest cost insurance, then you may be exempt. Likewise, if your income is not high enough to meet tax-filing requirements, then you may be exempt.

If you are eligible for insurance through your employer but refuse to accept the coverage, then you will be subject to pay the penalty unless you are exempt. Likewise, PA residents who are eligible for Obamacare but not enrolled in a health insurance plan will face tax penalties for the periods during which they are not covered. People uninsured for less than two consecutive months in a 12-month period will not be penalized

Secure

What Health Services Are Available in Pennsylvania?

From Obamacare health insurance plans to Medicaid and Medicare, there are various types of health coverage available in Pennsylvania. Each type of insurance can be accessed through a different application method. To learn about the easiest ways to apply for affordable health care in GA, download our comprehensive guide on health services.

Who Is Eligible for Affordable Health Services in Pennsylvania?


Affordable and free health services are often limited to Pennsylvania residents who meet all established eligibility requirements. Income, age and household size are often key factors taken into consideration when determining an applicant’s qualifications. Discover if you qualify for free or reduced-cost health insurance by reviewing the in-depth information on all program eligibility requirements within our comprehensive guide.