Pennsylvania Health Services

Residents can access Pennsylvania health care services through various programs administered or managed by the state Department of Health. The Pennsylvania Department of Health is committed to helping people and families get the health services and resources they need to live healthy lives. Pennsylvania health care programs like Medicare and Medicaid are available to qualified residents who need financial assistance in obtaining medical services. Medicaid is referred to as Medical Assistance in PA since it provides eligible low-income residents with aid for health care coverage. Medicare and Medicaid insurance are for specific groups of people and only those who meet program eligibility requirements will receive benefits. Low cost insurance in Pennsylvania is also available through the federal health care marketplace. Being able to obtain affordable insurance plans in Pennsylvania is important for each resident especially following the Affordable Care Act, otherwise referred to as Obamacare, which implements penalties for those who do not have coverage. You can find more information about the different low-cost insurance plans and health insurance programs below, as well as more specific details in our free PA guide.

Medicaid Insurance in Pennsylvania

Medicaid insurance or Pennsylvania Medical Assistance provides health care for eligible individuals. People who qualify for Medicaid coverage usually have a low income or limited income with high medical expenses. Medicaid is a government-supported program that exists throughout the United States and assists with health care costs and access. Medicaid insurance programs are joint agreements between the state and the federal government that enables low-income individuals and families to access medical treatment. In Pennsylvania, Medicaid primarily serves the poor and has strict income eligibility requirements.

Medicaid insurance offers many benefits such as access to essential medical services at reduced or no cost. Applicants must submit an application form to the Pennsylvania Department of Health to find out if they meet the program's requirement to receive coverage. The specific health care services provided by Medicaid insurance may vary state to state, but there are basic medical treatments that each PA beneficiary has access. It is important to understand the details about how Medicaid works in Pennsylvania, who qualifies and what kinds of services are available for you and your family. Read More

Affordable Care Act Insurance in Pennsylvania

Congress approved the Affordable Care Act (ACA) in 2010, which introduced new guidelines for the Medicaid program as well as general health care access for all. The Obamacare program enabled more people to access affordable health care insurance plans in Pennsylvania and throughout the United States than ever before. Since the implementation of the ACA, more than 20 million people across the country gained basic and necessary health care insurance that enabled them to see the doctor and cover the costs of health care services and prescription drugs.

Before the Affordable Care Act, many working people still could not get health insurance because it was too cost prohibitive. Additionally, the Medicaid insurance requirements were so strict that many low-income residents could not qualify for coverage. Some people with pre-existing conditions also could not qualify for insurance and were denied benefits. By broadening eligibility and establishing different income-based options, the ACA expanded the number of people eligible for health insurance benefits and left fewer people uninsured. More residents in PA can now have access to affordable health insurance by qualifying for cost-sharing reductions in the form or advanced tax subsidies. However, applicants will need to know when they can enroll in coverage, the income thresholds to receive financial assistance and what the expected costs for health care services are. Read More

Medicare Insurance in Pennsylvania

The Pennsylvania Department of Health also manages the Medicare program in the state. Medicare insurance provides coverage for a range of medical costs for elderly residents and those with certain qualifying conditions. Established in 1966, Medicare is a federal health insurance program with funds that come from contributions workers pay into the system during their employment. Medicare services do not fluctuate state-to-state in the same way Medicaid insurance does since it is a federal program. Find out more about the health care services covered by Medicare and Medicaid in our comprehensive guide.

To be eligible to receive Medicare insurance, you must meet the minimum age requirement, have a qualifying health condition or receive benefits from other programs such as Supplemental Security Income. Some residents may be automatically signed up for this no- or low-cost insurance in Pennsylvania while others will need to be aware of their initial enrollment period or risk missing the deadline to request coverage. While there are a few enrollment periods in which residents can apply or request a change in coverage, PA petitioners will need to be aware of these times or face late enrollment penalties.

There are different sections to Medicare insurance: basic coverage for hospital stays (Part A), coverage for physician and laboratory costs and outpatient medical services (Part B) and prescription drug coverage (Part D). Medicare Part C permits private health insurance companies to provide Part A and Part B benefits. Medicare recipients may be responsible for paying monthly premiums as well as deductibles and copayments for hospital and other costs. Medicare insurance coverage can be vital for health maintenance and access to Pennsylvania health care services. Read More