Pennsylvania health insurance plans
How individual and family health coverage works in Pennsylvania, in plain language.
Where Pennsylvania residents shop
Pennsylvania residents who buy their own coverage shop on Pennie at www.pennie.com. That is also where income-based help with monthly premiums (premium tax credits) is applied. Pennsylvania runs its own marketplace, so it has its own enrollment dates and rules.
Pennsylvania's Medicare counseling program changed its name from APPRISE to PA MEDI in July 2021 -- same program and services, run by the Department of Aging, just under a new name, so older references to APPRISE still point to the same free help.
Enrolling
Open enrollment dates are set by the marketplace and can change from year to year, so confirm this year’s window on the marketplace site before you plan around it. Outside open enrollment you generally need a qualifying life event, such as losing other coverage, moving, or a change in household size.
What affects the plans you see
- Where you live. Plans and premiums are set by area within Pennsylvania, so your county matters. Find your county.
- Income and household size. These determine help with premiums and whether you may qualify for Medicaid instead.
- Plan level. Metal levels (Bronze, Silver, Gold, Platinum) trade a lower monthly premium against higher costs when you use care.
Pennsylvania Medicaid (Medical Assistance) is administered by the Department of Human Services (DHS) -- DHS is the right place to start if your Pennsylvania Medicaid eligibility changed.
Pennsylvania runs its own ACA marketplace, Pennie, instead of the federal HealthCare.gov site, with its own open enrollment period running November through January.
Free Medicare counseling is available in Pennsylvania through PA MEDI (formerly known as APPRISE) at 1-800-783-7067, run by the Pennsylvania Department of Aging and separate from Pennsylvania Insurance Plans's own free phone help.
Questions
Where do I shop for ACA health plans in Pennsylvania?
Pennsylvania residents shop through Pennie (https://www.pennie.com). An independent agent such as Lander LLC can explain the plans for you, but the marketplace is the only place premium tax credits are applied.
How do I apply for Medicaid in Pennsylvania?
Medicaid in Pennsylvania is run through Pennsylvania Department of Human Services (DHS) (https://www.pa.gov/agencies/dhs/resources/medicaid). Eligibility depends on income, household size and other factors, and it is decided by the state, not by an insurance agency.
Who regulates insurance in Pennsylvania?
Pennsylvania Insurance Department (https://www.pa.gov/agencies/insurance/consumer-help-center) regulates insurance companies and agents in Pennsylvania. You can use it to check that an agent or company is licensed and to file a complaint.
Is there free, unbiased Medicare help in Pennsylvania?
Yes. PA MEDI (Pennsylvania Medicare Education and Decision Insight, formerly APPRISE) (1-800-783-7067) offers free Medicare counseling through the State Health Insurance Assistance Program (SHIP), separate from any insurance agency.
Does Pennsylvania Insurance Plans cost anything to use?
There is no cost to call or to speak with an agent. Insurance premiums and plan costs are set by the insurance companies and are separate from our help.
Questions about Pennsylvania health plans? Call 855-367-1095
Call Lander LLC to go over your options. There is no cost to call or to speak with an agent, and you are never required to enroll in anything.
Call 855-367-1095Reviewed by Richard Lander, licensed insurance agent (NPN 21255551), Lander LLC. Last updated October 3, 2026. This page is educational and is not a quote, an offer of coverage, or legal or tax advice.