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Health Insurance in Pennsylvania
Pennie® Pennsylvania’s official health coverage
Pennie® is Pennsylvania’s official health coverage marketplace and the only place to get financial assistance to help lower the cost of coverage and care. Your Modified Adjusted Gross Income and other specifics entered on your application will determine the amount of subsidy you are eligible to receive, which could mean lower costs for you. This means that you are able to get income based Health Insurance pricing.
Open Enrollment occurs each year from November 1st through January 15 - but you may have other opportunities throughout the year to enroll as well.
As a licensed Pennie Broker, we offer no cost assistance with completing your Pennie application and determining which plan will work best for you and your family.
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I’m turning 65 this year, when do I need to start signing up for Medicare?You may begin enrollment into Medicare Parts A&B ninety days prior to the month you turn 65. This enrollment is done through Social Security.
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What if I still have employer insurance when I turn 65?If you or a spouse are still actively employed with creditable coverage when turning 65 and there are over 20 employees at the workplace, you will have options. There are many things to consider and you should reach out to us for a conversation.
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How do I sign up for Medicare?Online through SSA.gov or by reaching out to your local Social Security office. Smoke signals are not recommended.
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How much does Medicare cost?Part A is hospital insurance and premium free for most people when they become Medicare eligible. Part B covers medical services and most people will pay a monthly premium for Part B based on their income. From there your costs will be determined by if you choose a Medicare Advantage Plan or Medicare Supplement Insurance Plan.
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Do I need Medicare Parts A&B?You will need both parts when you are ready to fully go onto Medicare. If you are staying on employer insurance when turning 65, you most likely only want Part A but there are multiple things we should talk through with you.
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Do I have to start my Social Security draw at the same time as Medicare?No. Even though both pieces are handled through the Social Security Administration, they are two separate decisions that can easily have different start dates.
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Could I have a Medicare Advantage Plan and a Medicare Supplement Insurance Plan so I am double covered?Nice try, but…no. You are not allowed to have both.
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Can I just have Medicare A&B and no additional coverage?Well, technically yes but we definitely don’t recommend it! You would have no prescription coverage and an uncapped 20% medical coinsurance for starters, which could be significant in the event of something major. Many Medicare Advantage Plans are $0 premium plans that include Part D Prescription coverage and are structured with copays instead of 20% for medical services.
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What is Part C?Another name for a Medicare Advantage Plan. Are you confused yet?
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I’m approaching my 65th birthday and keep getting calls from Medicare to sign me up for my insurance.There is a lot of fraud in the Medicare Insurance industry. Medicare will never reach out to you to sign up for insurance. We advise not engaging in those phone calls.
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Can my spouse be on my Medicare plan?Sorry, but no. Medicare eligibility and Medicare Insurance Plans are individual. If your spouse is Medicare eligible, they can apply for their own coverage.
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I have VA benefits and am on Medicare, what do I need to do?You will need to enroll with Medicare A&B through the Social Security Administration when approaching your 65th birthday. You also have the option of adding on a Medicare Advantage Plan or Medicare Supplement Insurance Plan to give you options for medical care outside of the VA. Thank You for your service.
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What is Part D?Prescription Drug Coverage as either a stand-alone plan or wrapped into a Medicare Advantage Plan.
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What happens if I don’t sign up for Medicare when I’m supposed to?You may be subject to a penalty depending on the amount of time you went without creditable coverage after turning 65. Rumors of limb chopping have circulated as well…(kidding!) Medicare Parts B&D are where penalties can occur. If you are assessed a penalty, it will most likely stay with you for the rest of your life. Ouch.
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Does Medicare cover dental and vision?There is no preventative dental or vision through Original Medicare. Some Medicare Advantage plans will include these additional benefits or you can add on a stand-alone plan. We offer multiple companies.
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How much are your fees to help me figure all of this out?!Absolutely ZERO! You will never pay us a dime for our services and there will be no additional cost through your insurance. We are solely compensated through the insurance companies. Everybody likes $0!
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Can I keep all my doctors when I go onto Medicare?This should not be a problem. Some plans have networks and we will check your doctor’s participation.
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I have a retiree plan available to me, I don’t have to do anything.You will still need to put Medicare A&B in place through Social Security. From there, you will want to compare the option of staying on the retiree plan vs going onto a straight Medicare plan. Retiree plans are not always better!
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How can I ever thank you for all your help?Well, chocolate will not be turned down LOL, but seriously if we have been helpful to you through this process - a referral to someone else that would appreciate our services is the biggest compliment and thank you we can receive 💗
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