Pennsylvania Health Insurance Policies

→ Visit the Pennsylvania Insurance Department's website

Guaranteed Health Insurance Plan

As a HIPAA eligible enrollee, you will be:

• Guaranteed the right to purchase an individual Blue Cross Blue Shield health insurance policy
• Be offered a choice of at least two state-approved policies. These benefits must be similar to others Blue Cross Blue Shield typically sells

HIPAA Eligibility

To be HIPAA eligible in Pennsylvania, you must:

1. Have 18 months of continuous creditable coverage, with at least the last day under the Brethren Ministers Group; and
2. Not be eligible for Medicare, Medicaid or a group plan; and
3. Apply for health insurance for which you are HIPAA eligible within 63 days of losing your prior coverage; and
4. Not have health insurance.

Note: If you know your group coverage is about to end, you can apply for coverage for which you will be HIPAA eligible.

Blue Cross Contact Information

Which Blue Cross policy you should use depends on where in Pennsylvania you live. Here is a list of regional Blue Cross companies:

HighMark Blue Cross Blue Shield (Western Pennsylvania)

(800) 544-6679

Blue Cross of Northeastern Pennsylvania (NE Pennsylvania)

(800) 829-8599

Capital Blue Cross and Blue Shield (Central Pennsylvania)

(800) 958-5558

Independence Blue Cross and Blue Shield (Philadelphia area)

(800) 453-2566

How much will my insurance policy cost?

Premiums will vary depending on your family size and type of policy you want. Premiums are capped at 125% to 200% of the average market rate. Premiums for a guaranteed issue individual health insurance policy from a Blue Cross Blue Shield plan are community rated: they will not vary based on your health status, age, or other factors.

Where can I obtain more information?

For more information visit the Pennsylvania Insurance Department's website at www.insurance.state.pa.us or call them at (877) 881-6388 [in-state] or (717) 787-2317.

Special insurance for children: Cover All Kids

Children up to 19 years of age, regardless of their family income, are eligible for Cover All Kids.

• Do you qualify? Visit Eligibility
• To see a physician directory visit Providers Information
• Questions? Call (800) 986-5437