health insurance laws in PA (Philadelphia, Pittsburgh: how much, employment, transfer to)

[TristansMommy]

Hi,

Okay..so I was wondering.. what are the laws in PA regarding health insurance.

For example..NY residents CAN NOT be denied coverage or charged more for health insurance if they have a chronic condition (I'm a juvenile Diabetic). However, it is my understanding that not all states operate the same way regarding health insurance.

IN some states you can be turned down or charged a much higher premium (not that it's not already too high) and was wondering if anyone knew about the laws pertaining to that in PA.

Thanks in advance for your help

[mm_mary73]

Originally Posted by TristansMommy

Hi,

Okay..so I was wondering.. what are the laws in PA regarding health insurance.

For example..NY residents CAN NOT be denied coverage or charged more for health insurance if they have a chronic condition (I'm a juvenile Diabetic). However, it is my understanding that not all states operate the same way regarding health insurance.

IN some states you can be turned down or charged a much higher premium (not that it's not already too high) and was wondering if anyone knew about the laws pertaining to that in PA.

Thanks in advance for your help

What does your current carrier say?

[Lehigh Valley Native]

Originally Posted by TristansMommy

Hi,

Okay..so I was wondering.. what are the laws in PA regarding health insurance.

For example..NY residents CAN NOT be denied coverage or charged more for health insurance if they have a chronic condition (I'm a juvenile Diabetic). However, it is my understanding that not all states operate the same way regarding health insurance.

IN some states you can be turned down or charged a much higher premium (not that it's not already too high) and was wondering if anyone knew about the laws pertaining to that in PA.

Thanks in advance for your help

Well, you can't be denied coverage here either, but if you don't have group benefits, prepare to pay a lot of money. The Blues (Blue Cross & Blue Shield) are designated in PA as insurers of last resort. They get tax breaks from the state, but in return, must insure anybody, no matter the health of the person. You may have a pre-existing condition clause, with a waiting period for coverage for that condition, but that depends on several circumstances.
They will charge you more for a guaranteed issue policy, versus a policy that a person without chronic conditions could get.
PA does offer CHIP, which provides health insurance to any uninsured child under 18 for free or reduced fee based on income. CHIP does not have any preexisting condition clause. Adultbasic is also offered to uninsured adults, however, you must be below a certain income level. For both of these plans, you must have been uninsured for the previous 90 days and a resident of PA for 60 days.

[TristansMommy]

Originally Posted by Lehigh Valley Native

Well, you can't be denied coverage here either, but if you don't have group benefits, prepare to pay a lot of money. The Blues (Blue Cross & Blue Shield) are designated in PA as insurers of last resort. They get tax breaks from the state, but in return, must insure anybody, no matter the health of the person. You may have a pre-existing condition clause, with a waiting period for coverage for that condition, but that depends on several circumstances.
They will charge you more for a guaranteed issue policy, versus a policy that a person without chronic conditions could get.
PA does offer CHIP, which provides health insurance to any uninsured child under 18 for free or reduced fee based on income. CHIP does not have any preexisting condition clause. Adultbasic is also offered to uninsured adults, however, you must be below a certain income level. For both of these plans, you must have been uninsured for the previous 90 days and a resident of PA for 60 days.

Thank you.. that information is VERY helpful. It turns out that Empire Blue cross/ Blue Shield is the BEST insurance for a diabetic to have,as they get new insulin pump wearers a new pump every 4 years, when the warranty runds out and cover our supplies the best. I will have to research how much more they'll charge me for my condition.

I think pre-existing clause only exists for something you haven't consistantly been covered for before.. and i have had coverage for my diabetes since the age of 16 (I'm 33).

Thank you for yoru help.. this is all good to know.

[Lehigh Valley Native]

Originally Posted by TristansMommy

Thank you.. that information is VERY helpful. It turns out that Empire Blue cross/ Blue Shield is the BEST insurance for a diabetic to have,as they get new insulin pump wearers a new pump every 4 years, when the warranty runds out and cover our supplies the best. I will have to research how much more they'll charge me for my condition.

I think pre-existing clause only exists for something you haven't consistantly been covered for before.. and i have had coverage for my diabetes since the age of 16 (I'm 33).

Thank you for yoru help.. this is all good to know.

You're welcome. My son who is 13 is also type 1 and currently has HighMark Blue Cross. They are also awesome. New pump every 4 years as well, and takes care of his pump supplies in full. I think most Blue Cross plans are the best you can get.
If you currently have empire blue cross, it might be easier for you to transfer to a PA Blue. Here is a list of BC & BS in PA.
Independence Blue Cross - Serves Philadelphia and southeast PA
Capital Blue Cross - Serves Harrisburg, Lancaster, Lehigh Valley areas and parts of central of PA
Highmark Blue Cross - Serves Harrisburg, Lancaster, Lehigh Valley areas and parts of central PA
Northeastern Blue Cross- Serves Wilkes-Barre / Scranton, Poconos area
HighMark Blue Cross (Pittsburgh) - Serves Pittsburgh and western PA

As you can see the Lehigh Valley, Harrisburg, Lancaster areas have two blues serving it. It makes pricing between the two very competitve.

[TristansMommy]

Originally Posted by Lehigh Valley Native

You're welcome. My son who is 13 is also type 1 and currently has HighMark Blue Cross. They are also awesome. New pump every 4 years as well, and takes care of his pump supplies in full. I think most Blue Cross plans are the best you can get.
If you currently have empire blue cross, it might be easier for you to transfer to a PA Blue. Here is a list of BC & BS in PA.
Independence Blue Cross - Serves Philadelphia and southeast PA
Capital Blue Cross - Serves Harrisburg, Lancaster, Lehigh Valley areas and parts of central of PA
Highmark Blue Cross - Serves Harrisburg, Lancaster, Lehigh Valley areas and parts of central PA
Northeastern Blue Cross- Serves Wilkes-Barre / Scranton, Poconos area
HighMark Blue Cross (Pittsburgh) - Serves Pittsburgh and western PA

As you can see the Lehigh Valley, Harrisburg, Lancaster areas have two blues serving it. It makes pricing between the two very competitve.

That is AWESOME>. thank you so much.. I just got the newest pump with Real Time.. Im' just waiting for the proccess of getting the insurance company to approve the sensor part so that my blood sugars are taken every 5 mintues and sent to the pump. I can't wait!!! Especially since I plan on getting pregnant again and taking myblood sugar every hour was just plain nuts.. You should look into it for your son if he is due for a new pump soon. Mini Med actually called ME to get me on the new pump.

Thanks again!

[lowcostpahealthinsurance.]

There are several types of health insurance available in Pennsylvania. There are guarenteed issue plans available. Blue Cross Blue Shield has a number of these programs available. However, they are significantly more expensive than the medically underwritten plans that they make available. Why is this? With the guarenteed issue plans the insurance companies are accepting much more risk. The same principle is true of Group Health Insurance verses individual health insurance. Here is a resource that explains what type of options may be the best available for you, Group or Individual Health Insurance Pittsburgh, Affordable Plan Philadelphia PA. . Hope I was helpful in answering some of your concerns.

Originally Posted by TristansMommy

Hi,

Okay..so I was wondering.. what are the laws in PA regarding health insurance.

For example..NY residents CAN NOT be denied coverage or charged more for health insurance if they have a chronic condition (I'm a juvenile Diabetic). However, it is my understanding that not all states operate the same way regarding health insurance.

IN some states you can be turned down or charged a much higher premium (not that it's not already too high) and was wondering if anyone knew about the laws pertaining to that in PA.

Thanks in advance for your help

[Positiveone]

Hi how are you? I saw your post , which i pasted below and had a few questions. I'm alos originally from Long Island, moved away from LI to Henderson NV back in 1996, now we are looking to move somewhere back east to raise our children plus to be closer to our family on LI.

but my manin question is about the health insurance laws in NY & in PA, , do you mean that NY state cant use a pre-existing injury/disease against one? Like i have a bunch of pre-existing issues, so if i moved back to NY all insurance companies would have to cover me without a higher premium? Is that how it is? Here in NV they could charge higher, or some insurnace companys wont cover you at all for pre-existing.

And how much did you find out about PA's law? Sound Ok there?

We are also considering Lancaster Pa , but we are a bit worried about employment there. My uncle retired there and he sends me the newspaper, i havent seen much of a help wanted section, thats the one positive about living near Vegas, out here there are a ton of jobs, alot pay well with benefits.

Hope to hear from you --Tony

Originally Posted by TristansMommy

Hi,

Okay..so I was wondering.. what are the laws in PA regarding health insurance.

For example..NY residents CAN NOT be denied coverage or charged more for health insurance if they have a chronic condition (I'm a juvenile Diabetic). However, it is my understanding that not all states operate the same way regarding health insurance.

IN some states you can be turned down or charged a much higher premium (not that it's not already too high) and was wondering if anyone knew about the laws pertaining to that in PA.

Thanks in advance for your help

[TristansMommy]

Originally Posted by lowcostpahealthinsurance.

There are several types of health insurance available in Pennsylvania. There are guarenteed issue plans available. Blue Cross Blue Shield has a number of these programs available. However, they are significantly more expensive than the medically underwritten plans that they make available. Why is this? With the guarenteed issue plans the insurance companies are accepting much more risk. The same principle is true of Group Health Insurance verses individual health insurance. Here is a resource that explains what type of options may be the best available for you, Group or Individual Health Insurance Pittsburgh, Affordable Plan Philadelphia PA. . Hope I was helpful in answering some of your concerns.

Hi Tony.
Well in NY they CAN't discriminate and charge higher premiums based on pre-existing conditions. There is, however, a pre-existing clause. If you go without health insurance I think beyond like 90 days or a year or something to that effect, you can be denied coverage for your pre-existing condition for a certain period of time.

I purchase my own health insurance because i'm self employed and they do not ask about your health, age etc. before signing up, so it's not based on that.

it is my understanding, from some other posts on this board, that PA can not deny you coverage but CAN charge a higher premium for your insurance if you have a condition.. atlesat that's what I got from someone else's resonse. I have not yet looked into it completley , as Im' not ready yet to
make the move and are only doing preliminary.

I super suggest that you second guess your idea about coming BACK to LI. It's really become super expensive. Check out the Long Island threads about the issue. There aer so many places you can live that are more affordable ,yet near LI enough to be a car drive away. I grew up here and have lived here my entire 33 years and i've just about had it with the cost of living!!