Pennie is Pennsylvania’s health insurance marketplace where residents can shop for affordable health and dental coverage and enroll in financial assistance programs. This article provides an overview of what Pennie is, how it works, who is eligible, and what health insurance options are available.
What is Pennie?
Pennie stands for “Pennsylvania Heath Insurance Exchange.” It is the state-based marketplace for Pennsylvanians to compare and enroll in health insurance plans.
Some key things to know about Pennie:
Pennie is Pennsylvania’s official health and dental insurance marketplace. It was established in 2019 under state law.
Pennie is the only place where Pennsylvanians can receive financial assistance to reduce the cost of health coverage and care.
Pennie is not an insurance company. It is an online marketplace that connects consumers to private health insurers and their plan options.
Pennie allows you to shop for, compare, and enroll in health insurance from major carriers like UPMC, Geisinger, Highmark, and Independence Blue Cross.
Pennie offers comprehensive medical plans that cover essential health benefits as required by the Affordable Care Act.
In addition to medical insurance, Pennie also offers stand-alone dental plans from leading insurers like Dominion National.
How Does Pennie Work?
Pennie serves as an online marketplace where you can shop for health plans and apply for financial assistance if eligible. Here are the key steps to using Pennie:
Browse plans – You can view all the health insurance options in your area, including plan benefits, provider networks, and estimated prices.
Check eligibility for savings – Pennie will check if you qualify for lower monthly premiums and out-of-pocket costs based on your household size and income.
Compare plans – See plan prices after estimated financial assistance. You can filter and compare by price, benefits, providers, and insurance company.
Enroll – Select a health plan that fits your needs and budget. Provide information to complete the application and enrollment process.
Get coverage – Once enrolled, you will receive plan documents and insurance cards. Coverage starts on your selected effective date.
Pennie also provides tools to help estimate your overall costs based on your expected healthcare usage. This allows you to select the optimal plan based on premiums, deductibles, copays, and total spending.
Who is Eligible for Pennie?
Pennie is open to all Pennsylvania residents seeking individual health coverage, regardless of pre-existing conditions. You are not required to meet any eligibility requirements to browse plan options on Pennie.
To enroll in a Pennie health plan and receive financial assistance, you must:
- Be a resident of Pennsylvania
- Be a U.S. citizen or legal resident
- Not be incarcerated
- Not be eligible for Medicare, Medicaid, or CHIP
Financial assistance is based on household size and annual income. Pennie uses your expected income for the current year to estimate subsidies. Households earning 100-400% of the Federal Poverty Level may receive subsidized premiums and reduced out-of-pocket costs.
In 2023, the income limits are:
- Individual: $13,590 to $54,360
- Family of 2: $18,310 to $73,240
- Family of 3: $23,030 to $92,120
- Family of 4: $27,750 to $111,000
When Can You Enroll in Pennie?
There is an annual Open Enrollment Period each fall when any Pennsylvania resident can enroll in a Pennie health plan. For 2023 coverage, Open Enrollment was November 1, 2022 through January 15, 2023.
Outside of Open Enrollment, you can qualify for a Special Enrollment Period if you experience certain qualifying life events like:
- Loss of health coverage
- Move to Pennsylvania
- Marriage or divorce
- Birth or adoption of a child
- Income change impacting subsidy eligibility
With a Special Enrollment Period, you typically have 60 days from the event to enroll in coverage on Pennie.
Health Insurance Options on Pennie
Pennie offers a variety of medical insurance plans at different coverage levels and premium price points:
Catastrophic – Low monthly premium but very high deductible. Good for the young and healthy.
Bronze – Lower premium but you pay 40% of costs on average. Minimum coverage.
Silver – Mid-range monthly premium. You pay 30% of costs on average. Moderate coverage.
Gold – Higher premium but lower out-of-pocket costs (20% on average). Good coverage.
Platinum – Highest premiums but lowest cost-sharing (10% on average). Robust coverage.
In addition to these standard metal tier plans, Pennie offers:
HSA-qualified HDHPs – Pair these high deductible plans with a Health Savings Account.
Copay-only plans – Set dollar copays instead of coinsurance for predictable costs.
PPO plans – See out-of-network providers for a higher cost.
All Pennie medical plans cover essential health benefits like doctor visits, hospitalization, maternity care, prescriptions, mental healthcare, and more. Most plans also include dental coverage for kids.
Standalone dental plans are available on Pennie for adults and families from leading insurers like Dominion National. Vision coverage can be purchased separately outside Pennie.
Pennie Insurance Carriers
Pennie offers health plans from the major insurance companies in Pennsylvania:
- Highmark Blue Cross Blue Shield
- UPMC Health Plan
- Independence Blue Cross
- Geisinger Health Plan
- Oscar Health
- Ambetter from PA Health & Wellness
- Keystone Health Plan Central
- Capital Blue Cross
Pennie does not itself provide insurance coverage. It allows you to easily compare plans across these leading carriers to find your best option.
How to Save Money on Pennie
The key way to save money on health insurance through Pennie is to qualify for financial assistance based on your income.
Premium Tax Credits lower your monthly premium payment. The savings get automatically applied when you enroll.
Cost-Sharing Reductions lower the amount you pay out-of-pocket for healthcare services. These apply when you receive medical care.
To maximize savings:
Accurately estimate your expected household income for the coverage year
Pick a silver-tier plan to unlock cost-sharing reductions
Shop and compare to find the optimal plan based on total estimated spending
Even higher income households may benefit from comparing Pennie plans to alternatives. The competitive marketplace helps keep premiums in check.
Pennie Customer Support
Pennie provides numerous resources if you need help enrolling or have questions:
Call Center – Pennie Customer Service at 1-844-844-8040
Chat Online – Live web chat at pennie.com
Find Local Help – Search for in-person assisters in your county
Email Questions – Submit inquiries through the Pennie Member Portal
Pennie Connect – Browse articles, videos, and other resources
There is also support available in multiple languages as well as accessibility services for those with disabilities.
Enrolling in Pennie
To get started with Pennie, visit pennie.com and click “Shop Now” to browse plans and pricing.
Create an account to save your application progress. You will need to provide household and income details to check subsidy eligibility.
Work through the enrollment steps to compare plans side-by-side and select the best medical or dental option.
You can enroll online, over the phone, or locally with a Pennie-certified assister. Member services is available if you need any help.
The Bottom Line on Pennie PA
Pennie serves as Pennsylvania’s online health insurance marketplace for comparing and enrolling in private medical and dental plans. All Pennsylvanian residents should consider using Pennie when seeking individual coverage.
The key benefits of Pennie include:
- Financial assistance for lower income households
- Ability to shop and compare plans from leading insurers
- Transparent pricing and coverage information
- Choice of plan types like HMO, PPO, HDHP, copay plans
- Streamlined online enrollment process
- Local help from licensed assisters if needed
Check your potential subsidy savings and explore Pennie health plan options during the next Open Enrollment period or if you have a qualifying event. Pennie provides an affordable path to comprehensive health insurance for Pennsylvanians.
What is the Pennsylvania Pennie Health Insurance Program?
Who qualifies for Pennie insurance in Pennsylvania?
What income is counted for Pennie?
Include as income?
Social Security Disability Income (SSDI)
Why am I not eligible for Pennie?
Is Pennie the same as marketplace?