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Pennsylvania Family or Individual Health Insurance
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Individual or family health insurance can provide the important
protection needed in the event of illness and for regular preventive
care. Using the strength and experience of our health insurance
markets, PA Group Insurance can offer affordable HMO, PPO, and
POS health insurance coverages throughout eastern Pennsylvania and
Delaware.
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Health insurance plans that allow you the most choices in doctors and
hospitals also tend to cost more than plans that limit choices.
Individual and family health insurance plans that help to manage the
care you receive, such as PPO and POS plans, usually cost you less,
but you must give up some freedom of choice.
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Learn more about HMO, PPO, and POS managed health care
insurance plans by clicking on a link below or click on the link for
information on Major Medical health insurance.
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* Preventive care emphasis
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* Primary care physician (PCP) coordinates your total care
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* Must get a referral from your PCP to visit a specialist
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* Fixed monthly fee
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HMO Health Insurance Policy Overview - Pennsylvania
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Subscribers to an HMO receive medical services from participating physicians,
clinics and hospitals. You choose a primary care physician (PCP) from a list of
participating Pennsylvania doctors. That doctor is used for typical
circumstances such as annual exams and usual health issues. If you need to see a
specialist, be hospitalized, or have lab or X-ray work, your doctor will refer you to
a provider or facility within the HMO system. Your doctor must give authorization
for those services to be covered by your HMO. In other words, you must see
HMO approved physicians and use HMO approved facilities or pay the entire
cost of the visit yourself.
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Similar to Point-of Service (POS) and PPO's, HMO's have made arrangements
for lower fees with a network of health care providers and give their policyholders
a financial incentive to stay within that network.
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You may have to pay some portion of the cost (co-payment) for each office or
hospital visit, such as $20 - $30 per doctor visit, regardless of what the services
cost. Also, some services such as emergency room, mental health and chemical
dependency services, may carry additional costs in an HMO health maintenance
plan.
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Click on the link below to fill out a quote request form for a Pennsylvania Individual
or Family HMO Health Insurance plan policy that will provide excellent health
insurance coverage at an affordable cost.
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* Convenient access to quality health care
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* Large and diverse network available of primary care physicians, specialists,
hospitals & clinics.
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* Pay for services as they are provided
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PPO Health Insurance Policy Overview (Family or Individual)
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You can see any health care professional in the network any time you choose
to make an appointment. You don't need referrals for specialists or other
services as you do in an HMO. You can see doctors or specialists outside
your PPO network, however, your portion of the costs will be higher.
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You may have to pay some portion of the cost (co-payment) for each office
or hospital visit, such as $20 - $30 per doctor visit, regardless of what the
services cost. Also, some services such as emergency room, mental health
and chemical dependency services, may carry additional costs in a PPO
health insurance plan.
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Click on the link below to fill out a quote request form for a Pennsylvania
Individual or Family PPO Health Insurance plan policy that will provide
excellent health insurance coverage at an affordable cost.
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Click on the link below to fill out a quote request form for a
Pennsylvania Individual or Family Health Insurance policy that will
provide excellent insurance coverage at an affordable cost.
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Managed Health Care Plans:
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Fee-for-Service Health Plan:
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Learn more about the other types of Pennsylvania Individual or Family Health
Insurance policies we offer by clicking on a link below!
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Click HERE to fill out a Pennsylvania
Health Insurance quote form
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Learn more about the other types of PA Individual or Family Health
Insurance policies we offer by clicking on a link below!
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* Preventive care emphasis
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* Pays benefits for out-of-network care, but at a lower level
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POS Health Insurance Policy Overview (Family or Individual)
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Less restrictive than an HMO or PPO, a (POS) or Point of Service plan lets
you see any licensed health care professional for anything covered by the
insurance. Care you receive from out-of-plan health care professionals is
reimbursed, but you must pay an often times much higher co-payment or
deductible amount. While you may choose to see a physician outside the
network, if you don't receive permission from your (PCP) primary care
physician, you're likely to end up submitting the bills yourself and receiving
only a small reimbursement - if any.
Costs that exceed your deductible are covered by a co-insurance plan in
which you and the insurance company share the cost for services covered by
the policy.
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Also, some services such as emergency room, mental health and chemical
dependency services, may carry additional costs in a POS health insurance
plan.
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Click on the link below to fill out a quote request form for a Pennsylvania
Individual or Family POS Health Insurance plan policy that will provide
excellent health insurance coverage at an affordable cost.
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Learn more about the other types of Individual or Family Health
Insurance policies we offer by clicking on a link below!
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Major medical health insurance provides benefits up to a high limit for most
types of medical expenses incurred, subject to a deductible. Once you meet the
deductible, our Pennsylvania Major Medical Insurance plans pay
a percentage of what is considered the "Usual and Customary" charge for
covered services. The insurance company generally pays 80% of the Usual
and Customary costs and you pay the other 20%, which is known as co
insurance. If the insurance company charges more than the Usual and
Customary rates, you will need to pay both the co-insurance and the
difference.
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With Major Medical Insurance plans you can choose your doctor and any
hospital for your medical services. You or your doctor send the bill to the
insurance company, which pays part of it. Usually, you have a deductible
such as $250 or more to pay each year before the insurer starts paying. The
plan will pay for charges such as medical tests and prescriptions as well as
from doctors and hospitals.
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Major medical insurance coverages offer more choice of doctors (including
specialists, such as cardiologists and surgeons), hospitals, and other health
care providers than managed care plans, such as HMO, PPO, and POS.
Major Medical Insurance may not pay for some preventive care, such as
check-ups, and is usually a more expensive health insurance coverage than
utilizing an HMO, PPO, or POS plan.
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Learn more about the Individual or Family Managed Health Care
Insurance policies we offer by clicking on a link below!
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Click on the link below to fill out a quote request form for a Pennsylvania
Individual or Family Major Medical Health Insurance policy that will
provide excellent health insurance coverage at an affordable cost.
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National Healthcare Insurance Overview
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Enrollment began October 1, 2013 and coverage began January 1, 2014.
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Essential Health Benefits
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The Affordable Care Act passed in 2010 required individual health
insurance plans beginning on January 1, 2014 to offer essential health
benefits services. Below is the list of minimum services required
under all health insurance plans.
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1. hospitalization
2. maternity and newborn care
3. ambulatory patient services
4. emergency services
5. mental health and substance use disorder services, including
behavioral health treatment
6. prescription drugs
7. rehabilitative and habilitative services and devices
8. laboratory services
9. preventive and wellness services and chronic disease management
10. pediatric services, including oral and vision care
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Health Marketplace Insuranace Plans
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You can choose the plan that is right for your budget and needs. All
plans offer the 10 essential health services mentioned above. The cost
of each plan will be different whether your state has set up its own
Health Marketplace or uses the National Health Marketplace. Speak
with your health insurance agent for specific costs and enrollment
information.
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Bronze Plan
Silver Plan
Gold Plan
Platinum Plan
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The Bronze Plan has the lowest premium, but you'll pay a higher
share of costs when you get care. On the other end of the cost
spectrum, the Platinum Plan will have the highest monthly premiums
and the lowest out-of-pocket costs when care is needed.
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Marketplace Health Plans Pricing
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All insurance plans available through the Marketplace will be offered
by private insurance companies. Marketplace pricing will show any
cost savings you may be eligible for based on your income.
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Pre-existing Conditions
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An insurance company can't turn you down or charge you more
because of your health condition. It can't refuse to cover treatment
for pre-existing conditions.
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The only exception is for grandfathered individual health insurance
plans--the kind you buy yourself, not through an employer. If you
have one of these plans you can switch to a Marketplace plan during
open enrollment and get coverage for your pre-existing condition.
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The Marketplace will also tell you if you qualify for free or low-cost
coverage available through Medicaid or the Children's Health
Insurance Program (CHIP).
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Click HERE to fill out a Pennsylvania
Health Insurance quote form
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Pennsylvania Health Insurance Services
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PA Group Insurance, LLC
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"We are your Pennsylvania
Health Insurance Agents"
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We are a Rydal, PA insurance agency offering affordable health insurance premiums and services for
individuals and families located in the following Pennsylvania counties and cities: Montgomery County,
Philadelphia County, Delaware County, Chester County, Bucks County, Lehigh County, Berks County,
Lancaster County, York County, Emmanus, Hellertown, Whitehall, Cetronia, East Texas, Lanark, Dorneyville,
Wagnersville, Catasauqua, Walbert, Farmersville, Stiles, Friedensville, Mechanicsville, Hanover, North
Catasauqua, Stroudsburg, Springfield, King of Prussia, Woodlyn, Chester, Norwood, Ridley Park, Prospect
Park, Folcroft, Darby, Swarthmore, Drexel Hill, Rutledge, Yeadon, Upper Darby, Secane, Milmont Park,
Garden City, Wallingford, Morton, Aldan, Primos, Pilgrim Gardens, Colwyn, Lester, Essington, Eddystone,
Landsdowne, Fernwood, Milbourne, Havertown, Broomall, Penn Wynne, Merion Station, Wynnewood,
Haverford, Penn Valley, Bala-Cynwyd, Ardmore, Rosemont, Overbrook, Belmont Hills, Villanova, Rebel Hill,
Gulph Mills, Gladwyne, Conshohocken, Kings Manor, Swedeland, Swedesburg, Bridgeport, Norristown,
Lafayette Hill, Plymouth Meeting, Erdenheim, Oreland, Flourtown, Ardsley, North Hills, West Conshohocken,
La Mott, Cheltenham, Melrose Park, Elkins Park, Glenside, Wyncote, Roslyn, Abington, Huntingdon Valley,
Hatboro, Meadowbrook, Jenkintown, Hollywood, Rockledge, Somerton, Bustleton, Torresdale, Holmesburg,
Tacony, Kensington, Feltonville, Frankford, Olney, Andalusia, Cornwells Heights, Bridgewater, Croydon,
Bensalem, Nottingham, Bristol, Edgely, Newportville, West Bristol, Strafford, Devon, Berwyn, Port Kennedy,
Newtown Square, Gradyville, Cheyney, Concordville, Narberth, Milltown, Westtown, Trainer, Marcus Hook,
West Chester, Lancaster, York, Reading, Allentown, Bethlehem, Pottstown, Coatesville, Kulpsville,
Warminster, Montgomeryville, Levittown, Valley Forge, Malvern, Green Tree, Paoli, Devault, Chatwood,
Goshenville, Sugartown, Glenloch, Chester Springs, Audubon, Eagleville, Evansburg, Worcester, Blue Bell,
Center Square, Fort Washington, Philadelphia, Doylestown, Chalfort, Quakertown, Perkasie, Sellersville,
Soudertown, Willow Grove, Warrington, Morrisville, Ambler, Lower Gwynedd, Washington Crossing, New
Hope, Richboro, Feasterville, Southampton, Langhorne, Holland, Newtown, and Yardley, PA.
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Copyright 2004-2021 PA Group Insurance, LLC - All rights reserved
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**The information, pictures, and other content in this website about particular insurance services is only provided for
informational purposes. Any decisions regarding your insurance needs should be discussed with a licensed insurance
agent.
Please be advised that insurance coverage cannot be bound, changed or confirmed via voicemail, email, fax or online at
the agency's website. You must speak directly with a licensed insurance agent.
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Managed Health Care Plans:
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Fee-for-Service Health Plan:
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Managed Health Care Plans:
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Fee-for-Service Health Plan:
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Managed Health Care Plans:
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Family & Individual Health Insurance
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